This study focused on the sexual response changes of 280 mostly White, married, highly educated midlife women and on the attributions they made for these changes. In a U.S. sample of women participating in the Midlife Women's Health Survey (MWHS), women whose sexual response had changed in the past year (40%) reported more decrements than increases in sexual response. When asked how they accounted for these changes, women referred most often to the physical and emotional changes of menopause and to life circumstances, and less often to their relationships with their partners. The attributions showed a distinct pattern: Most of the decrements were explained by physical events related to menopause, whereas most of the increases were explained by life circumstances. These findings are discussed in terms of a need for studying women's sexuality from a biopsychosocial perspective.