Methodological problems in the study of sexuality and the menopause.

Few studies have considered the effects of menopause on sexuality. Large studies with representative samples using postal questionnaires have included only a few sexual variables. More comprehensive studies have tended to employ non-representative samples that raise questions concerning generalization of findings. Major problems in existing research have been: failure to collect data on variables known to affect sexuality and/or failure to utilize such data in analyses, studying only one, sometimes two, menopausal phases, gathering retrospective data, asking subjects directly about the relationship of menopause to sexuality, gathering too few sexual data, not providing a complete description of sexual measures, neglecting to report methodology clearly and completely, failing to evaluate data statistically, and inferring causation from correlations. Evidence from existing research suggests a decline in sexual interest, frequency of sexual intercourse, and vaginal lubrication in association with the menopause. Findings for variables such as capacity for orgasm, satisfaction with sex partner, and vaginal pain or discomfort are few and mixed.