Depressive symptoms, but not moderate-to-vigorous physical activity, impacts sexual well-being and menopause-specific quality of life in middle-aged women

Inadequate physical activity (PA), unhealthy weight status, prevalence of chronic conditions, and psychosocial distress are common in middle-aged women and are linked to reductions in well-being and quality of life. However, their potential interactive effects, specifically on sexual well-being and menopause-specific quality of life (MENQOL), have not been well characterized in postmenopausal women. PURPOSE: To determine if moderate-to-vigorous physical activity (MVPA) and adiposity (%Fat) influence sexual well-being and MENQOL outcomes, controlling for health status (chronic conditions; medications) and psychosocial well-being (depressive symptoms; perceived stress), in postmenopausal women. Postmenopausal women (n = 68, 58.6 +/- 3.4 yr, 80.9 percent married/partnered, 51.5 percent overweight/obese, nonsmoking) were recruited through e-mail advertisements and flyers placed throughout the community. Participants were scheduled for two laboratory visits 7-10 days apart where they were objectively assessed for MVPA with accelerometers (in the interim), adiposity via dual-energy X-ray absorptiometry (DXA), and self-report questionnaires to determine health status, depressive symptoms, perceived stress, sexual well-being, and MENQOL. Lower MVPA and higher %Fat were associated with lower physical domain MENQOL (both r = .27, p < .05); health status and psychosocial well-being were not associated (all p > .05). Hierarchical regression analyses revealed 1) greater number of chronic conditions and medications, and depressive symptoms scores predicted less favorable sexual well-being, independent of MVPA and %Fat (standardized beta range =.22-.56, all p < .05), 2) depression was most consistently associated with MENQOL (models p <= .001), and 3) greater adiposity augmented the negative influence of depression on the physical domain of MENQOL (beta = .40. p = .002). CONCLUSIONS: PA may influence sexual well-being and MENQOL indirectly through positive impacts on adiposity, chronic conditions, and depressive symptoms in middle-aged postmenopausal women, a sector of the population often afflicted with compromised sexual well-being.