Sexual function and the menopausal woman: the importance of age and partner's sexual functioning.

Sexual behavior involves a complex interplay of biochemical, neurophysiological, and cognitive processes (Bancroft, 1988). Age, and the availability and presence of a partner, further contribute to the multivariate nature of human sexuality (Segraves & Segraves, 1995). The influence of menopause on sexual function has received much attention in the research; however, the influence of age and partner presence is often not considered. Those studies that have considered the influence of age on the sexual function of the menopausal woman are inconsistent in their findings. McCoy (1998), in a recent study, also suggested that partner's sexual interest and partner's sexual function within the relationship need to be included as variables which may influence a woman's sexual function around the time she may be going through midlife and menopause. While some studies have included investigation of physiological changes related to sexual arousal which may be associated with menopause, few report on desire and frequency of intercourse. In particular, there is little understanding of each of these factors within the context of age and the sexual relationship between a menopausal woman and her partner. The present study investigated whether age and partner's sexual function were important factors to take into consideration in the understanding of the sexual function of the menopausal woman.

At menopause a decline in estrogen levels results in decreased vaginal blood flow and decrease in vaginal lubrication and vaginal elasticity. Many studies confirm the link between decreased levels of estrogen and an increase in pain with intercourse (Nachtigall, 1994; Nathorst-Boos, Wiklund, Mattsson, Sandin, & Schoultz, 1993; Riley, 1991), as well as increased urinary tract infections in menopausal women (Raz & Stamm, 1993; Van der Linden et al., 1993). During sexual stimulation in menopausal women there is some evidence that arousal, indicated by vaginal lubrication and engorgement of the genitals, is less than premenopausal levels (Leiblum, Bachnann, Kimmann, Colburn, & Swartzman, 1983; Morrell, Dixen, Carter, & Davidson, 1984; Semmens & Wagner, 1982). Painful intercourse has been found to reduce frequency of coitus in a large community-based sample of menopausal women (Dennerstein, Smith, Morse, & Burger, 1994).

Changes in sexual arousal have been linked to physiological consequences of menopause, particularly in clinic samples; however, the impact on sexual desire is less clearly understood. While Bancroft (1984) suggested that no clear demonstration of changes to sexual desire (either positive or negative) could be linked to hormonal changes associated with menopause, Channon and Ballinger (1986) found that 271 perimenopausal women who came to a menopause clinic had reduced desire, enjoyment, and frequency of orgasm. These researchers suggested that vaginal symptoms such as dryness and soreness resulted in decreased desire along with factors such as age and partner's age. The reason why there are conflicting reports by menopausal women of reduced desire are likely to be complex, and require further investigation.

Since menopausal women are usually entering the decade of their 50s, it would also appear important to consider the influence of age on the sexual functioning of the menopausal woman. Past research has reported mixed findings regarding the influence of age on the sexual function of the menopausal woman. Some studies have concluded age is a more appropriate predictor of sexual satisfaction than menopause, while others fail to account for menopausal status or include small numbers of menopausal women.

In some studies older age was found to significantly predict a decrease in the enjoyment of sexual behaviors in premenopausal and perimenopausal women (Mansfield, Voda, & Koch, 1995). Other studies have also found that age group influenced reports of sexual frequency. In a small group of menopausal women (n = 36), Hawton, Gath, and Day (1994) found that women enjoyed their sexual relationships less as they got older, preferring infrequent sexual activity. In a large community study, Hallstrom and Samuelsson (1990) round that increasing age, along with reports of anxiety neurosis and use of psychotropic medication, decreased sexual desire. However, menopausal status was not reported, so it is not clear if menopausal status contributed to reports of decreased sexual desire. Osborn, Hawton, and Gath (1988) also suggested that age was related to reports of sexual dysfunction significantly more than menopausal status. Osborn et al. found 49% of women aged over 50 years had one or more sexual dysfunctions, while 21% of women under 50 years had one or more sexual dysfunctions.

