title: Association of lifestyle and relationship factors with sexual functioning of women during midlife.
abstract: BACKGROUND
  As women progress through menopause, they experience changes in sexual functioning that are multifactorial, likely encompassing biological, psychological, and social domains.
  
  
  OBJECTIVE
  To examine the effects that physical activity, sleep difficulties, and social support have on partnered sexual activity and sexual functioning in women at different stages of the menopausal progression.
  
  
  METHODS
  As part of an ongoing 5-year longitudinal study, we conducted a cross-sectional analysis of sexual functioning data.
  
  
  METHODS
  Participation in partnered sexual activities, reasons for nonparticipation in such activities among sexually inactive women, and, among sexually active women, sexual functioning defined as engagement in and enjoyment of sexually intimate activities.
  
  
  RESULTS
  Of 677 participants aged 41-68, 68% had participated in any partnered sexual activities (i.e., were sexually active) during the past 6 months. Reasons for sexual inactivity included lack of a partner (70%), lack of interest in sex (12%) or in the current partner (5%), and physical problems (4%). Sexually active participants tended to be younger, married, more educated, have more social support in general, fewer comorbid medical illnesses, a lower body mass index, and a higher prevalence of vaginal dryness. Among the sexually active participants, their scores for engagement in activities ranging from kissing to sexual intercourse were higher if they were physically active, had more social support, and lacked sleeping difficulties. Likewise, scores for sexual enjoyment were higher if they were physically active, had more social support, and lacked vaginal dryness. Engagement and enjoyment scores were not associated with marital status or other factors.
  
  
  CONCLUSIONS
  In midlife women, having social support and being physically active are associated with enhanced sexual engagement and enjoyment.
authors.affiliation: Department of Medicine, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA, USA. hessr@upmc.edu
authors.forename: Rachel
authors.initials: R
authors.lastname: Hess
authors.forename: Molly B
authors.initials: MB
authors.lastname: Conroy
authors.forename: Roberta
authors.initials: R
authors.lastname: Ness
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Bryce
authors.forename: Stacey
authors.initials: S
authors.lastname: Dillon
authors.forename: Chung-Chou Ho
authors.initials: CC
authors.lastname: Chang
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008875:Middle Aged; D009043:Motor Activity; D047648:Perimenopause; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners; D012893:Sleep Wake Disorders; D012944:Social Support