For baby boom women nearing menopause, relationships and attitudes may affect sex more than menopause status.

The finding comes from a study of more than 3,100 women. Topics included health, menopause, relationships, desire, arousal, and pain during sex.

The goal: Find the biggest influences on the women's sex lives. The answer: For most aspects of sex, menopausal status mattered less than relationships, attitudes toward sex and aging, and other factors.

The best sex lives were reported by women with healthy relationships and positive attitudes about sex and aging, write Nancy Avis, PhD, and colleagues in Menopause.

Avis works in the public health sciences department at Wake Forest University's medical school.

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As Menopause Approaches

The study included women of black, white, Hispanic, Chinese, and Japanese backgrounds living in the U.S. The women were 42-52 years old.

Some had started perimenopause — the years leading up to menopause. They had menstruated sometime in the previous three months, but their cycles were less predictable than when they were younger. The other women still had their normal menstrual cycles.

Some women were married; others were single. Nearly six in 10 reported having sexual desire at least once a week. Of those who'd had sex with a partner in the last six months, 63 percent had sex at least weekly.

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What Mattered Most

Physical, social, and emotional factors can affect sex, for both men and women.

In this study, the biggest influence on the women's sex lives wasn't their menopausal status. Relationships, attitudes toward sex and aging, and cultural background were more important.

Vaginal dryness, which can be a symptom of menopause, also affected the women's sex lives. Vaginal dryness can lead to painful sex.

The researchers found that other factors must be involved in painful sex than just vaginal dryness.

"Perimenopausal women were about 40 percent more likely to report having frequent pain during intercourse than premenopausal women" even after considering vaginal dryness, write the researchers.

"We found that early perimenopausal women reported greater pain with intercourse than premenopausal women," they write. "But the two groups did not differ in terms of frequency of sexual intercourse, desire, arousal, or physical or emotional satisfaction."

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Group Differences

Some cultural differences were noted:

— Black women reported having "frequent" or daily sex more than the other groups.

— High ratings for pleasure and arousal were rarest among Hispanic women.

— Chinese and Japanese women had the lowest ratings for sexual desire.

— Chinese women were also more likely than white women to report painful sex.

Most of the Hispanic women were of Puerto Rican background. Other Hispanic women might have had different results, write the researchers.

Women reporting more frequent physical pleasure tended to have some things in common:

— Currently unmarried

— Felt sex was important

— Used contraception

— Were generally happy in a long-term relationship

The study does not state whether the women were newcomers to the U.S., or if they had been in America for several generations.

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By Miranda Hitti, reviewed by Michael W. Smith, MD

SOURCES: Avis, N. Menopause, July/August 2005; vol 12: pp 385-398. News release, The North American Menopause Society.