Scientific Society Symposium

Sexuality and the postmenopausal woman

Susan Davis (AU)


Introduction: Cross sectional and longitudinal studies show a considerable decline of sexual desire, arousal and an increase of sexual pain disorders in postmenopausal women. Although a considerable number of women consider these changes as normal part of the aging process., an increasing number of women consider sexuality an important part of their quality of life and ask for help Aim : Define the elements and structure of sexual health care for postmenopausal women taking into account the biological, psychological and interpersonal factors contributing to sexual ill health of this population Method: Review of the literature. Development of a program at our Institution in Basel Results: a) The postmenopausal woman alone. The diagnosis of the problem is based on the biopsychosocial model and the predominant factors are coexisting morbidities with drug treatment, lack of communcation with the partner, local estrogen deficiency, testosterone deficiency, The most frequently used interventions are counselling, psychoeducation, local estrogen, pelvic floor exercises, androgens,,individual psychotherapeutic sessions (early post menopause) b) The postmenopausal woman with her partner: We use the 3 axes model: The patient, her partner, the relationship For the patient and her partner a medical and psychological profile is established including deficits and ressources (see above) The communcation and interaction characteristics are evaluated. The predominant pathogenetic factors are comorbidities with drug treatment, lack of communication, partnerĀ“s dysfunction, lack of ovarian steroids, (local and systemic) in the woman, lack of androgens in the partner, untreated depression The most frequent interventions are couples sessions sometimes including sensate focus; Hormone treatment of the woman, Drug treatment of the partner, Individual psychotherapy Conclusion: Postmenopausal women who ask for help regarding sexual problems and sexual dysfunction need a multidimensional approach and comprehensive care ideally in a multidisciplinary team.