Interestingly Dennerstein, Dudley, Hopper, and Burger (1997) found that sexual function was affected only minimally by age, and not at all by menopausal status. In a cross-sectional study of 201 women from a community-based sample (all of whom had partners), age was round to account for levels of "sexual responsivity"; however, no other factors influenced measures of sexual function. Menopausal status did not predict sexual frequency, libido, feelings for the partner, partner problems, or vaginal dryness.

In contrast to the above findings, a small number of researchers have found that sexual interest was influenced more by menopausal status than by age (e.g., Hallstrom, 1977). After controlling for age, Hunter (1990) found in her sample of 474 community-sampled women that sexual interest decreased from pre- to peri- to postmenopause. However, Hunter argued that factors such as ill health (possibly an age-related factor) and stress should also be taken into consideration when investigating sexual function.

Thus, research on the influence of age on sexual response among menopausal women has resulted in inconsistent findings, even in community-based samples. Part of the problem may be that some studies have not included postmenopausal women (Mansfield et al., 1995), or that women have not spent a long time in menopause (Hawton et al., 1994; Osborn et al., 1988). The past research does highlight the importance of accounting for both menopausal stage and age in the understanding of the sexual function of the menopausal woman.

Exploration of the sexual function of the menopausal woman's partner may also enhance our understanding of sexual function at the menopause. Past research has round that sexual desire was highly correlated with partner availability and low frequency of intercourse, but not with menopausal status (Koster & Garde, 1993). Dennerstein et al. (1994) also found that some women indicated that reduced sexual desire was a result of poor partner health and partner disinterest. However, the involvement of the partner was not explored further in this study, and women who suggested their partner influenced sexual interest were excluded from some analyses.

Few researchers have reported on the effects of decreased arousal in the woman within the context of the sexual relationship with a partner. In a rare study of arousal in 50 married couples who sought help specifically for sexual dysfunction and not for menopause, Sarrel (1982) found that male partners felt inadequate when their wives did not become easily aroused (due to reduced lubrication from hormonal changes), and also feared hurting them during sexual intercourse. Twenty-eight of the male partners had experienced erectile difficulties either just before their partner's menopause or within a few years of menopause. Even though more than half of the male partners experienced sexual difficulties around the time of their partner's menopause, these findings have not been followed up in later studies.

Larson, Collins, and Landgren (1997) argued that while vaginal dryness may be partly associated with estrogen levels, vaginal dryness "can be explained by other factors such as relationship with a partner" (p. 103). Empirical research is needed to further investigate these suggestions.

Interestingly, few studies have considered sexual frequency, the menopausal woman, and her partner. In a very early study, George and Weiler (1981) found that marital adjustment and the male partner's role as initiator of sexual behavior was an important factor when considering sexual function and mid-life. Cessation of sexual activity was often due to the attitude and the ability of the male to perform sexually. In their small study of women who were recently postmenopausal, Hawton et al. (1994) suggested that a decrease in sexual frequency resulted from a decline in marital adjustment, partner interest, and partner availability.

The above studies point to the importance of including the influence of the partner's sexual functioning in any consideration of the sexual function of menopausal women, particularly in relation to variables of desire, arousal, and frequency. The paucity of studies in this area, however, suggest that investigation of the sexual function of the menopausal woman in the context of her relationship with a partner is needed.

The present study will investigate the relationships between menopausal status of women and age, sexual desire, and arousal factors among menopausal women and their partners in a large community based sample. It is hypothesized that both menopausal stage and age will contribute to sexual function in women aged 35 to 65 years. It is also hypothesized that the male partner will experience changes to his sexual function during this period in women's lives.

