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To the Editor We read with interest the article by Thomas et al1 on sexual activity in midlife women. The World Health Organization has been working in the area of sexual health since at least 1974 (http://www.who.int/topics/sexual_health/en/). There are, however, some aspects of the study that need clarification to make the results straightforward. An important aspect relates to the separation of women into the 2 categories of sexually activity at baseline (Table 1 in the article by Thomas et al1): any flaw in this starting point would undermine the validity of prospective results.
Maiorino MI, Bellastella G, Esposito K. Sexual Activity in Midlife Women and Beyond. JAMA Intern Med. 2014;174(7):1203-1204. doi:10.1001/jamainternmed.2014.1621