Function In Midlife Women Research Articles

Cardiovascular Health, Race, and Decline in Cognitive Function in Midlife Women: The Study of Women's Health Across the Nation.

Cognitive decline may progress for decades before dementia onset. Better cardiovascular health (CVH) has been related to less cognitive decline, but it is unclear whether this begins early, for all racial subgroups, and all domains of cognitive function. The purpose of this study was to determine the impact of CVH on decline in the 2 domains of cognition that decline first in White and Black women at midlife. Subjects were 363 Black and 402 White women, similar in baseline age (mean±SD, 46.6±3.0 years) and education (15.7±2.0 years), from the Chicago site of the Study of Women's Health Across the Nation. Cognition, measured as processing speed and working memory, was assessed annually or biennially over a maximum of 20 years (mean±SD, 9.8±6.7 years). CVH was measured as Life's Essential 8 (blood pressure, body mass index, glucose, non-high-density lipoprotein cholesterol, smoking, physical activity, diet, sleep). Hierarchical linear mixed models identified predictors of cognitive decline with progressive levels of adjustment. There was a decline in processing speed that was explained by race, age, and the 3-way interaction of race, CVH, and time (F1,4308=8.8, P=0.003). CVH was unrelated to decline in White women but in Black women poorer CVH was associated with greater decline. Working memory did not decline in the total cohort, by race, or by CVH. In midlife Black women, CVH promotion may be a target for preventing the beginnings of cognitive decline, thereby enhancing independent living with aging.

Abstract P122: Cardiovascular Fat And Cognitive Function Among Perimenopausal Women: The Study Of Women’s Health Across The Nation Cardiovascular Fat And Heart Ancillary Studies

Objective: Women experienced disproportionated prevalence of dementia and higher risk of cardiovascular disease (CVD) after menopause. Cardiovascular fat (CF) which is associated with CVD may impact cognitive function through vascular pathology. Perimenopausal women had more CF compared with pre/early perimenopausal women. However, research on the association between CF volume, density and cognitive function among perimenopausal women is limited. We aimed to assess associations of CF volume and density with future cognitive function among midlife women. Design: Midlife women with measures of CF volume and density along with cognitive function measured 1.46 (SD=0.68) years later were evaluated. Computed tomographic scans were used to quantify volume and density of total heart adipose tissue (TAT), EAT, and perivascular adipose tissue (PVAT) of the descending aorta. Digit span backward test, East Boston memory test, and symbol digit modalities test were used to test working memory, verbal episodic memory, and processing speed, respectively. The relationship between each CF measurement and each cognitive function metric was assessed separately with linear regression models. Final models included age, education level, race, menopausal status, waist hip ratio, number of cognitive tests conducted before the included test, and fat density for corresponding fat volume or fat volume for corresponding fat density. Results: Three hundred and eighty-five women (mean age of 50.6 (SD=2.4) years old; 29.2% post-menopausal) were included. In the final models (Table), higher EAT and TAT density were significantly associated with a higher processing speed and immediate episodic memory, respectively. However, there was a significant negative association between PVAT density and working memory. Conclusion: Our findings suggest an association between CF radio-density and future cognitive function in midlife women, which may differ by cardiovascular fat location (heart vs. vasculature).

Obesity Update in Women.

The Clinical Update series is intended to help busy providers stay up to date with important and potentially practice changing articles that have been published on topics pertinent to the care of women. The rates of obesity and the resultant morbidities are rising worldwide, making it a high-priority health issue for the medical community. Moreover, the pathophysiology and management of obesity and visceral fat accumulation in women has important nuances, distinct from those in men. It is important to consider the effect of unique female-specific influences such as reproductive stage and pregnancy. Therefore, we have chosen to review six high-impact recent studies relating to obesity and its management in women. These include guidelines for management of obesity in pregnancy, risk of nonmelanoma skin cancer in overweight/obese women, the association of vascular fat and decline in physical function in midlife women, the predictors for weight gain in premenopausal women with early-stage breast cancer, dietary patterns and obesity in postmenopausal women, and finally, normal weight obesity and mortality risk in postmenopausal women.

Androgen receptor gene polymorphism and sexual function in midlife women.