METHOD

Participants

The participants in this study were 304 adult females recruited from responses to advertisements in local and metropolitan newspapers and at community centres, in and around the city of Melbourne and rural Victoria. Women were assigned to either premenopausal status, perimenopausal status, or postmenopausal status using a number of criteria, including length of time since last period, the menopausal stage they classified themselves as belonging to, and the information they provided on hormonal status, for example, if they had undergone a hysterectomy (9.5%). There were 120 women who were classified as premenopausal (age range 35-54), 76 women who were perimenopausal (age range 35-54), and 108 women who were postmenopausal (age range 40-65). In terms of age groups, 90 women were aged 35-44 years, 142 women were aged 45-54 years, and 72 women were aged 55-65 years.

Materials

Structured questionnaires were formulated that assessed two areas of women's lives: demographic information and menopausal status, and sexual function within the relationship with a partner.

Demographic information and menopausal status. This section was developed by the authors and comprised 17 questions. Six questions asked women about their age, income levels, occupation, number of hours of work, level of education reached, and whether they were born in Australia. Two questions asked women to list any health problems they may have been experiencing, and whether they had been to the doctor recently for these health problems. One question asked women for the date of their last period, and a further question asked women to tick which stage of menopause they felt they belonged to. One question asked women about the symptoms they experienced with their periods (if this was relevant). Perimenopausal women and postmenopausal women were asked a further five questions about their menopause. Two of these questions (based on Kaufert & Syrotuik, 1981) asked women to nominate the symptoms of menopause they experienced when their periods first became irregular, and to indicate the symptoms they were experiencing at present. Women were also asked whether they took Hormone Replacement Therapy (HRT) and, if so, what hormones this therapy consisted of, why they had or had not decided to take HRT, and if they used anything else to help them with the symptoms of menopause.

A test-retest (n = 25) reliability of r = .98 (over 6-8 weeks) was obtained on the measure that asked women what stage of menopause they felt they belonged to. A reliability analysis was conducted for the questions that asked women to nominate the symptoms of menopause they had experienced; Cronbach's alpha for this measure was .70.

Sexual function. The present study used questions from the Sexual Communication subscale of the Sexual Function Scale (SFS) developed by McCabe (1998). Nine questions asked women to rate on a 6-point scale (0 - never, 5 - always) their enjoyment of sexual activity, the importance of sex within the relationship, whether their partner is caring as a lover, the routine nature of sex, whether women take an active role in sexual activity, how well their partner tunes in to what they like, whether they "turn off" during sexual activity, satisfaction with their sexual response, and if they think they are a sexual person. Coefficient alpha for the Sexual Communication subscale was .80, with a test-retest reliability coefficient of r = .90 (McCabe, 1998).

A further two questions examined current frequency of intercourse and frequency of intercourse one year ago (1 - a lot, 5 - not at all). Test- retest reliability (over a period of 6-8 weeks) for the measure of current sexual frequency was r = .95. Two questions asked women whether they and/or their partners were experiencing a sexual dysfunction, and two further questions asked women to nominate from a list the type of dysfunctions they and their partner were experiencing.

Procedure

Ethics approval was obtained from the Deakin University Ethics Committee for this study. One third of participants were recruited from advertisements in community centres, local newspapers, and newspapers aimed at providing information to midlife and older people. One third of participants responded to an article that appeared in a Victoria newspaper. The remaining participants volunteered through word of mouth. Initial contact was by telephone where the nature of the study was explained. When the participant agreed to take part in the study a plain language statement, consent form, questionnaire, and paid reply envelope were sent to the participant. All questionnaires were completed anonymously.

RESULTS

Frequency data will be considered first for both the demographic and sexual function questions. Regression analyses were performed to investigate the predictive values of menopausal stage and age on measures of sexual desire and arousal, as well as reported sexual dysfunctions of both the menopausal woman and her partner. By including two factors such as menopause and age in the regression analyses, it was important to determine if these factors were too highly correlated and therefore impacted on the results. To examine whether multicollinearity existed, bivariate correlation and tolerance levels were assessed (as suggested by Tabachnick & Fidell, 1995). None of these measures of multicollinearity were violated.

