Women's sexual functioning, lifestyle, mid-age, and menopause in 12 European countries.

OBJECTIVE: To assess whether there are differences between women from different European countries in lifestyles and sexual functioning, and to identify the relative impact of social, hormonal, and lifestyle factors on mid-aged women's sexual functioning.
DESIGN: Cross-sectional survey of a convenience sample of 601 women aged 45 to 60 years, consulting general practitioners in 12 European countries. Women completed the Short Personal Experiences Questionnaire and questions regarding social factors, lifestyle, attitudes, well-being, stress, health, and menopause status.
RESULTS: Significant differences were found in psychosocial and lifestyle variables between countries. The only domain of sexual functioning that varied between countries was frequency of sexual intercourse (P < 0.05), the highest being for the group of Latin or southern countries (France, Portugal, Italy, Spain). General linear modeling found that change of partner, existence of partner, well-being, parity, and exercise were associated with both sexual response and frequency of sexual intercourse. Menopause status and stress were significantly associated with sexual response. Country of origin and body mass index were significantly associated with frequency of sexual intercourse. Structured equation modeling found that recalled experience on each sexual domain was the most important factor influencing that domain, whereas feelings for partner and change of partner had significant effects. A similar explanatory model was found for the sexual functioning for mid-aged European women as for Australian mid-aged women.
CONCLUSIONS: There are significant differences between European countries in women's reports of lifestyles, psychosocial factors, and frequency of sexual intercourse but not in other aspects of their sexual response. These findings generate hypotheses to be tested in larger studies of female sexual functioning.