44. SEX AND SEXAGENARIANS

Abstract

This paper will describe the sexual function of postmenopausal women in their seventh decade and contrast this with their sexual function some 13 years earlier when the women were premenopausal.

The presentation uses data obtained in the Melbourne Women's Midlife Health project, a longitudinal population based study of women's health. Australian-born women aged 45!!55 and resident in Melbourne were eligible for the initial telephone interview. All those who were still menstruating and not taking the oral contraceptive pill were invited to take part in a longitudinal study.

At follow-up, a similar proportion of the women had a sexual partner at mean ages of 51 (81%) and 63 (83%). A marked decline in sexual function was evident. The percentage of partnered women who became sexually inactive increased from 17 to 23%, the percentage who had sex less than once a week increased from 15% to 42%, while the percentage having sex more than once a week declined from 20% to 4%.

The overall score on the SPEQ significantly declined but only 19% of these women were significantly distressed about this. When specific domains of sexual function were examined, women using hormone therapy at L13 have significantly higher libido and greater responsivity (Sexual Response) than postmenopausal women not using HT. There was no significant difference with respect to dyspareunia, frequency of intercourse, partner problems or partner feelings. Sexual Response was significantly affected by prior function, feelings for partner, change in partnership, estradiol level and mood as well as aging. The circulating level of estradiol is highly significantly linked to Sexual Response.

Thus both chronologic and reproductive aging have negative effects on sexual function and estradiol therapy may be needed.