Menopause doesn't have to impact a woman's sex life for the worst.

A national survey in the United Kingdom suggests less frequent sex in middle age has less to do with fluctuating hormones and more to do with stress and fatigue than many of us have been led to believe.

Of course menopause is still a time of deep physiological change, defined largely by an end to periodic cycles of menstruation and accompanied by a significant decline in estrogen and progesterone. Together with an ongoing drop in testosterone, these are hormones that play a significant role in libido and sexual function.

But just because low sex drive is a common complaint after menopause doesn't mean menopause itself is solely responsible.

"Few studies have taken women's views into account in trying to understand the range of factors influencing sexual experience in middle age," says sexual and reproductive health scientist Kaye Wellings from the London School of Hygiene and Tropical Medicine.

"The decline in frequency needs to be set in the context of social change as well as individual circumstances."

More women are opting to have children later in life these days. At the same time, their own parents are living longer, leading to a 'sandwich generation' in which middle-aged mothers find themselves financially and emotionally responsible for both their kids and their aging parents.

Many middle-aged women are also juggling a full-time job, and may even be dealing with their own declining health.

The combination of all these stresses seems to have left women without much energy to dedicate to a regular and pleasant sex life.

In a national survey of 2,133 female participants in Britain, researchers asked participants to rate their sex life using three measurements: satisfaction, frequency, and function.

In the end, a third of respondents said they had not had sex in the past month. Yet less than half that group felt dissatisfied with their sex lives.

In other words, middle-aged women generally liked the sex they were having when they were having it, even if it wasn't frequent.

Unhappiness in a romantic relationship was the only lifestyle factor tested that was independently associated with all three measures of sexual experience.

In fact, those who were unhappy in their romantic relationships were twice as likely to report being sexually inactive, more than twice as likely to report reduced sexual function, and nearly three times as likely to report being dissatisfied with their sex lives.

Other lifestyle factors, like poor mental health, were closely associated with lower sexual function. Whereas higher educational attainment was linked to greater sexual dissatisfaction – perhaps, researchers say, as a reflection of higher expectations.

In contrast, age and the stage of a person's menopause did not associate with any measures of their sexual experience.

Follow-up interviews with 23 female participants between the ages of 45 and 59 supported those results.

"Only two women directly attributed their lack of interest in sex to the menopause and, for one, the impact was compounded by other factors, onset having coincided with depression following a bereavement, a recent injury, and starting to work night shifts," researchers explain.

Many women who were interviewed said they had neither time nor opportunity in their lives to talk about sex with their partner.

"We're just tired," said one woman of her and her partner, "I'd rather sit in front of the telly with a glass of wine and fall asleep in the armchair, that's us."

Even those without children felt drained by the demands of life: " … you're busy, busy, busy all day, you're out with work colleagues in the evening … . and the only time you get to yourself is literally the five or six hours you get to sleep … "

Larger, population-based studies in other nations are needed to back up these findings, but the results suggest that middle-aged women in Britain don't see menopause as the main reason for their changing sex lives.

Studies to date have produced mixed results on whether menopause impacts a person's sexuality in mid-life. Some show no effect, while others have found that menopausal women treated with hormone replacement therapy see a 44 percent increase in their sexual activity.

Teasing apart the various factors that contribute to a person's health, well-being, mood, and sexual desires, however, is a challenge. This survey is unique in that it asks women directly what they are experiencing, although the study was limited to cis-females referring to their heterosexual relationships.

Nevertheless, the authors of the study warn against "focusing narrowly on the proximate determinants of sexual expression", like hormones, and instead emphasize "the wider social context" that influences sexual well-being.

"We hope the findings will be reassuring to women in showing they're not out of line with other women at this time in their lives," says Wellings.

"That frequency of sex bears little relation with satisfaction with sex lives suggests that intimacy may be a more important factor in determining sexual wellbeing – a message that health care workers might beneficially convey to women."

The study was published in the Journal of Sex Research.