![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Sexual well-being frequently declines following the menopause transition and can be associated with significant personal and relationship distress. This distress is the hallmark of female sexual dysfunction (FSD). FSD is highly prevalent in postmenopausal women. The prevalence of sexual problems increases with age, but conversely this is associated with decreasing distress with advancing age. This pattern has been seen across multiple international populations with varied cultural norms. While the etiology of FSD is multifactorial, the physiological changes of sex hormone insufficiency and postmenopausal symptoms, such as dyspareunia, are primary factors contributing to FSD at midlife. The International Menopause Society is working to increase awareness of FSD and to provide a framework for practitioners to address sexual medicine concerns. This White Paper aims to review the process of care for female sexual well-being following menopause, from initially approaching the discussion of FSD, to identifying clinical signs and symptoms, and ultimately determining the best available biopsychosocial therapies. As with most processes of care, the first step is often the most difficult. Health-care practitioners need to broach the topic of sexuality in the clinical setting. Lack of information on, comfort with, and biases about the topic of sexuality after menopause are significant hurdles that the International Menopause Society addresses in this document. Each member of the Writing Group remains committed to continued advocacy for the validity of FSD as a diagnosis, the need for therapies for women to be both available and included in health insurance coverage, and continued therapeutic research to provide evidence-based solutions.
Conflict of interest
J. A. Simon has served (within the last year) or is currently serving as a consultant to or on the advisory boards of: AbbVie, Inc. (North Chicago, IL), Allergan, Plc (Parsippany, NJ), AMAG Pharmaceuticals, Inc. (Waltham, MA), Amgen (Thousand Oaks, CA), Ascend Therapeutics (Herndon, VA), Bayer HealthCare Pharmaceuticals Inc. (Whippany, NJ), CEEK Enterprises, LLC. (Cambridge, MA), Covance Inc., (Princeton, NJ), Millendo Therapeutics, Inc. (Ann Arbor, MI), Mitsubishi Tanabe Pharma Development America, Inc. (Jersey City, New Jersey), ObsEva SA (Geneva, Switzerland), Radius Health, Inc. (Waltham, MA), Sanofi S.A. (Paris, France), Sebela Pharmaceuticals, Inc. (Roswell, GA), Shionogi Inc. (Florham Park, NJ), Symbiotec Pharmalab (Indore, India), TherapeuticsMD (Boca Raton, FL), and Valeant Pharmaceuticals (Laval, Canada). He has also served (within the last year) or is currently serving on the speaker’s bureaus of: AMAG Pharmaceuticals, Inc. (Waltham, MA), Duchesnay USA (Rosemont, PA), Novo Nordisk (Bagsvrerd, Denmark), Shionogi Inc. (Florham Park, NJ), and Valeant Pharmaceuticals (Laval, Canada). In the last year he has received or is currently receiving grant/research support from: AbbVie, Inc. (North Chicago, IL), Allergan, Plc (Parsippany, NJ), Agile Therapeutics (Princeton, NJ), Bayer Healthcare LLC. (Tarrytown, NY), Dornier MedTech (Munich, Germany), Endoceutics, Inc. (Quebec, Canada), GTx, Inc. (Memphis, TN), Ipsen (Paris, France), Myovant Sciences (Basel, Switzerland), New England Research Institute, Inc. (Watertown, MA), ObsEva SA (Geneva, Switzerland), Palatin Technologies (Cranbury, NJ), Symbio Research, Inc. (Port Jefferson, NY), TherapeuticsMD (Boca Raton, FL), and Tissue Genesis (Honolulu, HI). Dr Simon is a stockholder (direct purchase) in Sermonix Pharmaceuticals (Columbus, OH).
S. R. Davis has received honoraria from Abbott Australia, Pfizer Pharmaceuticals and Besins Healthcare and research funding support from Lawley Pharmaceuticals.
S. E. Althof is an investigator or member of an advisory board for: AMAG/Palatin, Clinical Outcomes Solutions, Endoceutics, Ixchelsis, Promescent, Strategic Science Technologies and Sprout/Valeant.
P. Chedraui has no disclosure of interest to declare.
A. H. Clayton has received grants from: Axsome, Endoceutics, Inc., Janssen, Palatin Technologies, Sage Therapeutics, and Takeda. She is a consultant or member of a scientific advisory board for: Alkermes, AMAG Pharmaceuticals, Inc., Fabre-Kramer, Ivix, Palatin Technologies, S1 Biopharma, Sprout Pharmaceuticals, Valeant Pharmaceuticals, and Takeda. She has received royalties/copyright from: Ballantine Books/Random House, Changes in Sexual Functioning Questionnaire, and Guilford Publications. She has shares/restricted stock units in: Euthymics and S1 Biopharma.
S. A. Kingsberg is a consultant for, member of scientific advisory board or clinical investigator for: AMAG, Endoceutics, TherapeuticsMD, Pfizer, Palatin Technologies, Emotional Brain, Valeant Pharmaceuticals, Sermonix Pharmaceuticals, Duchesney, Dare, IVIX, GTx, Materna, Strategic Scientific Solutions (SST), Sprout Pharmaceuticals, and Lupin.
R. E. Nappi has received fees as a speaker for Novo Nordisk, Bayer Healthcare AG, Pfizer Inc., MSD, TEVA Women’s Health Inc., Shionogi Limited, Gedeon Richter, Exceltis and Endoceutics. She is a member of scientific advisory boards for Bayer Healthcare AG, MSD, TEVA Women’s Health Inc., Shionogi Limited, and Gedeon Richter. She has received research grants from Shionogi Limited and Gedeon Richter.
S. J. Parish is a member of scientific advisory boards for: Allergen, AMAG, and Duchesnay Pharmaceuticals. She has received fees as a speaker for: AMAG and Valeant Pharmaceuticals and has acted as a consultant for Strategic Science Technologies. She has received writing support, with no compensation, from Allergen and Pfizer Pharmaceuticals.
W. Wolfman has been on the advisory boards for Pfizer and Acerus. She has received fees as a speaker for Pfizer, Merck and Searchlight. She has received a grant from Pfizer for fellowship training and research.