title: Correlates of sexual function among multi-ethnic middle-aged women: results from the Study of Women's Health Across the Nation (SWAN).
abstract: OBJECTIVE
  To examine sexual function in a cohort of Baby Boomer women of diverse racial/ethnic backgrounds; to compare differences between pre-and early perimenopausal women; and to identify sociodemographic, health-related, and psychosocial (including psychological, behavioral, and relationship) factors related to sexual function.
  
  
  METHODS
  Six domains of sexual function were studied in 3,167 women in the baseline cohort of the Study of Women's Health Across the Nation (SWAN). Participants were 42 to 52 years old, pre-or early perimenopausal, and not using hormones. The study sample included non-Hispanic white, African American, Hispanic, Chinese, and Japanese women.
  
  
  RESULTS
  Early perimenopausal women reported greater pain with intercourse than premenopausal women (P = 0.01), but the two groups did not differ in frequency of sexual intercourse, desire, arousal, or physical or emotional satisfaction. Variables having the greatest association across all outcomes were relationship factors, the perceived importance of sex, attitudes toward aging, and vaginal dryness. Despite controlling for a wide range of variables, we still found ethnic differences for arousal (P < 0.0001), pain (P = 0.03), desire (P < 0.0001), and frequency of sexual intercourse (P = 0.0003). African American women reported higher frequency of sexual intercourse than white women; Hispanic women reported lower physical pleasure and arousal. Chinese women reported more pain and less desire and arousal than the white women, as did the Japanese women, although the only significant difference was for arousal.
  
  
  CONCLUSIONS
  Relationship variables, attitudes toward sex and aging, vaginal dryness, and cultural background have a greater impact on most aspects of sexual function than the transition to early perimenopause.
authors.affiliation: Department of Public Health Sciences, Section on Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1063, USA. navis@wfubmc.edu
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Avis
authors.forename: Xinhua
authors.initials: X
authors.lastname: Zhao
authors.forename: Catherine B
authors.initials: CB
authors.lastname: Johannes
authors.forename: Marcia
authors.initials: M
authors.lastname: Ory
authors.forename: Sarah
authors.initials: S
authors.lastname: Brockwell
authors.forename: Gail A
authors.initials: GA
authors.lastname: Greendale
mesh_terms: D000328:Adult; D000375:Aging / Q000208:ethnology / Q000523:psychology; D001294:Attitude to Health; D015331:Cohort Studies; D003267:Contraception; D003430:Cross-Sectional Studies; D004414:Dyspareunia / Q000150:complications; D005260:Female; D006240:Happiness; D006801:Humans; D007989:Libido; D017533:Marital Status; D008875:Middle Aged; D047648:Perimenopause; D017697:Premenopause; D044469:Racial Groups; D012725:Sexual Behavior / Q000208:ethnology*; D012893:Sleep Wake Disorders / Q000150:complications; D011795:Surveys and Questionnaires; D014481:United States; D014621:Vagina / Q000378:metabolism