(Published May 2005)

Summary and Recommendations

Female sexuality at midlife and beyond is a burgeoning area of interest for providers, patients, researchers, and pharmaceutical companies. Much work needs to be done to gain a clearer understanding of the issues surrounding female sexuality. Below, you’ll find some recommendations for bringing sexuality issues into the routine patient encounter and offering education, counseling, and referrals, with the goal of improving quality of life and well-being for women in midlife and beyond.

Recommendations for Health Care Providers

• Place literature about sexual and marital concerns (e.g., brochures from The Women’s Sexual Health Foundation, www.twshf.org, or the National Women’s Health Resource Center’s April 2005 issue of the National Women’s Health Report: Menopausal Women & Sexual Health, available at www.healthywoman.org) in your waiting and exam rooms, to indicate to patients that you are open to and available for discussing sexual problems.
• Reassure patients that sexual concerns are common.
• Include inquiries and assessment of sexual concerns in routine patient examinations (e.g., annual, menopause, and postsurgical visits, as well as when treating depression or chronic illnesses).
• Recognize that a woman’s sexual response is circuitous and complex, involving physiological and psychological components, and help the patient understand these issues.
• Recognize that loss of desire or other sexual problems may not need treatment unless they cause distress to the woman.
• Adopt a nonjudgmental attitude to patients’ sexual disclosures and activities and reassure patients that their activities are common and normal.
• Don’t assume that all patients are involved in long-term relationships with heterosexual partners. Many patients may be in same-sex relationships or new relationships, and whether coupled or uncoupled, engaging in masturbation.
• If a woman is in a relationship, view her sexual concerns as a couple’s problem, not just the woman’s problem.
• Educate and inform patients about common sexual problems that can occur with aging (e.g., vaginal dryness, loss of desire, dyspareunia), as well as with use of certain medications or the presence of some diseases or after surgery.
• Offer advice on techniques for enhancing sexual communication, arousal (e.g., extended clitoral stimulation), relieving boredom, and coping with a partner’s sexual disorders (such as erectile dysfunction) and the resumption of sexual activity after a period of abstinence.
• Partner with other health professionals, such as psychologists, sex educators, sexologists, physical therapists specializing in sexuality, and sex therapists, to provide a comprehensive approach to female sexual disorders. Certified sex educators, counselors, and therapists can be found through the American Association of Sex Educators, Counselors, and Therapists at www.aasect.org.