This finding had something to do with Jeong's assertion [2] that middle-aged couples' marital satisfaction reached the lowest level compared with couples in other life cycles, due to factors coming from long marital life, general physical and mental changes of middle age, and their grownup children. Therefore, evaluation of middle-aged adults' SQOL should not focus on sexual satisfaction through physical contacts, but on general sexual life including various emotional factors such as sexual self-esteem perceived through sexual intercourse, psychological and emotional fitness, as well as consideration and general feelings for spouse [30].