Demographics

The mean age group of the women who participated in the survey was between 45 and 49 years (see Table 1 for frequency and percentage of age groups). The majority of women were born in Australia (80.9%), with the remaining women born in Western countries such as the United States and the United Kingdom. One quarter (25.3%) of the participants came from rural areas in Victoria, New South Wales, and Western Australia.

Women appeared to be spread across both income and educational levels. Demographic data for income and education level are presented in Table 1. As previous research has found that the effects of menopause are mediated by social class (Hunter, Battersby, & Whitehead, 1986; McKinlay, McKinlay, & Brambilla, 1987), analysis of sociodemographic data were performed. Chi square analysis found no significant associations between women of differing menopausal groups on education level and income level.

Percentages and frequency of women across menopausal groups is presented in Table 1. Women who were perimenopausal or postmenopausal were asked to indicate what symptoms of menopause they felt they had experienced when their periods first became irregular. Symptoms that women reported included hot flashes (61.8%), fatigue (52%), aching joints (34.7%), anxiety (34.1%), headaches (28.9%), tingling skin (23.7%), sweats (22%), diarrhea/constipation (17.3%), dizziness (15.6%), moodiness (15.6%), shortness of breath (11%), and insomnia (6.4%). Of the women who were either perimenopausal or postmenopausal, 18.4% were currently taking Hormone Replacement Therapy (HRT).

Sexual Function

Sexual Function Scale and frequency of intercourse. Current frequency of sexual intercourse was varied, with 31.7% of couples having intercourse once a week, and 25% having intercourse several times per week. For 22.3% of participants sexual intercourse occurred once a month, 11.7% had intercourse 1 to 6 times a year, 6.3% were not currently having intercourse, and only 3% of couples were having sexual intercourse daily. When women were asked if these frequencies had changed over the past year, nearly three quarters (72.3%) of the women indicated that frequency of intercourse remained unchanged over the past year, 16% of women were having less intercourse, 6% of women were having more intercourse, 4.7% of women were having a lot less intercourse, and 1% of women were having a lot more intercourse.

Multiple regression analyses were performed to investigate whether age group or menopausal group was a better predictor on measures of the Sexual Communication subscale, current frequency of intercourse, frequency of intercourse over the past year, and whether the female respondent and her male partner had experienced a sexual dysfunction in the past year. Menopausal group and age group were entered as the independent variables. Tables 2, 3, and 4 display the beta coefficients, the squared semi-partial correlations ([sr.sup.2]), Multiple R, and [R.sup.2], for each of the analyses.

Sexual Communication subscale. For the regression equation with the Sexual Communication subscale mean score as the dependent variable, R for regression differed significantly from zero, F(2,303) = 7.38, p < .001 (see Table 2). The variable which contributed significantly to the prediction of measures on the sexual communication subscale was age, t(303) = -2.51, p < .01. Age accounted for 3% of the unique variance, while menopausal group accounted for only 1% of the unique variance. Overall 5% of variability in sexual satisfaction was explained by menopausal and age status.

Frequency of intercourse. For the regression equation with Current Frequency of Intercourse as the dependent variable, R for regression differed significantly from zero, F(2,303) = 9.39, p < .0001 (see Table 3). Only age contributed significantly to the prediction of current frequency of intercourse, t(303) = -2.68, p < .01. Age accounted for 3% of the unique variance, while menopausal group accounted for 1% of the unique variance on measures of current frequency of intercourse. Overall, 6% of current frequency of intercourse was predicted by menopause group and age group.

For the regression equation with frequency of intercourse from one year ago, R for Regression did not differ significantly from zero, F(2,301) = 0.95, p > .39 (see Table 4). Neither age or menopausal group contributed significantly to frequency of intercourse from one year ago.

