Sexual activity and function in middle-aged and older women.

OBJECTIVE Data on the sexual activity of middle-aged and older women are scant and vary widely. This analysis estimates the prevalence and predictors of sexual activity and function in a diverse group of women aged 40-69 years. METHODS The Reproductive Risk Factors for Incontinence Study at Kaiser (RRISK) was a population-based study of 2,109 women aged 40-69 years who were randomly selected from long-term Kaiser Permanente members. Women completed self-report questionnaires on sexual activity, comorbidities, and general quality of life. Logistic and linear regression and proportional odds models were used when appropriate to identify correlates of sexual activity, frequency, satisfaction, and dysfunction. RESULTS Mean age was 55.9 (+/- 8) years and nearly three fourths of the women were sexually active. Of the sexually active women, 60% had sexual activity at least monthly, approximately two thirds were at least somewhat satisfied, and 33% reported a problem in one or more domains. Monthly or more frequent sexual activity was associated with younger age, higher income, being in a significant relationship, a history of moderate alcohol use, and lower body mass index (BMI) (all P < .05). Satisfaction with sexual activity was associated with African-American race, lower BMI, and higher mental health score (all P < .05). More sexual dysfunction was associated with having a college degree or greater, poor health, being in a significant relationship, and a low mental health score (all P < .05). CONCLUSION Middle-aged and older women engage in satisfying sexual activity, and one third reported problems with sexual function. Demographic factors as well as some issues associated with aging can adversely affect sexual frequency, satisfaction, and function. LEVEL OF EVIDENCE II-3.