Sexual Disharmony in Menopausal Women and Their Husband: A Qualitative Study of Reasons, Strategies, and Ramifications

Abstract

ObjectivesThe goal of this study was to explore perceptions and experiences of general practitioners and midwives during sexual dialogue with menopausal women.MethodsIn a descriptive exploratory qualitative study, 13 midwives and 12 general practitioners were selected using a semi-structured interview and purposive sampling method. Data analysis was conducted using qualitative content analysis adopted by Graneheim and Lundman.ResultsThrough data analysis “sexual disharmony” emerged as a central theme, which included three categories of reasons, strategies, and ramifications of sexual disharmony. Reasons for sexual disharmony included subcategories of aging and health related-problems, marital problems, and stereotypical perceptions regarding menopause and sexuality and daily concerns. Strategies used by couples to address sexual disharmony consisted of changing roles and values, pretending to reach orgasm, suppressing sexual desire, meeting sexual needs of husbands in accordance with religious rules, seeking help of peers, seeking friends or traditional medicine and health providers, seeking a help charmer, engaging in sex with other women to fulfill sexual needs, pretending to be moody to alleviate sexual tension. Sexual disharmony may lead to spending money on a prostitute instead of engaging in sex out of wedlock or a surge in social pathologies such as sexually transmitted disease.ConclusionsHealthcare providers must be aware of various sexual behavior of menopausal women and their husbands when they detect sexual disharmony in their patients. Results of this study can facilitate development of restricted guidelines for sexual discussion with menopausal women.

The impact of menopause on sexual function in women and their spouses

“…Approximately more than half of menopausal women suffer from low sexual desire 7 . Decreasing levels of estrogen cause vaginal dryness and dyspareunia 8 . Many women face the symptoms of menopause positively and virtually pain-free; for others, the transition brings debilitating side effects, affecting the activities of daily living.…”

“…Menopause isn't merely a harsh period for women, it's as well as difficult for their spouses. Due to the menopausal symptoms, no surprise why men are afraid of menopause 8 . In a survey, 38% of spouses of menopausal women said the low sex drive due to menopause has affected their intimacy and relationship 13 .…”

“…In a survey, 38% of spouses of menopausal women said the low sex drive due to menopause has affected their intimacy and relationship 13 . It has been generally assumed that female sexual problem after menopause plays a significant role in determining a spouse's sexual function 8 . Of course, Men also experience hormonal changes with aging, so that low testosterone can affect sexual desire and performance 14 .…”

“…ED is the incapability of a man to create an erection that's adequate for intercourse. In addition to aging, cardiovascular diseases, diabetes, education, cigarette smoking, and alcohol consumption have an association with the prevalence of ED 8 . Also, attitudes and feelings toward sex, being confronted with the realities of aging, menopausal symptoms in the female partner effect on sexual life 16 .…”

Cultural Barriers Influencing Midwives' Sexual Conversation with Menopausal Women

“…Sexual health is considered as essential part of holistic care, while sexual problems are not being commonly discussed by the most of the health care providers and their patients 1234. This could be due to several reasons, including personal and demographic characteristics of the health providers such as their age, gender, level of education, work experience, birthplace, and the country they have graduated in, as well as their patients' embarrassment and the level of self-confidence of health care providers 356789…”