Objective: To investigate the prevalence of dyspareunia and its associated factors in a cohort of middle-aged women. Design: A cross-sectional, population-based study was carried Out using an anonymous, self-report questionnaire completed by 200 Brazilian-born women, 40 to 65 years of age, with 11 years or more of formal education. The evaluation instrument was based on file Short Personal Experiences Questionnaire. Sociodemographic, clinical, behavioral, reproductive, and partner-related factors were assessed. Poisson multiple regression analysis was performed, and prevalence ratios (PRs) with their 95% CIs were calculated. Results: The prevalence of dyspareunia was 39.5%. Multiple analysis showed that dyspareunia was more common in women who reported nervousness (PR = 1.73, 95% CI: 1.14-2.63) and depression (PR = 1.69, 95% CI: 1.09-2.61). A score of more than 3 for frequency of sexual activity (PR = 0.20, 95% CI: 0.05-0.84) and having had more than two pregnancies (PR = 0.62, 95% CI: 0.48-0.81) were factors indicative of a protective effect against dyspareunia. Conclusions: Dyspareunia was common in this cohort of middle-aged women. Nervousness and depression increased the likelihood of experiencing dyspareunia. These findings suggest that psychological symptoms should be taken into consideration in the management of the middle-aged woman with dyspareunia, and measures should be adopted to minimize the repercussions of these factors on sexuality.15611841190Sao Paulo Foundation for the Support of Research [04/10524-8]Sao Paulo Foundation for the Support of Research [04/10524-8]