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Sex and the 50-Something Woman—Women & Infants Expert

Tuesday, September 18, 2012

 

Nearly half of post-menopausal women experience sexual problems, and an expert from Women & Infants thinks doctors need to be more candid with patients about this possibility.

One of the most common side effects of menopause is also one of the least treated, according to a physician at Women & Infants Hospital of Rhode Island, who recently published an essay called “Sex and the 50-Something Woman: Strategies for Restoring Satisfaction” that urges the nation’s physicians to open the dialogue with their post-menopausal patients in order to help them.

John E. Buster, MD, associate director of the Center for Reproduction and Infertility at Women & Infants, explained the various causes of what is called female sexual dysfunction (FSD) and the simple interventions obstetrician/gynecologists and primary care physicians can recommend. But often do not.

“Female sexual dysfunction affects many women after menopause, lowering their sexual desire, affecting their sexual function and even causing pain,” Dr. Buster said. “The impact is subtle but can be insidious.”

Nearly half of women experience a sexual problem

In general, research has shown that approximately 45% of all women experience a sexual problem, including 39% who reported lower sexual desire. Negative life experiences, such as an abusive relationship, can cause sexual problems for women of any age. But, as women go through menopause, there are biological reasons for sexual issues, largely due to lower production of the hormones estrogen or androgen. The lower hormone levels affect the body’s sexual function directly and also indirectly by causing hot flashes, irritability, memory lapses and insomnia. Older women are also more likely to be taking medication for such chronic diseases as diabetes, hypertension, obesity or breast cancer, which can also affect sexual desire.

When is it FSD?

“FSD is diagnosed when a woman’s symptoms cause her personal distress or when the loss of sexual desire causes trouble in her relationship,” Dr. Buster said, noting that the American Psychiatric Association details four categories of FSD that can be treated directly by a woman’s physician.

Treatment of FSD centers on managing the causes, he continues. This includes:

  • Counseling for women who have experienced adverse life events
  • Medication management for those being treated for chronic illnesses
  • Lowering or eliminating antidepressants, replacing or augmenting it with therapy
  • Prescribing estrogen or testosterone specific to the patient’s biological needs

“There is an abundance of high-quality evidence documenting how testosterone can effectively restore sexual desire in women with diminished androgen production,” Dr. Buster said. The key, he stressed was having an active and open dialogue between patients and their physicians.

“Although it may seem obvious, simply talking to patients about their sexuality is key to pinpointing an FSD and, ultimately, treating it,” Dr. Buster said.

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