Sexual dysfunction. Tables 5 and 6 present frequencies across menopausal

groups for the types of sexual dysfunctions experienced by the female respondent and her male partner. Postmenopausal women were more likely to report experiencing a combination of poor lubrication, lack of sexual interest and failure to have an orgasm (14.7%) compared to 9.8% of perimenopausal women and 6.1% of premenopausal women (see Table 5).

Postmenopausal women were also more likely to have a partner who had experienced failure to have an erection (15.7%), compared to 8.7% of perimenopausal women and 7% of premenopausal women (see Table 6).

Female respondents. For the regression equation with whether the female respondent had experienced a sexual dysfunction, R for Regression was significantly different from zero, F(2,297) = 8.56, p < .0001 (see Table 7). Menopausal group contributed significantly to this prediction, t(297) = -2.09, p < .05. Menopausal group accounted for 2% of the unique variance on reports of a sexual dysfunction, while age group accounted for 1% of the unique variance. Overall, 6% of the variability in whether females experienced a sexual dysfunction was explained by menopausal group and age group.

Male partner. For the regression equation with whether the male partner had experienced a sexual dysfunction, R for Regression differed significantly from zero, F(2,303) = 9.35, p < .0001 (see Table 8). Age group contributed significantly to this predication of whether a male partner had experienced a sexual difficulty, t(303) = -2.95, p < .005. The squared semi-partial correlations were 3% for age group and 0% for menopausal group. Overall, 6% of the variability in whether the male partner experienced a sexual dysfunction was explained by menopausal group and age group.

DISCUSSION

It appears that age group was a better predictor of sexual satisfaction, current frequency of intercourse, and whether a male partner had experienced a sexual dysfunction than menopausal group. Menopausal status was a better predictor of whether the female respondent had experienced a sexual dysfunction.

Women who were younger were more likely to be satisfied with their sexual relationship and to have more frequent sexual intercourse than women who were older. Male partners of older women were more likely to have experienced a sexual dysfunction than male partners of younger women. Women who were menopausal were more likely to have experienced a sexual dysfunction than women who were premenopausal.

These findings suggest that menopausal stage and age have varying effects on measures of sexual function. However, the overall variability of sexual satisfaction, sexual frequency, and reports of sexual dysfunction were only minimally predicted by menopausal status and age. This finding appears to confirm the belief that sexual function is influenced by multiple variables of which age and menopausal status play a small, but important part. Understanding the roles that menopausal status and age may have on the various measures of sexual function are important to understanding the menopausal woman and sexual function.

Previous researchers have mostly focused on the hormonal changes associated with menopause, concluding that women report decreased desire and frequency associated with vaginal changes (Bachmann et al., 1985; Channon & Ballinger, 1986). Nearly 10% of postmenopausal women in the present study had experienced changes to their vaginal physiology, which resulted in decreased vaginal lubrication, while 14% of women reported a combination of poor lubrication along with reduced sexual interest and failure to have an orgasm. Menopausal status was a better predictor of women experiencing a sexual dysfunction than age and accounted for 12% of the unique variance. Due to the endocrine changes associated with menopause this finding is consistent with the findings of past researchers (Nachtigall, 1994; Nathorst-Boos et al., 1993; Riley, 1991).

Nearly half of the partners were reported to have a sexual dysfunction. Partners of postmenopausal women were more likely to have experienced failure to have an erection and reduced sexual interest, and to have had more than one sexual dysfunction. Sarrel (1982) suggested that the perceived decrease in arousal and lubrication associated with menopausal changes may have meant male partners feared hurting their partner, and they then developed erectile problems in response to this fear. However, in the present study age-related changes appeared to account for whether the male partner experienced a sexual dysfunction more than menopausal status. This finding suggests that both age and the sexual function of the male partner are important considerations when understanding the sexual function of the menopausal woman. However, the present study is limited by asking the female respondent to report on her male partner. Future research is needed that directly studies the male partner's sexual function within the sexual relationship of the menopausal woman.

