Background: Sexual function can be affected by several factors. Menopause and its symptoms including somatic, psychological, and urogenital symptoms can be associated with sexual dysfunction during menopause.

  Objective: The aim of this study was to determine the effects of the severity of menopausal symptoms on sexual function in postmenopausal women.

  Methods: This analytical study was conducted in 405 postmenopausal women -40 to 60 years old- in Nowshahr and Chaloos during 2013 and 2014. Subjects were selected by multi-stage random sampling method . Data were collected using the Female Sexual Function Index (FSFI), the Menopause Rating Scale (MRS), and a researcher-made questionnaire. Data were analyzed using Pearson's correlation coefficient, Spearman correlation coefficient, T-test, multiple linear regression and logistic regression.

  Findings: Sixty one percent of the subjects had sexual dysfunction. The most severe menopausal symptoms were related to psychological domain and the lowest score was related to urogenital domain. All domains of MRS and the MRS total score had significantly negative correlation with the FSFI total score. The urogenital score (r=0.283, P<0.001) and the MRS total score (r=0.116, P=0.020) had significantly positive correlation with sexual dissatisfaction. Urogenital score and MRS total score were significantly higher in women with decreased sexuality and sexual relationship after menopause compared to others. The severity of menopausal symptoms was negative predictor of all domains of sexual function except for satisfaction and the FSFI total score. The MRS total score was a predictor of variation in sexuality and sexual relationship after menopause and satisfaction.

  Conclusion: The severity of menopausal symptoms could have a negative effect on sexual function. Controlling these symptoms should be noted to improve sexual function for women's health policy making.