Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology

Abstract

Sexual function in aging women Sexuality is an integral part of human expressions. Mental health plays a major role in sexuality. Several psychological interventions are proposed to increase the sexual quality of life in older women with diverse gynecologic pathology. A biopsychosocial approach utilizing brief strategies can be easily implemented in clinics to help women of all ages increase their sexual quality of life. The impact of female pelvic floor disorders on sexual function in older women Female pelvic floor disorders include urinary incontinence, pelvic organ prolapse, and fecal incontinence. These disorders increase dramatically with increasing age. Urinary incontinence has been demonstrated to have a negative impact on a woman’s sexual function. Among sexually active older women with urinary incontinence, 22% report being moderately or extremely worried that sexual activity would cause urine loss. An increased prevalence of sexual distress [9% (6/76) vs. 1.3% (2/216), p=0.005] has been reported in sexually active women over 40 years old with urinary incontinence. Treatment of urinary incontinence can improve sexual function in older women. Among sexually active women (N=53) who underwent midurethral slings procedures for the correction of urinary incontinence, increased coital frequency, decrease fear of incontinence with coitus, decreased embarrassment due to incontinence was reported six months after surgery. Pelvic organ prolapse, a hernia of the vagina resulting in a visible vaginal bulge, has also been associated with a negative impact on sexual function. Women with advanced pelvic organ prolapse (POP-Q stage III or IV) have been demonstrated to have decreased body image reporting that they are more self-conscious about their appearance [adjusted odds ratio (AOR) 4.7; 95% confidence interval (CI) 2.9, 51], feel less feminine (AOR 4.0; 95% CI 1.2, 15) and less sexually attractive (AOR 4.6; 95% CI 1.4, 17) compared with women who have normal pelvic support. Both vaginal and abdominal approaches to surgical correction of pelvic organ prolapse have been demonstrated to improve sexual function. Mental health Mental health plays a major role in older woman’s sexuality. Sexual interest and satisfaction is tied to emotional expressivity, women’s self-worth, feelings of depression and loneliness as well as cognitive function. Research has shown that both general practitioners and specialists lack training in sexual assessments. Behavioral health specialists, such as a psychologist, can play an integral role in helping to facilitate communication between the patient and the provider. A main focus of communication training is to facilitate open and genuine conversation between the provider and the patient. Providers are encouraged to ask open ended questions while patients are encouraged to discuss symptoms while coping with an internal state of anxiety. Despite the known prevalence of sexual dysfunction among older women, few studied empirically based interventions have been published with these wome...

Sexuality in Older Adults (65+)—An Overview of The Recent Literature, Part 2: Body Image and Sexual Satisfaction

“…Similar empirical support has been obtained for the importance of mental health problems, particularly those related to depression and anti-depressant medication use (Dundon & Rellini, 2010;Kim & Jeon, 2013;McCall-Hosenfeld et al, 2008;Scott et al, 2012;Thompson et al, 2011;Wang et al, 2014). Finally, moderate to strong associations between sexual satisfaction and well-being, and sexual health disorders or impaired sexual function (Ratner, Erekson, Minkin, & Foran-Tuller, 2011) have been consistently observed (Heiman et al, 2011;Laumann et al, 2006;Traeen & Schaller, 2010). In addition to relatively frequent agerelated loss of sexual interest in both men and women (DeLamater et al, 2008), erectile problems among men and problems with lubrication, genital pain, and diminished orgasmic function were frequently found to negatively affect sexual satisfaction in older age (Field et al, 2013;Heiman et al, 2011;Laumann et al, 2006).…”

Sexual function in older women with pelvic floor symptoms: a cross-sectional study in general practice

“…From previous studies, it is known that improvement or deterioration of sexual function after surgery seems to depend on the surgical technique used. 27 However, there is no information available about the surgical procedure that was used in women who underwent pelvic floor surgery and therefore it is hard to explain the association between pelvic floor surgery and sexual functioning. Although the current evidence on the influence of pelvic floor surgery on sexual function is still inconclusive, [28][29][30][31] pelvic floor surgery results in anatomic and functional changes in the pelvic floor area that potentially influence sexuality.…”

Health Care Students’ Attitudes Towards Working with Sexual Health in Their Professional Roles: Survey of Students at Nursing, Physiotherapy and Occupational Therapy Programmes

“…However, health care providers often lack education concerning sexological issues, and their attitudes towards working to promote sexual health can be challenged by their own believed non-importance of sexual health for persons with disease or disability (Esmail, Darry, Walter, & Knupp, 2010;Low & Zubir, 2000). Sexual health is strongly related to feelings of well-being and general health (Field et al, 2013;Lindau & Gavrilova, 2010;Ratner, Erekson, Minkin, & Foran-Tuller, 2011), and previous research has shown that rehabilitation can promote sexual health (Kristina Areskoug- Josefsson & Gard, 2015;K. Areskoug-Josefsson & Oberg, 2009;Egan et al, 2013;Josefsson & Gard, 2012;Rosenbaum, 2006).…”