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In Reply We appreciate and read with interest the thought-provoking letters submitted to the editor in regard to our Research Letter.1
Maiorino et al expressed concern about excluding sexually inactive women at baseline. For this analysis, we were interested in the factors associated with continuation of sexual activity at midlife, so we necessarily only included women who were sexually active at baseline. They also noted that the 0.5 difference in Female Sexual Function Index (FSFI) scores between women who became sexually inactive and women who remained sexually active was not significant. We agree, and that is why we concluded that FSFI scores did not differ significantly between these 2 groups. The mean (SD) FSFI scores among women who became sexually inactive vs women who remained sexually active were 21.8 (3.8) and 22.3 (3.8), respectively (P = .67). In this cohort, 92.3% of the women had an FSFI score below 27, consistent with a designation of sexual dysfunction.2
Thomas HN, Hess R. Sexual Activity in Midlife Women and Beyond—Reply. JAMA Intern Med. 2014;174(7):1205. doi:10.1001/jamainternmed.2014.1592