Reviewer ’s report  
 
Title: Sexual motivations during the menopausal transition amo ng Iranian women: A qualitative 
inquiry  
 
Version: 1 Date: 20 Feb 2018  
 
Reviewer: Elke Doris Reissing  
 
Reviewer's report:  
 
Thank you for the opportunity to review "Sexua l motivations during the menopausal transition 
among Iranian women: A qualitative inquiry". I enjoyed reading this insightful and informative 
submission and consider it a significant contribution to the literature on menopause, sexuality, 
and culture.  
 
 
I would like the authors to consider the use of sexual desire and sexual motivation in the paper 
and clarify carefully whether the two are used as synonyms or, if not, to clarify the difference. 
Otherwise, I have indicated below a few caveats and suggested co rrections.  
 
 
p.3ln.20 -21: "Diminished sexual motivation has been identified as one of the main domains in 
the formation of women's sexual behaviors [9]." This sentence is not clear to me…I imagine the 
authors might want to written "formation of sexual dysf unction"?  
 
 
p.4ln.10: Keep the paragraph about relational factors together and separate paragraph introducing 
the importance of understanding sexual motivation from a culturally competent perspective.  
 
 
Method: I am very interested in learning more on how *e xactly* the women were approached to 
participate in this study. As the authors indicate in the introduction, sexuality is a topic Iranians 
do not discuss openly, hence approaching women to discuss their sexual motivation must have 
been quite tricky. In add ition, for readers to find out more about the specific means by which 
participants were recruited is important to understand the sample of women. Were they a highly 
selected sample of very liberal women? The authors state that they went to great length to recruit 
a diverse sample of women from all walks of life, hence, more information on recruitment could 
do justice to the sample.  
 
 
p.6ln.4: what do the authors mean by "In cases that required further exploration, additional 
interviews were conducted"… how was this decided, what would require "further exploration"?  
 
 
The authors need to outline either in the introduction or the method section what they mean by 
perimenopause and menopause and most importantly "menopausal women"; would the latter 
imply women who  are postmenopausal?  
 
 
Data analysis: apologies, but I don't know what the following is… given that I may not be the 
only reader who is unfamiliar with this analytic strategy, I suggest some explanation: "Finally, 
the sampling with maximum variation approac h enhanced the confirmability and credibility of 
the data."  
 
 
p.8ln.8: "Sexual desire is the concept women used most often to refer to sexual capacity." This 
may be an issue of translation; I don't believe the term "sexual capacity" is used in English. 
Hence , perhaps sexual desire is the concept that women use to refer to sexual motivation?  
 
 
p.18ln.14: The following paragraph may be better placed at the beginning of the section 
discussing the socio -cultural script.  
 
 
p.20ln.16: This sentence (on partners) prec eding the limitations would be better placed within the 
paragraph discussing the limitations.  
 
 
I am curious about the report of pain with sexual activity in one of the quotes and the general 
reports in the literature related to pain due to less or lack of lubrication as well as genito -urinary 
syndrome of menopause and how this is handled in the context of the socio -cultural script of 
submitting to sex regardless of personal disposition. Perhaps the authors could speak to this as 
well.  
 
 
Please review referen ce section to be in line with BMC Women's Health submission guidelines.  
 
 
While the manuscript is generally written well, some proof reading could improve style and 
some spelling errors. The quotes are translated a little awkwardly; I would leave if change would 
imply any compromise on content.  
 
 
 
 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to t he authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financi ally from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of th e above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
i declare that I have no competing interests  
 
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