To assess the impact of serum androgen levels and androgen receptor CAG polymorphism on sexual function in 45 healthy midlife women living in a heterosexual relationship. Cross-sectional study [Cantonal Ethics Committee Bern (Ref.-Nr. 087/13)]. Association between androgen serum levels, androgen receptor CAG polymorphism and sexual function was assessed by the FSFI-d questionnaire. In our cohort of healthy, midlife, well-educated, middle-class, mostly postmenopausal women living in a heterosexual satisfying partnership, sexual function was perceived to remain stable or to decline during menopausal transition with sexual desire scoring lowest (FSFI-d 3.3 ± 0.9). Androgen serum levels did not correlate with sexual function. Mean CAG repeat number was 21.6 ± 1.9. There was a highly inverse though non-significant correlation between female sexual function and AR CAG repeat polymorphism with specifically higher numbers of CAG repeats being significantly positively correlated to more frequent or more severe pain during or after sexual intercourse. The AR polymorphism is a non-negligible factor in female sexual function. Future studies on female sexual (dys)function should incorporate its assessment.

Relationship of Interferon-γ to Cognitive Function in Midlife Women with Schizophrenia.

Recent literature suggests that schizophrenia is linked to an abnormal response of the immune system. Interferon-γ is a cytokine that acts as a mediator between immune stimulation and the kynurenine pathway and may be related to cognitive abilities. The objectives of the present study are to determine if serum cytokines are correlated with cognitive function differently in patients with schizophrenia compared to controls. Fourteen midlife (30-70year-old) females with DSM-IV diagnosis of schizophrenia or schizoaffective disorder and 13 midlife control females were analyzed. Cytokines were collected from serum blood draws and analyzed at the Cytokine Core Lab at the University of Maryland, Baltimore. The RBANS, HVLT-R, and UPSA were performed to measure cognition and social performance. The results demonstrate a non-significant difference between interferon-γ levels in women with schizophrenia compared to controls, but this cytokine appears to correlate to cognitive abilities differently in these groups. There were several significant negative correlations between interferon-γ and cognition in midlife patients with schizophrenia, but only one in the midlife control group. The negative correlations between interferon-γ and cognition in patients with schizophrenia suggest the hypothesis that inflammation and the kynurenine pathway have important roles in this disorder.

Peripheral oxytocin and vasopressin are associated with clinical symptom severity and cognitive functioning in midlife women with chronic schizophrenia

Peripheral oxytocin and vasopressin are associated with clinical symptom severity and cognitive functioning in midlife women with chronic schizophrenia

M27. Peripheral Oxytocin and Vasopressin are Associated With Clinical Symptom Severity and Cognitive Functioning in Midlife Women With Chronic Schizophrenia

Abstract Background: Neuroendocrine factors may contribute to the etiology, cognitive and clinical symptom severity, and treatment response in schizophrenia. Very few studies to date focus on midlife women, a subgroup of patients that may be particularly vulnerable to both cognitive and symptom exacerbations as they experience menopause-related hormonal changes. Here we examined the degree to which stress and sex steroid hormones levels are associated with cognitive functioning and clinical symptom severity in midlife women with chronic schizophrenia. Methods: Twenty-six midlife women with schizophrenia/schizoaffective disorder (median age, 42 y; 58% African American) and 20 similarly-matched healthy midlife women were evaluated on clinical symptoms (BPRS, modified SANS, BAI) and completed the RBANS, HVLT-R, and UPSA to assess cognition and everyday functioning. Blood and saliva samples were obtained to assess serum estradiol, oxytocin (OT), and arginine vasopressin (AVP) as well as salivary cortisol levels. Multivariable regression analyses were conducted to examine the contribution of hormones to cognitive functioning and clinical symptom severity after adjusting for age. Menopausal stage was adjusted as needed. Results: Among female patients, lower OT levels were associated with more severe overall clinical symptomatology and positive symptoms on the BPRS (βs = −.61, Ps −.54 Ps −.39, Ps −.70, Ps < .02) and in the domain of visuospatial abilities (β = −.71, P = .03). Higher cortisol levels were associated with better attention (β = .62, P = .02). Conclusion: Menopause-related hormonal changes during midlife appears to contribute to both worse cognitive performance and clinical symptom severity in women with chronic schizophrenia. OT and AVP appear more predictive in female patients whereas estradiol and cortisol appears more predictive in female controls. Larger scale, longitudinal studies are needed to understand the role of neuroendocrine factors in cognitive and clinical symptom severity in schizophrenia as well as across other psychotic disorders where hormonal alterations are common.

