Sexual Functioning in Postmenopausal Women: The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial

Abstract

Our objective was to describe sexual functioning and to examine the associations between selected demographic, anthropometric, behavioral, medical, and psychologic characteristics and sexual functioning in a large sample of postmenopausal women. We used a cross-sectional analysis of baseline data from a multicenter clinical trial. Participants were women (n = 874) aged 45–64 years who participated in the Postmenopausal Estrogen/Progestin Interventions (PEPI) trial and completed a sexual functioning questionnaire. The overall score on the Watts Sexual Function Questionnaire (WSFQ) and scores on the desire, arousal, orgasm, and satisfaction subscales of the WSFQ were the main outcome measures. The mean age of the 874 women was 56.1 years. Current sexual activity was reported by 64% of participants. The leading reason (64%) for sexual inactivity was the absence of a partner. One in five sexually inactive women attributed inactivity, at least in part, to a physical problem in her partner. Among sexually active women, the mean WSFQ global score was 54.6 (maximum 85; higher scores indicate better function). Mean scores ± SD for the desire, arousal, orgasm, and satisfaction scales were 17.7 ± 3.36, 12.7 ± 3.65, 12.3 ± 3.23, and 12.0 ± 1.96, respectively. Greater body mass index, physical activity, and life satisfaction were related to higher global sexual function. Vaginal dryness was negatively associated with global sexual function. Higher global sexual function was seen among women who were widowed or separated. These factors, as well as duration of menopause, ever-use of estrogen, smoking, antihypertensive use, mood, and ethnicity, were associated with sexual functioning on one or more of the WSFQ subscales. Relatively high satisfaction ratings imply that women may be satisfied with sexual function despite the appearance of functional limitations in other domains. Several anthropometric, medical, psychologic, behavioral, and sociodemographic characteristics were correlated with sexual function in these postmenopausal women.