The relative effects of hormones and relationship factors on sexual function of women through the natural menopausal transition

Objective: To investigate the relative effects of hormonal and relationship factors on female sexual function during the natural menopausal transition. Design: Prospective population-based questionnaire study. Setting: interviews were conducted in the patients' homes. Patient(s): Four hundred thirty-eight Australian-born women aged 45-55 years who were still menstruating at baseline. Eight years of longitudinal data were available for 336 of these women, none of whom were hysterectornized. Intervention(s): Hormonal levels, age, menopausal status, partner status, and feelings for partner were measured and evaluated with longitudinal structural equation modeling. Main Outcome Measure(s): Short personal experiences questionnaire. Result(s): Sexual response was predicted by prior level of sexual function, change in partner status, feelings for partner, and E, level (R-2 =.65); dyspareunia was predicted by prior level of dyspareunia and E-2 level (R-2 =.53); and frequency of sexual activities was predicted by prior level of sexual function, change in partner status, feelings for partner, and level of sexual response (R-2 =.52). The minimum effective dose needed to increase sexual response by 10% (700 pmol/L E-2) is twice that needed to decrease dyspareunia. Conclusion(s): Prior function and relationship factors are more important than hormonal determinants of sexual function of women in midlife. (c) 2005 by American Society for Reproductive Medicine.