Factors Affecting Sexual Function in Midlife Women: Results from the Midlife Women's Health Study.

The objective of this study was to estimate the importance of risk factors affecting sexual function in sexually active midlife women. A cohort of 780 women undergoing the menopausal transition was surveyed each year for up to 7 years. Data were collected from sexually active women on sexual function, including frequencies of enjoyment, arousal, orgasm, passion for partner, satisfaction with partner, pain, lack of lubrication, fantasizing, and sexual activity. Data were also collected on a large number of potential risk factors for sexual dysfunction, including behaviors (smoking and alcohol use), health status (overall and frequency of different disorders), and demographic information (race, education, income, etc.). Height and weight were measured at an annual clinic visit; serum hormone concentrations were assayed using blood samples donated annually. Data on individual outcomes were examined with ordinal logistic regression models using individual as a random effect. An overall sexual function score was constructed from individual outcome responses, and this score was examined with linear regression. All factors with univariate associations of p < 0.1 were considered in multivariate model building with stepwise addition. A total of 1,927 women-years were included in the analysis. Women with much more physical work than average had higher sexual function scores and higher rates of enjoyment, passion, and satisfaction. Higher family income was associated with lower sexual function score and more frequent dry sex. Married women had significantly lower sexual function scores, as did those with frequent irritability or vaginal dryness. A higher step on the Ladder of Life was associated with a higher sexual function score and higher frequency of sexual activity. The factors associated with sexual outcome in menopausal women are complex and vary depending on the sexual outcome.

The Effect of a Healthy Lifestyle on Future Physical Functioning in Midlife Women.

This study aimed to examine the prospective association between healthy lifestyle behaviors and objectively measured physical function in midlife women. Participants included 1769 racially/ethnically diverse women, ages 56-68 yr, from the Study of Women's Health Across the Nation cohort. Physical function was assessed at the 13th follow-up visit with the Short Physical Performance Battery (4-m walk, repeated chair stands, and balance test) and grip strength. A healthy lifestyle score (HLS), which ranged from 0 to 6, was calculated by averaging as many as three repeated measures of self-reported smoking, physical activity, and diet, all assessed before the 13th follow-up. Multivariable linear and logistic regressions modeled each component of physical performance as a function of HLS and, in separate models, of each lifestyle behavior, adjusted for the other behaviors. In multivariable analyses, the time for the 4-m walk was 0.06 s faster (P = 0.001) for every 1 point increase in the HLS. The time for the repeated chair stands was significantly shorter by approximately 0.20 s. Neither grip strength nor balance problems were significantly associated with the HLS (P = 0.28 and P = 0.19, respectively). The model examining the individual health behaviors showed that only physical activity was significantly associated with physical performance. Regular physical activity in early midlife has the potential to reduce the likelihood of physical functional limitations later in midlife.

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

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

Higher Leptin and Adiponectin Concentrations Predict Poorer Performance-based Physical Functioning in Midlife Women: the Michigan Study of Women's Health Across the Nation.

Excess fat mass is a greater contributor to functional limitations than is reduced lean mass or the presence of obesity-related conditions. The impact of fat mass on physical functioning may be due to adipokines, adipose-derived proteins that have pro- or anti-inflammatory properties. Serum samples from 1996 to 2003 that were assayed for leptin, adiponectin, and resistin were provided by 511 participants from the Michigan site of the Study of Women's Health Across the Nation. Physical functioning performance was assessed annually during study visits from 1996 to 2003. Among this population of Black and White women (mean baseline age = 45.6 years, SD = 2.7 years), all of whom were premenopausal at baseline, higher baseline leptin concentrations predicted longer stair climb, sit-to-rise, and 2-pound lift times and shorter forward reach distance (all p < .01). This relationship persisted after adjustment for age, BMI, percent skeletal muscle mass, race/ethnicity, economic strain, bodily pain, diabetes, knee osteoarthritis, and C-reactive protein. Baseline total adiponectin concentrations did not predict any mobility measures but did predict quadriceps strength; a 1 µg/mL higher adiponectin concentration was associated with 0.64 Nm lower quadriceps strength (p = .02). Resistin was not associated with any of the physical functioning performance measures. Change in the adipokines was not associated with physical functioning. In this population of middle-aged women, higher baseline leptin concentrations predicted poorer mobility-based functioning, whereas higher adiponectin concentrations predicted reduced quadriceps strength. These findings suggest that the relationship between the adipokines and physical functioning performance is independent of other known correlates of poor functioning.

