Sexual difficulties are common across the female lifespan, increasing at midlife. Although changing hormone levels at menopause may contribute to the development of female sexual dysfunction, other factors, including relationship issues; psychological wellbeing; physical wellbeing; and medication use, such as antidepressants, need to be taken into consideration. The most common sexual difficulties reported by women across the perimenopause include dyspareunia, diminished desire, arousal capacity and difficulty in achieving orgasm.
This article summarises female sexual dysfunction in the perimenopausal woman, and discusses advice the general practitioner can offer women and possible treatment options.
Many women experience loss of libido, reduced desire, difficulty in achieving orgasm and dyspareunia during their late reproductive and perimenopausal years. It is important that a woman is assessed in the context of her personal circumstances, partnership status, sexual experiences and cultural expectations. Management options range from informative discussions through to counselling and therapeutic intervention.
The World Health Organization has defined sexual health as ‘a state of physical, emotional, mental and social wellbeing related to sexuality; it is not merely the absence of disease, dysfunction or infirmity’. Surveys conducted across a range of cultures demonstrate that the vast majority of women believe sexual activity to be important1 and it has been shown higher levels of physical pleasure in sex are significantly associated with higher levels of emotional satisfaction.2
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