Quality of Sexual Life and Menopause
The importance of female sexual fulfillment is increasingly recognized in today's society. Women's sexual lives continue well into the menopausal years and beyond; however, the impact of menopause on the quality of that sexual life has not been comprehensively studied in the medical literature. This review attempts to clarify the impact of the physiological, psychological and psychosocial changes occurring at midlife that may affect women's quality of sexual life. Pharmaceutical and psychological interventions that may assist in improving the quality of sexual life of menopausal women are discussed. Female sexuality is complex and not fully understood and, consequently, controversy frequently arises in the discussion of female sexual problems and their treatment. This article highlights some of these controversies and provides a future perspective on how the impact of menopause on the quality of sexual life may be more cohesively investigated.
The recent surge of medical interest in the sexuality of menopausal and older women reflects a wider cultural shift in the attitude towards female sexuality. The perception that the end of a woman's reproductive years equates to the end of her sexual life has been replaced by the knowledge that satisfying sexual activity can, and does, continue into the menopause and beyond. This change in attitude may be driven partly by increasing scientific understanding of the human sexual response and the search for a 'female Viagra' to match the commercial success of the male impotence drug, and partly by the characteristics of the 'baby boomer' generation, who are perhaps more likely than the previous generation to demand that their health, and indeed sexual needs, be met.
Investigation into the prevalence of sexual activity in the menopausal population as distinct to the aging population appears to be rarely quantified, as studies tend to assess the prevalence of sexual activity in terms of age rather than menopausal status. However, a recent cross-sectional study of the sexual activities and behaviors of 2109 women aged 40–69 years indicated that approximately 75% were sexually active. Such data provide evidence that a substantial proportion of the female population are sexually active around the age of menopause and that their sexual needs are worthy of attention from the healthcare profession.
It is often easy to assume that middle-aged and older patients may be reluctant to discuss their sexual lives with healthcare practitioners. A recent analysis of the attitudes of General Practitioners in the UK revealed that many have the tendency to consider that sexual health may not be a 'legitimate' topic for discussion, whereas a number of studies indicate that, in fact, a significant proportion of middle-aged and older people would welcome enquiry into their sexual wellbeing.
The overall aim of this review is to use the current literature to assess the impact of menopause on women's quality of sexual life. Quality of sexual life is a term used to encompass aspects such as the absence or presence of bothersome sexual problems, sexual satisfaction and sexual wellbeing, and is inherently subjective. As will be outlined in this review, it is essential to remember that the presence of sexual problems is not synonymous with poor quality of sexual life.
In preparation for this review, no single piece of research was found that comprehensively investigates the impact of menopause on quality of sexual life. Instead, the majority of literature concentrates either on how menopause affects overall quality of life or the impact of menopause on sexual function, with most studies failing to adequately distinguish between the presence of a sexual dysfunction and poor quality of sexual life. Consequently, this review is an attempt to elucidate the impact of menopause on quality of sexual life from the information that can be gleaned from the current literature. It is not intended to be a systematic review.
In order to provide context and to introduce the difficulties associated with the assessment of the quality of sexual life in menopause, the available data on the prevalence of sexual activity and sexual problems in the menopausal population are outlined. The aim of this article is then to introduce the hormonal physiological changes of menopause, the symptoms associated with them and their impact on overall quality of life and quality of sexual life, followed by a discussion of the psychosocial aspects of menopause and midlife that may also bring about a change in quality of sexual life. Details of, and evidence to support the use of, specific therapeutic interventions aimed at improving middle-aged women's sexual lives are outlined.
Abstract and Introduction
Abstract
The importance of female sexual fulfillment is increasingly recognized in today's society. Women's sexual lives continue well into the menopausal years and beyond; however, the impact of menopause on the quality of that sexual life has not been comprehensively studied in the medical literature. This review attempts to clarify the impact of the physiological, psychological and psychosocial changes occurring at midlife that may affect women's quality of sexual life. Pharmaceutical and psychological interventions that may assist in improving the quality of sexual life of menopausal women are discussed. Female sexuality is complex and not fully understood and, consequently, controversy frequently arises in the discussion of female sexual problems and their treatment. This article highlights some of these controversies and provides a future perspective on how the impact of menopause on the quality of sexual life may be more cohesively investigated.
Introduction
The recent surge of medical interest in the sexuality of menopausal and older women reflects a wider cultural shift in the attitude towards female sexuality. The perception that the end of a woman's reproductive years equates to the end of her sexual life has been replaced by the knowledge that satisfying sexual activity can, and does, continue into the menopause and beyond. This change in attitude may be driven partly by increasing scientific understanding of the human sexual response and the search for a 'female Viagra' to match the commercial success of the male impotence drug, and partly by the characteristics of the 'baby boomer' generation, who are perhaps more likely than the previous generation to demand that their health, and indeed sexual needs, be met.
Investigation into the prevalence of sexual activity in the menopausal population as distinct to the aging population appears to be rarely quantified, as studies tend to assess the prevalence of sexual activity in terms of age rather than menopausal status. However, a recent cross-sectional study of the sexual activities and behaviors of 2109 women aged 40–69 years indicated that approximately 75% were sexually active. Such data provide evidence that a substantial proportion of the female population are sexually active around the age of menopause and that their sexual needs are worthy of attention from the healthcare profession.
It is often easy to assume that middle-aged and older patients may be reluctant to discuss their sexual lives with healthcare practitioners. A recent analysis of the attitudes of General Practitioners in the UK revealed that many have the tendency to consider that sexual health may not be a 'legitimate' topic for discussion, whereas a number of studies indicate that, in fact, a significant proportion of middle-aged and older people would welcome enquiry into their sexual wellbeing.
The overall aim of this review is to use the current literature to assess the impact of menopause on women's quality of sexual life. Quality of sexual life is a term used to encompass aspects such as the absence or presence of bothersome sexual problems, sexual satisfaction and sexual wellbeing, and is inherently subjective. As will be outlined in this review, it is essential to remember that the presence of sexual problems is not synonymous with poor quality of sexual life.
In preparation for this review, no single piece of research was found that comprehensively investigates the impact of menopause on quality of sexual life. Instead, the majority of literature concentrates either on how menopause affects overall quality of life or the impact of menopause on sexual function, with most studies failing to adequately distinguish between the presence of a sexual dysfunction and poor quality of sexual life. Consequently, this review is an attempt to elucidate the impact of menopause on quality of sexual life from the information that can be gleaned from the current literature. It is not intended to be a systematic review.
In order to provide context and to introduce the difficulties associated with the assessment of the quality of sexual life in menopause, the available data on the prevalence of sexual activity and sexual problems in the menopausal population are outlined. The aim of this article is then to introduce the hormonal physiological changes of menopause, the symptoms associated with them and their impact on overall quality of life and quality of sexual life, followed by a discussion of the psychosocial aspects of menopause and midlife that may also bring about a change in quality of sexual life. Details of, and evidence to support the use of, specific therapeutic interventions aimed at improving middle-aged women's sexual lives are outlined.