Everything Is Hot except My Libido: Sexuality and Menopause

Women in the menopausal transition often report lower sexual desire, decreased arousal and diminished satisfaction with their sexuality. The evidence supporting a hormonal basis for this is controversial however the voices of women continue to he heard by nurses and other health care providers. These women complain that beginning as early as the 3^rd and 4^th decade, sexual changes are experienced and these impact on the quality of life for women and satisfaction with their relationships.

 

How is this influenced by lifestyle factors such as body image, family issues and societal pressure to appear and act in a certain manner? What is the role of the partner in this and how do the issues of the aging male or female partner impact on the sexuality of the woman?

 

What is the role for hormone therapy, including supplemental testosterone? Over the past three years, numerous applications have been made to the FDA for approval of among other products, the testosterone patch for women. One application for this was turned down in late 2005 but many others remain under investigation. In the light of the findings of the Women’s Health Study, how supportive can we be of hormonal supplementation that will be used for many years with uncertain long term safety? Can herbal remedies help women? Are natural products any safer and how do we weigh the little evidence we have for these products? The evidence for a variety of pharmaceutical and lifestyle interventions will be examined as will our way of thinking about the sexuality of mid-life women.