Vascular risk factors and cognitive function in midlife women: The study of women’s health across the nation (SWAN)

Modifiable cardiovascular risk factors are promising targets for dementia prevention. The preclinical course of dementia spans decades, and the effects of risk factors are likely cumulative over the life-span. Thus, better understanding the relation of cardiovascular risk factors to cognition in midlife, prior to development of impairment is critical. We examined longitudinal associations of modifiable risk factors with cognition in the SWAN cohort of middle aged women. SWAN is a community based multi-site, multi-ethnic longitudinal study of the menopause transition. Pre- or early peri-menopausal women aged 42-52, were recruited at 7 sites between 1996-1997. Analyses include 1701 women who completed cognitive evaluations at the 4th annual study visit (Mean age 46 years, 78% had > high school education). Cognitive assessments included processing speed (Symbol Digit Modalities Test (SDMT)), Verbal episodic memory immediate and delayed recall (East Boston Memory Test (EBMT)), and working memory (Digit Span Backward (DSB)). Tests were repeated at the 6th-10thSWAN visit s(median 4 assessments). Glucose, insulin, and lipids were measured using standardized assays, and waist, BMI, blood pressure, and medical history were assessed using standardized protocols. Risk factors were dichotomized based on established criteria. Linear mixed effects models with random intercept were used to examine the relation of baseline cardiovascular risk factors to cognitive change, adjusting for age, education, race/ethnicity, depressive symptoms, alcohol use, smoking, and menopause status. Models included a spline at the third assessment, to reflect that cognitive performance showed improvement consistent with learning effects over the initial 3 assessments, and showed no significant change thereafter. Women with hypertension, high triglycerides or glucose, diabetes or high HOMA-insulin resistance index showed a significantly reduced rate of improvement in SDMT over the initial 3 cognitive assessments. Elevated glucose and diabetes were associated with less improvement in DSB. Improvement in EBMT delayed recall was reduced among those with obesity, or high HOMA-IR (All p< 0.05). In this healthy middle-aged cohort without evidence of cognitive decline, factors related to pre-diabetes were associated with diminished learning effects over repeated cognitive assessments, particularly tests of executive function. Further research is needed to determine if early control of cardiovascular risk factors can curtail cognitive decline.

Masturbation frequency and sexual function domains are associated with serum reproductive hormone levels across the menopausal transition.

To determine whether reproductive hormones are related to sexual function during the menopausal transition. The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of the menopausal transition located at seven US sites. At baseline, the 3302 community-based participants, aged 42-52, had an intact uterus and at least one ovary and were not using exogenous hormones. Participants self-identified as White, Black, Hispanic, Chinese, or Japanese. At baseline and at each of the 10 follow-up visits, sexual function was assessed by self-administered questionnaires, and blood was drawn to assay serum levels of T, estradiol, FSH, SHBG, and dehydroepiandrosterone sulfate. Self-reported frequency of masturbation, sexual desire, sexual arousal, orgasm, and pain during intercourse. Masturbation, sexual desire, and arousal were positively associated with T. Masturbation, arousal, and orgasm were negatively associated with FSH. Associations were modest. Estradiol was not related to any measured sexual function domain. Pain with intercourse was not associated with any hormone. Reproductive hormones were associated with sexual function in midlife women. T was positively associated, supporting the role of androgens in female sexual function. FSH was negatively associated, supporting the role of menopausal status in female sexual function. The modest associations in this large study suggest that the relationships are subtle and may be of limited clinical significance.

Sexual function in women on estradiol or venlafaxine for hot flushes: a randomized controlled trial.

