A biopsychosocial approach to women’s sexual function and dysfunction at midlife: A narrative review

Abstract

A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to define sexual function and dysfunction, (b) to present theoretical models of female sexual response, (c) to examine longitudinal studies of how sexual function changes during midlife, and (d) to review treatment options. Four types of female sexual dysfunction are currently recognized: Female Orgasmic Disorder, Female Sexual Interest/Arousal Disorder, Genito-Pelvic Pain/Penetration Disorder, and Substance/Medication-Induced Sexual Dysfunction. However, optimal sexual function transcends the simple absence of dysfunction. A biopsychosocial approach that simultaneously considers physical, psychological, sociocultural, and interpersonal factors is necessary to guide research and clinical care regarding women’s sexual function. Most longitudinal studies reveal an association between advancing menopause status and worsening sexual function. Psychosocial variables, such as availability of a partner, relationship quality, and psychological functioning, also play an integral role. Future directions for research should include deepening our understanding of how sexual function changes with aging and developing safe and effective approaches to optimizing women’s sexual function with aging. Overall, holistic, biopsychosocial approaches to women’s sexual function are necessary to fully understand and treat this key component of midlife women’s well-being.

Women's Sexual Health and Aging

“…A lubricant is suggested for initial encounters to facilitate a pleasurable experience while the body adjusts to resuming sexual activity. Water-based lubricants are popular because they are nongreasy, clean up easily and 2 GRANVILLE AND PREGLER OCTOBER 2018-VOL. 0, NO.…”

“…Sexual desire is equated with sexual arousal, which occurs after, not before, sex is initiated. 2 Population-based research supports this view. In studies of middle-aged and older women, nearly half report no or little desire before sex is initiated, but fewer than 15% report discontent with their sexual experiences.…”

“…Most women, even in the oldest age groups, in which sex with a partner is less common, state that sex has some importance in their lives. 2,4 Research on the sexual health of older lesbian, bisexual, and transgender women is lacking.…”

Burden of Misconception in Sexual Health Care Setting: A Cross-Sectional Investigation among the Patients Attending a Psychiatric Sex Clinic of Bangladesh

“…” Positive sexual health requires respectful approach to sexuality with possibility of having pleasurable and safe sexual experiences with those who are free of coercion, discrimination, and violence [1, 2]. Sexuality, partner role, distribution of dysfunctions, perception, and expression of sexual complaints often vary in the aspects of different cultures, societies, countries, religions, and other such aspects.…”

Female sexual dysfunction and associated co-morbidities: a cross sectional study with Female Sexual Function Index (FSFI) in a tertiary care hospital of Bangladesh

“…9,[12][13][14] Repeated researches revealed a strong positive association between sexual function and quality of life as sexual function is an integral part of life. 15 FSD occurs when a woman is unable to fully experience pleasure during sexual activity that causes distress, affects a woman's quality of life, lead to interpersonal relationship impairments. 1 FSD encompasses four main phases of desire, arousal, orgasm, and pain disorders.…”