The reasons that age may have been a more appropriate predictor of sexual frequency than menopausal status are likely to be complex. While previous researchers have found that aging was related to increased reports of sexual dysfunction (Osborn et al., 1988), this was not evident in the present study, and menopausal status appeared to be a better predictor of sexual dysfunction.

Age may have influenced reports of sexual frequency in other ways. Women in this study may have had partners who were older than themselves and they may not have been as inclined to participate in sexual behaviour as they had been when younger. Bachmann et al. (1985) found that reduced sexual desire was related to partner disinterest and availability. While all of the women who took part in this study had a partner, the information was provided by the woman participant and it is not known how old, how willing, or how interested in sexual intercourse the male partner was.

It may be that other factors contributed to reports of sexual frequency. Faith and Schare (1993) found that poor body image scores were linked to decreases in the frequency of sexual behavior in both males and females. Women in the older age group as opposed to the younger group in the current study may have been feeling less like participating in sexual intercourse because they did not feel as positive about the way their bodies looked and felt. Relationship satisfaction would also appear to be an important contributing factor in reports of sexual satisfaction and frequency (as suggested by Hawton et al., 1994). It would have been beneficial in the present study to explore the influence of relationship satisfaction on reports of sexual frequency and satisfaction.

Interestingly, on measures of sexual satisfaction age group accounted for significantly more of the variance than menopausal status. The Sexual Communication subscale asked women about their enjoyment of sex, the importance of sex in their relationship, and whether they took an active role in sex, for example. The findings of the present study appear to support those of Mansfield et al. (1995) who found that older age predicted a decrease in sexual enjoyment and interest. The present study found that age was a more important predictor than menopausal status of sexual satisfaction. It is interesting that menopausal status only contributed such a small percentage to predictions of sexual satisfaction, and yet it was a significant predictor for reports of sexual dysfunction. The differential effects of age and menopausal status on different measures of sexual function are an important finding that future research should further consider, particularly for the practitioner who deals with the menopausal woman who is in midlife.

The present study was limited by its cross-sectional design, and the restriction to women who had a partner. An investigation of how women who do not have a partner rate some of the arousal and desire factors would increase our understanding of the influence of menopause on sexual function. Women who participated in this study were recruited from the general population; however, they were all self-selecting. Further study using random selection procedures and a longitudinal design would increase the generalisability of the findings from this research. It would also be important to examine the sexual function of women and their male partners who seek treatment for menopausal related concerns.

The results of this study suggest that both menopause and age can be used to predict levels of sexual satisfaction, frequency of sexual intercourse, and the experience of sexual dysfunction in both the female and male partner from a community population. The effects of menopause and age on sexual function were relatively small overall, however, further suggesting the need to consider the multidimensionality of sexual function. The influence of other contributing factors, such as feelings of attractiveness and relationship satisfaction, for example, may also have contributed to reports of sexual frequency during the menopausal transition and midlife and require further investigation.

Table 1. Demographics as Frequency and Percentage Data

Demographics                      n     %

Age group
  35-39 years                     36   11.8
  40-44 years                     55   18.2
  45-49 years                     73   24.0
  50-54 years                     67   22.0
  55-59 years                     46   15.1
  60-65 years                     27    8.9

Gross family income levels
($1 Aust = 50-60 US Cents)
  Less than $10,000                6    2.0
  $10,000 - $20,000               19    6.3
  $20,000 - $30,000               36   11.8
  $30,000 - $40,000               39   12.8
  $40,000 - $50,000               51   16.8
  $50,000 - $60,000               44   14.4
  More than $60,000              109   35.9

Education level
  Partly completed high school   108   35.5
  Matriculation/HSC               78   25.7
  Undergraduate degree            64   21.1
  Postgraduate degree             54   17.8

Menopausal group
  Premenopause                   120   39.4
  Perimenopause                   76   25.0
  Postmenopause 1-5 yrs           54   17.8
  Postmenopause 6-10 yrs          54   17.8
Table 2. Prediction of Sexual Satisfaction