To evaluate sexual function in midlife women taking low-dose oral estradiol or venlafaxine for hot flushes. In an 8-week randomized controlled trial among women aged 40-62 years, sexual function was compared between 0.5 mg oral estradiol per day or 75 mg venlafaxine per day (both compared with a placebo). Measures included composite and six domain scores from the Female Sexual Function Index and sexually related personal distress. Participants were aged 54.6 years (standard deviation [SD] 3.8) years, 59% white, with 8.1 (SD 5.3) daily hot flushes. Median composite baseline Female Sexual Function Index score was 16.3 (SD 11.9, n=256) for all women and 21.7 (SD 9.3, n=198) among sexually active women. Composite mean Female Sexual Function Index change from baseline to week 8 was 1.4 (95% confidence interval [CI] -0.4 to 3.2) for estradiol, 1.1 (95% CI -0.5 to 2.7) for venlafaxine, and -0.3 (95% CI -1.6 to 1.0) for placebo. Composite Female Sexual Function Index and sexually related distress change from baseline did not differ between estradiol and placebo (P=.38, P=.30) or venlafaxine and placebo (P=.79, P=.48). Among sexually active women, Female Sexual Function Index domain score change from baseline differences (active compared with placebo) in desire was 0.3 (95% CI 0.0-0.6) for estradiol, -0.6 (95% CI -1.2 to 0.0) in orgasm for venlafaxine, and 0.9 (95% CI 0.2-1.6) in penetration pain for venlafaxine. No women reported adverse events related to sexual dysfunction. Overall sexual function among nondepressed midlife women experiencing hot flushes did not change over 8 weeks with low-dose oral estradiol or venlafaxine (compared with placebo), although a subtle increase in desire (estradiol) and decreases in orgasm and pain (venlafaxine) may exist. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01418209. I.

Prospective associations between inflammatory and hemostatic markers and physical functioning limitations in mid-life women: Longitudinal results of the Study of Women's Health Across the Nation (SWAN)

BackgroundDue to the public health burden of age-related declines in physical functioning, it is important to identify targets for intervention for the prevention of functional decline. We prospectively examined whether higher levels of inflammatory and hemostatic markers (high-sensitivity C-reactive protein (hs-CRP), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator antigen (tPA-ag), fibrinogen, and Factor VIIc (FVIIc)) were prospectively associated with reporting greater limitations in perceived physical functioning, and explored potential racial differences in the associations, in a multi-ethnic sample of mid-life women. MethodsWomen (45–56years) in the Study of Women's Health Across the Nation who completed the physical functioning scale of the Medical Outcome Short Form (SF-36) at follow-up visits 4, 6, or 8 and had inflammatory/hemostatic measures in the preceding year were included (n=2296). The continuous SF-36 physical function score was categorized as: no limitation (86–100 points), some limitation (51–85 points), and substantial limitation (0–50 points). Physical function category at time t was modeled a function of each biomarker, separately, at time t−1 using ordinal generalized estimating equations. ResultsAfter adjusting for age, race/ethnicity, body size, sociodemographic, medical and lifestyle factors, higher levels of tPA-ag and hs-CRP were associated with subsequently reporting greater limitations in physical functioning, although the latter was only marginally significant (p=0.13). For each standard deviation (SD) increase in logtPA-ag, the odds of some or substantial limitations was 1.18 (95%CI 1.09,1.27); for each SD increase in loghs-CRP, the odds of some or substantial limitation was (1.08, 95%CI 0.98,1.19). In African American women only, higher fibrinogen levels were associated with subsequently reporting greater limitations (OR=1.30, 95%CI 1.13,1.50, for each one SD increase in fibrinogen). ConclusionsHigher levels of inflammatory and hemostatic markers were prospectively associated with greater limitations in perceived physical functioning in mid-life women.

