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Abstract
The interactions between the biological, psychological, social and cultural dimensions of sexuality as they impinge on a woman's sexual health from the menopause and beyond are considered. The various sexual problems encountered at this time are not so different from those occurring earlier in life, but in the final life-stage, they arise in a context of involution. Those not involved in relationships may still have problems relating to sexuality—changes in body image and regrets at never having reproduced are common themes. Consideration is given to the impact of a premature or surgical menopause and to whether ‘storm and stress’ in the perimenopause are necessary or functional for continuing sexual health into old age. The short- and long-term effects of oestrogen withdrawal and the option for replacement therapy are discussed, particularly in relation to the demographic trend towards an increasing proportion of post-menopausal women in the UK.