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Sexual well-being after menopause: an International Menopause Society White Paper

Sexual wellbeing frequently declines following the menopause transition and can be associated with significant personal and relationship distress. This distress is the hallmark of female sexual dysfunction (FSD). The International Menopause Society is working to increase awareness of FSD and to provide a framework for practitioners to address sexual medicine concerns. This White Paper aims to review the process of care for female sexual well-being following menopause, from initially approaching the discussion of FSD, to identifying clinical signs and symptoms, and ultimately determining the best available biopsychosocial therapies.

Introduction (from White Paper)

Sexual wellbeing following menopause may seem anunattainable goal for many women. Dependent upon thepsychosocial circumstances, the biological changes atmenopause may be associated with significant personaland relationship distress. Studies across a number of countrieshave shown that women place high value on sexualintimacy in their relationships1,2. Sexual problems at midlifecan be divided into chronic sexual symptoms involvingsexual desire, arousal, orgasm, and pain. Screening for female sexual concerns is often short changed during the clinical encounter because of a multitude of factors including,but not limited to, misinformation, absent orinadequate physician/practitioner training in sexual medicine, the belief that such menopausal changes are a normal and inevitable part of ageing, and time constraints.The purpose of this review is to provide clinicians with aframework for:

(1) Approaching the discussion of female sexual wellbeing following menopause;

(2) Clinically identifying women with sexual dysfunctionthrough patient symptoms, physical signs and validated instruments;

(3) Managing sexual difficulties in postmenopausal womenwith the available biopsychosocial therapies.

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pdfSexual wellbeing after menopause: An International Menopause Society White Paper1.28 MB

Abstract

Sexual well-being frequently declines following the menopause transition and can be associated withSexual well-being frequently declines following the menopause transition and can be associated withsignificant personal and relationship distress. This distress is the hallmark of female sexual dysfunction(FSD). FSD is highly prevalent in postmenopausal women. The prevalence of sexual problemsincreases with age, but conversely this is associated with decreasing distress with advancing age.This pattern has been seen across multiple international populations with varied cultural norms.While the etiology of FSD is multifactorial, the physiological changes of sex hormone insufficiencyand postmenopausal symptoms, such as dyspareunia, are primary factors contributing to FSD at midlife.The International Menopause Society is working to increase awareness of FSD and to provide aframework for practitioners to address sexual medicine concerns. This White Paper aims to reviewthe process of care for female sexual well-being following menopause, from initially approaching thediscussion of FSD, to identifying clinical signs and symptoms, and ultimately determining the bestavailable biopsychosocial therapies. As with most processes of care, the first step is often the mostdifficult. Health-care practitioners need to broach the topic of sexuality in the clinical setting. Lack ofinformation on, comfort with, and biases about the topic of sexuality after menopause are significanthurdles that the International Menopause Society addresses in this document. Each member of theWriting Group remains committed to continued advocacy for the validity of FSD as a diagnosis, theneed for therapies for women to be both available and included in health insurance coverage, andcontinued therapeutic research to provide evidence-based solutions.

Reference

J. A. Simon, S. R. Davis, S. E. Althof, P. Chedraui, A. H. Clayton, S. A.J. A. Simon, S. R. Davis, S. E. Althof, P. Chedraui, A. H. Clayton, S. A.Kingsberg, R. E. Nappi, S. J. Parish & W. Wolfman (2018): Sexual well-being after menopause: AnInternational Menopause Society White Paper, Climacteric, DOI: 10.1080/13697137.2018.1482647

Content created October 2018

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