Sexual health and wellbeing and the menopause: An EMAS clinical guide

Stavroula A. Paschou, Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece. Electronic address: s.a.paschou@gmail.com.
Kleoniki I. Athanasiadou, Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece.
Trish Hafford-Letchfield, University of Strathclyde, Scotland, UK.
Sharron Hinchliff, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, UK.
Melissa Mauskar, Department of Dermatology and Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA.
Margaret Rees, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.
James A. Simon, Department of Obstetrics & Gynecology, George Washington University, IntimMedicine Specialists, Washington, DC, USA.
Eleni Armeni, Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Greece; Royal Free Hospital NHS Foundation Trust, London, United Kingdom.
C Tamer Erel, Istanbul-Cerrahpaşa University, Cerrahpaşa School of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey.
Ivan Fistonic, Faculty for Health Studies, University of Rijeka, Rijeka, Croatia.
Timothy Hillard, Department of Obstetrics and Gynaecology, University Hospitals Dorset, Poole, UK.
Angelica Lindén Hirschberg, Department of Women's and Children's Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
Blazej Meczekalski, Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
Nicolás Mendoza, Department of Obstetrics and Gynecology, University of Granada, Spain.
Alfred O. Mueck, Department of Women's Health, University Hospital Tuebingen, Germany.
Tommaso Simoncini, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy.
Petra Stute, Department of Obstetrics and Gynecology, University Clinic Inselspital, Bern, Switzerland.
Dorenda van Dijken, Department of Obstetrics and Gynecology, OLVG Hospital, Amsterdam, the Netherlands.
Irene Lambrinoudaki, Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Greece.

Document Type

Journal Article

Publication Date

11-1-2024

Journal

Maturitas

Volume

189

DOI

10.1016/j.maturitas.2024.108055

Keywords

Menopause; Sexual diversity; Sexual dysfunction; Sexual health and wellbeing; Sexual problems; Women's health

Abstract

INTRODUCTION: Sexual health and wellbeing are significant aspects of quality of life. However, taking a sexual history is often avoided in medical practice, leaving a void in management and awareness. As the menopause can have a major impact on sexual health, it is imperative that healthcare providers are appropriately trained in sexual health and wellbeing and the aligned disciplines in order to achieve optimal care. AIM: To provide an evidence-based clinical guide for the assessment and management of sexual problems at the menopause and beyond. MATERIALS AND METHODS: Review of the literature and consensus of expert opinion. RESULTS AND CONCLUSION: The assessment of sexual problems includes history taking, examination and laboratory investigation (if indicated), and occasionally the use of specific validated questionnaires. Management of sexual problems requires a multidimensional approach using biopsychosocial measures. Medical management and psychosexual counselling include pharmacological and non-pharmacological interventions, and sex therapy and psychoeducation. Furthermore, perimenopausal women should be advised about the need for contraception if they wish to avoid pregnancy. Also, sexually transmitted diseases can be acquired at any age. To conclude, taking a sexual history should be incorporated into medical practice and healthcare providers should be appropriately trained to assess and manage sexual problems at the menopause and beyond.

Department

Obstetrics and Gynecology

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