Objective To assess the influence of psychosocial factors, behavior and hormones on postmenopausal sexuality. Methods Nine hundred and ninety-nine women (age range 41-60 years) underwent physical and supplementary tests and answered questionnaires regarding sexual behavior. Sixty healthy women with 1 or more years of amenorrhea, without hormone replacement therapy and with a partner capable of intercourse were chosen from this group. Logistic regression models with dependent variables (sexual satisfaction and orgasmic capacity) and independent variables (sexual initiation, psychosocial factors, behavior, relationship, menopause and hormones) were developed. Results Important variables for sexual satisfaction were: good self-esteem (p < 0.01), first orgasm obtained by masturbation (p = 0.004), major personal income (p = 0.007), sexual initiation in adulthood (p = 0.008), value physical contact with partner (p = 0.021) and major orgasmic capacity (p = 0.040). The following contributed towards orgasmic capacity with the partner: sexual Initiation in adulthood (p = 0.012), regular physical activity (p = 0.040) and higher testosterone levels (p = 0.050). Conclusions The importance of relationship, psychological, hormonal, economic and behavioral factors confirm the complexity of sexuality, and we note that current as well as prior events seem to affect the sexual satisfaction and orgasmic capacity of healthy postmenopausal women.