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Associations between body mass index and sexual functioning in midlife women: the Study of Women's Health Across the Nation

Nackers, Lisa M. PhD, MPH1; Appelhans, Bradley M. PhD1,2; Segawa, Eisuke PhD1; Janssen, Imke PhD1; Dugan, Sheila A. MD1,3; Kravitz, Howard M. DO, MPH1,4

doi: 10.1097/GME.0000000000000452
Original Articles
Editorial

Objective: This study aims to examine baseline and longitudinal associations between body mass index (BMI) and sexual functioning in midlife women.

Methods: Midlife women (N = 2,528) from the Study of Women's Health Across the Nation reported on sexual functioning and underwent measurements of BMI annually beginning in 1995-1997, with follow-up spanning 13.8 years. Associations between baseline levels and longitudinal changes in BMI and sexual desire, arousal, intercourse frequency, and ability to climax were assessed with generalized linear mixed-effects models. Models were adjusted for demographic variables, depressive symptoms, hormone therapy use, alcohol intake, menopause status, smoking status, and health status.

Results: Mean BMI increased from 27.7 to 29.1 kg/m2, whereas all sexual functioning variables declined across time (P values ≤ 0.001). Higher baseline BMI was associated with less frequent intercourse (P = 0.003; 95% CI, −0.059 to −0.012). Although overall change in BMI was not associated with changes in sexual functioning, years of greater-than-expected BMI increases relative to women's overall BMI change trajectory were characterized by less frequent intercourse (P < 0.001; 95% CI, −0.106 to −0.029) and reduced sexual desire (P = 0.020; 95% CI, −0.078 to −0.007).

Conclusions: Although women's overall BMI change across 13.8 years of follow-up was not associated with overall changes in sexual functioning, sexual desire and intercourse frequency diminished with years of greater-than-expected weight gain. Results suggest that adiposity and sexual functioning change concurrently from year to year. Further research should explore the impact of weight management interventions as a strategy for preserving sexual functioning in midlife women.

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1Department of Preventive Medicine, Rush University Medical Center, Chicago, IL

2Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL

3Department of Physical Medicine and Rehabilitation, Rush University Medical Center, Chicago, IL

4Department of Psychiatry, Rush University Medical Center, Chicago, IL.

Address correspondence to: Lisa M. Nackers, PhD, MPH, Department of Preventive Medicine, Rush University Medical Center, Suite 470, 1700 W Van Buren St, Chicago, IL 60612. E-mail: Lisa_M_Nackers@rush.edu

Received 25 November, 2014

Revised 26 January, 2015

Accepted 26 January, 2015

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging, National Institute of Nursing Research, Office of Research on Women's Health, or National Institutes of Health.

Funding/support: This work was funded by the National Institutes of Health. The Study of Women's Health Across the Nation received grant support from the National Institutes of Health, Department of Health and Human Services, through the National Institute on Aging, National Institute of Nursing Research, and National Institutes of Health Office of Research on Women's Health (grants U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, and U01AG012495).

Financial disclosure/conflicts of interest: None reported.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.menopause.org).

© 2015 by The North American Menopause Society.