BACKGROUND: Female sexual dysfunction is a focus of medical research but few studies describe the prevalence and covariates of recent sexual activity and satisfaction in older community-dwelling women.METHODS: 1303 older women from the Rancho Bernardo Study were mailed a questionnaire on general health, recent sexual activity, sexual satisfaction, and the Female Sexual Function Index (FSFI).RESULTS: 806 of 921 respondents (87.5%) age ≥3d 40 years answered questions about recent sexual activity.The median age was 67; mean years since menopause 25; most were upper-middle class; 57% had attended at least one year of college; 90% reported good to excellent health.Half (49.8%) reported sexual activity within the past month with or without a partner, the majority of whom reported arousal (64.5%), lubrication (69%), and orgasm (67.1%) at least most of the time, although one-third reported low, very low, or no sexual desire.Although frequency of arousal, lubrication, and orgasm decrease with age, the youngest (<55 yrs) and oldest (>80 yrs) women reported a higher frequency of orgasm satisfaction.Emotional closeness during sex was associated with more frequent arousal, lubrication, and orgasm; estrogen therapy was not.Overall, two-thirds of the sexually active women were moderately or very satisfied with their sex life as were almost half of sexually inactive women.CONCLUSION: Half these women were sexually active, with arousal, lubrication, and orgasm maintained into old age, despite low libido in one-third.Sexual satisfaction increased with age and did not require sexual activity.