Sexual Function in Nondepressed Women Using Escitalopram for Vasomotor Symptoms

To evaluate sexual function in midlife women using selective serotonin reuptake inhibitors for vasomotor symptoms. Selective serotonin reuptake inhibitors effectively treat vasomotor symptoms but adversely affect sexual function in depressed populations. Information on sexual function in nondepressed midlife women using selective serotonin reuptake inhibitors for vasomotor symptoms is lacking; any treatments that might impair function are of concern. This was a randomized controlled trial comparing 8 weeks of escitalopram with placebo in women ages 40-62 years with 28 or more bothersome vasomotor symptoms per week. Change in Female Sexual Function Index composite score (ranges from 2 [not sexually active, no desire] to 36) and six sexual domains (desire, arousal, lubrication, orgasm, satisfaction, pain) and the Female Sexual Distress Scale, and a single-question of sexually-related personal distress from the Female Sexual Distress Scale, were compared between groups. Among all women, median composite baseline Female Sexual Function Index score was 18.1 (interquartile range 2.4-26.5, n=200) and among sexually active women was 22.8 (interquartile range 17.4-27.0, n=75) in the escitalopram group and 23.6 (interquartile range 14.9-31.0, n=70) in the placebo group. Treatment with escitalopram did not affect composite Female Sexual Function Index score at follow-up compared with placebo (P=.18 all women; P=.47 sexually active at baseline). Composite mean Female Sexual Function Index change from baseline to week 8 was 0.1 (95% confidence interval [CI] -1.5 to 1.7) for escitalopram and 2.0 (95% CI 0.2-3.8) for placebo. The Female Sexual Distress Scale results did not differ between groups (P=.73) nor did adverse reports of sexual function. At week 8, among those women sexually active at baseline, there was a small difference between groups in Female Sexual Function Index domain mean score change in lubrication (P=.02) and a marginal nonsignificant difference in orgasm (P=.07). Escitalopram, when used in the treatment of vasomotor symptoms, did not worsen overall sexual function among nondepressed midlife women.

Physical functioning related to C-reactive protein and fibrinogen levels in mid-life women

We investigated whether subclinical inflammatory markers high-sensitivity C-reactive protein (CRP) and fibrinogen are related to measures of physical functioning in mid-life women. Our sample included 543 participants in the Michigan site of Study of Women’s Health Across the Nation (SWAN). Predictors included CRP from serum and fibrinogen from plasma. Performance-based outcomes included measures of gait, hand grip strength, flexibility, stair climb, 40-foot walk, and chair rise. Perception of physical functioning was assessed with the Medical Outcomes Study Short-Form 36 questionnaire. Regression analyses adjusted for relevant covariates. Cross-sectional associations were identified between higher CRP and more time spent in double support (with both feet on the floor while walking), shorter forward reach, slower 2-lb lift, and slower stair climb. Higher CRP and fibrinogen were associated with worse perceived functioning in cross-sectional analyses. Predictive associations across time were found between higher CRP and increased time spent in double support, diminishing forward reach distance and grip strength and worse perceived physical functioning. Predictive associations across time were also found between higher fibrinogen and greater time spent in double support, slower stair climb and worse perceived physical functioning. Our results suggest that inflammatory processes are associated with poor physical functioning in mid-life women.

Factors associated with determinants of sexual functioning in midlife women

Objectives The present study was conducted to assess the associations between a woman's passionate love for her partner and sexual satisfaction and demographic factors, health and life-style characteristics, menopausal status, and menopausal symptoms. Methods A cross-sectional study was conducted among women (40–60 years) residing in Maryland ( n = 846). χ 2-tests were performed to evaluate the associations between each of the outcome variables (sexual satisfaction and passionate love for the partner) and predictor/independent variables. Logistic regression analysis was performed to determine whether significant associations from χ 2 analyses remained significant after adjustment for confounders. Results Older age (adjusted odds ratio (OR) 1.04; 95% confidence interval (CI) 1.01, 1.07), higher education (OR 1.47; 95% CI 1.09, 1.99), and alcohol intake (OR 1.42; 95% CI 1.03, 1.95) were associated with low passion for the partner. Older age was also a significant predictor of low sexual satisfaction (OR 1.04; 95% CI 1.01, 1.07). Women experiencing vaginal dryness had higher odds of low passion for partner (OR 1.67; 95% CI 1.21, 1.31) and low sexual satisfaction (OR 1.58; 95% CI 1.14, 2.20) than women not experiencing vaginal dryness. Conclusions Older age, higher education, alcohol intake, and vaginal dryness are significantly associated with lower levels of passionate love for the partner, while older age and vaginal dryness are significantly associated with lower levels of sexual satisfaction in midlife women.