Correlates of sexual satisfaction among sexually active postmenopausal women in the women's health initiative-observational study

BACKGROUND: Satisfaction with sexual activity is important for health-related quality of life, but little is known about the sexual health of postmenopausal women. OBJECTIVE: Describe factors associated with sexual satisfaction among sexually active postmenopausal women. DESIGN: Cross-sectional analysis. PARTICIPANTS: All members of the Women's Health Initiative- Observational Study (WHI-OS), ages 50-79, excluding women who did not respond to the sexual satisfaction question or reported no partnered sexual activity in the past year (N=46,525). MEASUREMENTS: Primary outcome: dichotomous response to the question, "How satisfied are you with your sexual activity (satisfied versus unsatisfied)?" Covariates included sociodemographic factors, measures of physical and mental health, and gynecological variables, medications, and health behaviors related to female sexual health. RESULTS: Of the cohort, 52% reported sexual activity with a partner in the past year, and 96% of these answered the sexual satisfaction question. Nonmodifiable factors associated with sexual dissatisfaction included age, identification with certain racial or ethnic groups, marital status, parity, and smoking history. Potentially modifiable factors included lower mental health status and use of SSRIs. The final model yielded a c-statistic of 0.613, reflecting only a modest ability to discriminate between the sexually satisfied and dissatisfied. CONCLUSIONS: Among postmenopausal women, the variables selected for examination yielded modest ability to discriminate between sexually satisfied and dissatisfied participants. Further study is necessary to better describe the cofactors associated with sexual satisfaction in postmenopausal women.