One of the most common side effects of menopause is also one of the least treated, according to a physician at Women & Infants Hospital of Rhode Island, who recently published an essay urging the nation's physicians to open the dialogue with their post-menopausal patients in order to help them.
John E. Buster, MD, associate director of the Center for Reproduction and Infertility at Women & Infants, authored "Sex and the 50-Something Woman: Strategies for Restoring Satisfaction" in the professional journal Contemporary Obstetrics and Gynecology. His intent was to explain the various causes of what is called female sexual dysfunction (FSD) and the simple interventions obstetrician/gynecologists and primary care physicians can recommend.
"Female sexual dysfunction affects many women after menopause, lowering their sexual desire, affecting their sexual function and even causing pain," Dr. Buster explains. "The impact is subtle but can be insidious."
In general, research has shown that approximately 45% of all women experience a sexual problem, including 39% who reported lower sexual desire. Negative life experiences, such as an abusive relationship, can cause sexual problems for women of any age. But, as women go through menopause, there are biological reasons for sexual issues, largely due to lower production of the hormones estrogen or androgen. The lower hormone levels affect the body's sexual function directly and also indirectly by causing hot flashes, irritability, memory lapses and insomnia. Older women are also more likely to be taking medication for such chronic diseases as diabetes, hypertension, obesity or breast cancer, which can also affect sexual desire.
"FSD is diagnosed when a woman's symptoms cause her personal distress or when the loss of sexual desire causes trouble in her relationship," Dr. Buster says, noting that the American Psychiatric Association details four categories of FSD that can be treated directly by a woman's physician.
Treatment of FSD centers on managing the causes, he continues. This includes:
- Counseling for women who have experienced adverse life events
- Medication management for those being treated for chronic illnesses
- Lowering or eliminating antidepressants, replacing or augmenting it with therapy
- Prescribing estrogen or testosterone specific to the patient's biological needs
"There is an abundance of high-quality evidence documenting how testosterone can effectively restore sexual desire in women with diminished androgen production," Dr. Buster states.
The key, he stresses, is having an active and open dialogue between patients and their physicians.
"Although it may seem obvious, simply talking to patients about their sexuality is key to pinpointing an FSD and, ultimately, treating it," Dr. Buster notes.
About Women & Infants Hospital
Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. The primary teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the eighth largest stand-alone obstetrical service in the country with nearly 8,400 deliveries per year. In 2009, Women & Infants opened the country's largest, single-family room neonatal intensive care unit.
New England's premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's only mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.
Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the National Institutes of Health's Pelvic Floor Disorders Network.