title: A higher sense of purpose in life is associated with sexual enjoyment in midlife women.
abstract: OBJECTIVE
  The aim of this study was to understand the association between sense of purpose in life and sexual well-being in a cohort of midlife women.
  
  
  METHODS
  Participation in partnered sexual activities and indicators of sexual well-being (the engagement in and enjoyment of sexually intimate activities) were measured in a longitudinal cohort of 677 eligible women aged 40 to 65 years. At a single time point, women completed the Life Engagement Test, a measure of life purpose. Univariable and multivariable mixed models were used to assess the association between the Life Engagement Test and longitudinal sexual well-being.
  
  
  RESULTS
  A higher sense of purpose in life was associated with higher levels of enjoyment (coefficient = 2.89, P < 0.001) but not with participation in partnered sexual activity (coefficient = 0.49, P = 0.63) or engagement in partnered sexually intimate activities (coefficient = 1.0, P = 0.30). Participation was associated with younger age, lower body mass index, being married, reporting any vaginal dryness, and better emotional well-being. Hormone therapy use approached, but did not reach significance in association with participation, with P = 0.05. Engagement in sexually intimate activities was associated with younger age, more social support, and better emotional well-being. Higher levels of enjoyment were associated with more social support, better emotional well-being, and less vaginal dryness. Menopause status was not associated with engagement or enjoyment, and only being 5 years or more postmenopausal was related to decreased participation.
  
  
  CONCLUSIONS
  Higher sense of purpose in life is associated with more enjoyment of sexually intimate activities, adjusting for other known factors that influence sexual well-being and independent of demographic factors and menopause or hormone therapy status.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, School of Medicine, Magee-Womens Hospital, Pittsburgh, PA 15213, USA. prairieba2@upmc.edu
authors.forename: Beth A
authors.initials: BA
authors.lastname: Prairie
authors.forename: Michael F
authors.initials: MF
authors.lastname: Scheier
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.forename: Chung-Chou H
authors.initials: CC
authors.lastname: Chang
authors.forename: Rachel
authors.initials: R
authors.lastname: Hess
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life / Q000523:psychology*; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D016387:Women's Health