title: Change in sexual functioning over the menopausal transition: results from the Study of Women's Health Across the Nation.
abstract: The aim of the study was to identify whether there is a decline in sexual functioning related to the menopausal transition or to hysterectomy.
  
  
  
  In a cohort of 1,390 women aged 42 to 52, with intact uterus and at least one ovary, not using hormone therapy, and pre- or early perimenopausal at baseline, we fit piecewise linear growth curves to 5,798 repeated measurements (seven visits spanning 14.5 y) of a sexual functioning score (range, 5-25) as a function of time relative to date of final menstrual period (FMP) or hysterectomy.
  
  
  
  Mean sexual functioning at baseline in women with a dateable FMP was 18.0 (SD, 3.4). There was no change in sexual function until 20 months before the FMP. From 20 months before until 1 year after the FMP, sexual function decreased by 0.35 annually (95% CI, -0.44 to -0.26) and continued to decline more than 1 year after the FMP, but at a slower rate (-0.13 annually, 95% CI, -0.17 to -0.10). The decline was smaller in African Americans and larger in Japanese than whites. Vaginal dryness, lubricant use, depressive symptoms, or anxiety did not explain decline in sexual function. Women who had a hysterectomy before the FMP did not show a decline in sexual function before hysterectomy, but scores declined afterward (0.21 annually, 95% CI, -0.28 to -0.14).
  
  
  
  Decline in sexual function became apparent 20 months before FMP and slowed 1 year after FMP through 5 years afterward. A decline in sexual function was observed immediately after hysterectomy and persisted for the 5 years of observation.
authors: 1Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 2Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA 3Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 4Department of Medicine, University of Massachusetts Medical Center, Worcester, MA 5University of Utah School of the Health Sciences, Salt Lake City, UT 6Department of Obstetrics and Gynecology, University of California, Davis School of Medicine, Davis, CA.
authors: Nancy E
authors: NE
authors: Avis
authors: Alicia
authors: A
authors: Colvin
authors: Arun S
authors: AS
authors: Karlamangla
authors: Sybil
authors: S
authors: Crawford
authors: Rachel
authors: R
authors: Hess
authors: L Elaine
authors: LE
authors: Waetjen
authors: Maria
authors: M
authors: Brooks
authors: Ping G
authors: PG
authors: Tepper
authors: Gail A
authors: GA
authors: Greendale
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy; D007564:Japan / Q000208:ethnology; D008137:Longitudinal Studies; D008593:Menopause / Q000208:ethnology / Q000502:physiology*; D008875:Middle Aged; D010052:Ovariectomy; D017698:Postmenopause / Q000208:ethnology / Q000502:physiology; D017697:Premenopause / Q000208:ethnology / Q000502:physiology; D019529:Sexuality / Q000208:ethnology / Q000502:physiology; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D016387:Women's Health / Q000208:ethnology