Sexuality in the middle years.

Sexual function undergoes natural changes at menopause, reflecting the effects of ovarian hormones on the nervous and cardiovascular systems. Most studies indicate deterioration of function as the impact of the biological changes is compounded by psychological reactions and sociocultural influences. This article reviews studies of sex and menopause and discusses etiological considerations with regard to ovarian hormones and sexual dysfunction. The concluding section describes ways in which the clinician can help the menopausal woman and her partner understand and deal with sexual dysfunction.