An update on female sexual function and dysfunction in old age and its relevance to old age psychiatry

Old Age Psychiatry, Sheffield Health and Social Care Trust, Eastglade Centre, Sheffield, UK.
Aging and Disease (Impact Factor: 3.07). 10/2012; 3(5):373-84.
Source: PubMed


Numerous studies have now demonstrated that many older women retain an interest in their sexual lives. Yet, how many old age psychiatrists commonly check with older women about whether the depression they are treating, or the SSRIs (Selective Serotonin Re-uptake Inhibitors) they have prescribed, have adversely affected their patient's sexual lives? We consider the latest evidence regarding cultural, social and medical influences on older women's sexual lives and some specific issues which affect lesbian and transsexual people. We examine how mental illness and psychotropic medication in particular can adversely affect older women's sexual functioning and at how difficult it often proves to be for women to seek help. We also focus on why doctors and in particular psychiatrists may not take a sexual history, look for sexual side effects or refer for appropriate treatment, especially when interviewing older women patients. Most published information about psychiatric training and sexual issues focuses on the younger male patient. We therefore aimed to provide a broad-ranging review of the literature regarding female sexual functioning in old age, the difficulties that can arise and the role that old age psychiatrists have an opportunity to fulfil, in this often neglected aspect of their patients' treatment. From our review it was clear that, in the light of the increasing cultural acceptability of discussions regarding sexuality and older women, the training of student doctors and trainee psychiatrists needs to reflect this change so that old age psychiatrists can enhance the quality of their patient care.

Download full-text


Available from: Kevan Wylie,
  • [Show abstract] [Hide abstract]
    ABSTRACT: To explore occupational therapists’ perspectives on addressing sexuality in the context of rehabilitation services for older people. Method: A qualitative exploratory design was used. Data were collected using a series of focus groups (n = 5) among occupational therapists (n = 22) working with older people. Data were analysed using content analysis. Results: Occupational therapists in this study rarely addressed sexuality in the context of rehabilitation services for older people. Three major categories emerged in relation to barriers which influence therapists’ practice in this area: (i) the influence of culture on decisions regarding whether or not to address sexuality, (ii) perceived competence and confidence to address sexuality and (iii) the impact of resources regarding the inclusion or exclusion of sexuality from rehabilitation. Conclusions: Although sexuality is increasingly considered an important and relevant aspect of successful ageing the extent to which healthcare professionals are prepared to address sexual concerns identified by older people is less clear. If new expectations of healthy ageing are to be met, healthcare professionals must acknowledge the importance of sexuality and be prepared to be involved in sexual health management.Implications for Rehabilitation Healthcare professionals continue to be reluctant to respond to older peoples’ concerns relating to sexuality. Occupational therapists in Ireland identified socio-cultural norms relating to sexuality, perceived professional competence and confidence and prioritization of resources as key barriers. Education is needed to improve therapists’ perceived competence and confidence in addressing sexuality with older adults. Policy change is required to consider the underlying assumptions about sexuality, ageing and disability.
    Disability and Rehabilitation 06/2013; DOI:10.3109/09638288.2013.805823 · 1.99 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Während der urogenitale Östrogenmangel bei jüngeren oder peri- bis postmenopausalen Frauen bis 55 Jahre gut untersucht ist, fehlen eigenständige Daten für das höhere Frauenalter weitgehend. Zusätzlich werden entsprechende Symptome von den betroffenen Frauen zu selten im Rahmen ärztlicher Konsultationen angesprochen. Eine topische Östrogentherapie ist die bisher wirksamste Behandlung zur Vermeidung einer fortschreitenden Atrophisierung. Es existiert eine breite Palette zusätzlicher pflegender und befeuchtend wirksamer Substanzen, wenn eine Östrogenbehandlung vermieden werden soll.
    Gynäkologische Endokrinologie 11/2013; 11(4). DOI:10.1007/s10304-013-0564-4
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess sexual function among women via self-evaluation of female sexual dysfunction (FSD) and to determine risk factors for FSD among Korean women. A preliminary questionnaire-based study in Ansan, Korea, enrolled 935 women between January and December 2010. Participants completed the Female Sexual Function Index and a self-administered survey. Participants were divided into 2 groups: in the recognized group (RG), women were aware of their sexual problems; in the unrecognized group (URG), women were not. The prevalence of FSD was 46.1% (n=431). The prevalence of recognized FSD was 21.5% (n=201), whereas that of unrecognized FSD was 24.6% (n=230) Younger women showed a significantly more positive attitude toward sex compared with older individuals (P<0.001). Sexual desire, sexual arousal, dyspareunia, lubrication, and sexual satisfaction were factors of sexual dysfunction in the RG. In the URG, sexual arousal, sexual desire, orgasm, dyspareunia, and sexual satisfaction were identified as significant factors. Women in the RG had positive attitudes toward sex, whereas those in the URG had negative attitudes. Women who were unsatisfied with their sexual life did not express a need for treatment. The sociocultural background of Korean women should be considered in the diagnosis and treatment of FSD.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 01/2014; 125(1). DOI:10.1016/j.ijgo.2013.10.006 · 1.54 Impact Factor
Show more