Variables in Equation     B     Beta   [sr.sup.2]   t       Sig t

Age group                -.30   -.20      .03       -2.51   .01
Menopausal group        -1.95   -.02      .01        -.20   .84
Constant                 4.60                       26.87   .000
  Multiple R              .22
  R square                .05                         F     Sig F
  Standard error         1.03                        7.38   .001

Note. Mean scores from Sexual Communication subscale.
Table 3. Prediction of Current Frequency of Intercourse

Variables in equation     B     Beta   [sr.sup.2]   t       Sig t

Age group                -.36   -.22      .03       -2.68   .008
Menopausal group        -4.72   -.03      .01        -.41   .68
Constant                 4.46                       22.63   .000
  Multiple R              .24
  R square                .06                         F     Sig F
  Standard error         1.19                        9.39   .000
Table 4. Prediction of Frequency of Intercourse 1 Year Ago

Variables in equation     B     Beta   [sr.sup.2]     t     Sig t

Age group               -5.69   -.07     .00         -.77    .44
Menopausal group        -1.41   -.02     .00         -.23    .82
Constant                 2.96                       27.74    .000
  Multiple R              .08
  R square                .01                          F    Sig F
  Standard error          .64                         .95    .39
Table 5. Frequencies of Women Across Menopausal
Groups for Nominated Sexual Dysfunction

Sexual                    Pre-           Peri-           Post-
dysfunction            menopause (%)   menopause (%)   menopause (%)

Painful intercourse        0.6             0.0             0.0
Poor lubrication           1.8             2.5             9.8
Lack of sexual
  interest                 9.2             5.5             8.6
Reduced satisfaction       0.6             1.8             1.2
Failure to orgasm          2.5             1.2             2.5
Insertion of penis
  impossible               0.0             0.0             0.6
Reduced frequency of
  masturbation             0.0             1.2             0.6
Combination -- poor
  lubrication, lack
  of interest, &
  failure to orgasm        6.1             9.8            14.7
Other                      1.2             0.0             2.5

Note. Frequencies expressed as a percentage.
Table 6. Frequencies of Sexual Dysfunction for
Male Partners Across Menopausal Groups

Sexual                     Pre-            Peri-           Post-
dysfunction             menopause (%)   menopause (%)   menopause (%)

Painful intercourse         0.0             0.0             0.9
Failure to have
  erection                  7.0             8.7            15.7
Lack of sexual
  interest                  4.3             2.6             5.2
Reduced satisfaction        1.7             0.0             0.0
Premature ejaculation       8.7             4.3             5.2
Delayed ejaculation         2.6             2.6             1.7
More than one
  dysfunction               2.6             6.1            14.8
Other                       1.7             0.0             3.5

Note. Frequencies expressed as a percentage
Table 7. Prediction of Whether Females Have Experienced
A Sexual Difficulty In Past Year

Variables in equation     B     Beta   [sr.sup.2]     t     Sig t

Age group               -5.26   -.08      .01        -.94    .35
Menopausal group        -9.92   -.17      .02       -2.09    .037
Constant                 1.77                       21.82    .000
  Multiple R              .23
  R square                .05                         F     Sig F
  Standard error          .49                        8.56    .000
Table 8. Prediction of Whether Male Partners Have
Experienced A Sexual Difficulty In Past Year

Variables in equation     B     Beta    [sr.sup.2]     t     Sig t

Age group                -.16   -.24       .03       -2.95    .003
Menopausal group        -2.59   -.017      .00        -.06    .96
Constant                 1.92                        24.18    .000
  Multiple R              .24
  R square                .06                          F     Sig F
  Standard error          .48                         9.35    .000

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Manuscript accepted July 20, 2001

Address correspondence to Marita P. McCabe, PhD, FAPS, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria, Australia 3125; e-mail: [e-mail].