Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-23T01:49:42.954Z Has data issue: false hasContentIssue false

5 - Sexual health

from Part I - Health promotion

Published online by Cambridge University Press:  21 August 2009

Margaret R. H. Nusbaum
Affiliation:
Department of Family Medicine, University of North Carolina, Chapel Hill, NC, USA
Jo Ann Rosenfeld
Affiliation:
The Johns Hopkins University
Get access

Summary

Case: a 50 year-old woman presents for her wellness exam. She has no chronic illnesses or allergies, and she is on no medications. She is married, has five children, and has not worked outside of the home since she was married at age 22. Her review of systems is remarkable for tearfulness and occasional feelings of “nervousness.” The youngest, and last of her five children to leave home, leaves for college in ten days.

Importance

Sexuality and sexual health are some of the least scientifically studied areas of health and human interaction, and the sexual health of mid-life women is no exception.

Sexuality is much more then sexual behavior. Sexuality is an important part of one's health, quality of life, and general wellbeing. Sexuality is an integral part of the total person, affecting the way each individual – from birth to death – relates to herself, her sexual partner(s), and every other person. This time of life can and should be a tremendously positive time for women in regards to sexual health. How a woman successfully navigates sexual health risks depends on the complexity of how she defines herself and her sexuality in relationship to aging, menstruation, childbearing capability, success with overcoming challenges of her past, and the quality of intimate partnership(s). Risks to sexual health can include unplanned pregnancy, the physiologic changes of transition into and through menopause and with aging, the increased probability of chronic illness and its medical and surgical treatment, abuse in any form, and sexually transmitted infections.

Type
Chapter
Information
Women's Health in Mid-Life
A Primary Care Guide
, pp. 61 - 80
Publisher: Cambridge University Press
Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Association of Sex Educators, Counselors and Therapists: http://www.aasect.org
Sexuality Information and Education Council of the US: http://www.siecus.org
Gay and Lesbion Medical Association (GLMA): http://www.glma.org
AARP/Modern Maturity Sexuality Study: http://research.aarp.org/health/mmsexsurvey_1.htm
Renshaw, D. C.Sexology. J. Am Med. Assoc. 1984; 252:2291–6CrossRefGoogle Scholar
Laumann, E. O., Gagnon, J. H., Michael, R. T. and Michael, S. The Social Organization of Sexuality: Sexual Practices in the United States. Chicago: University of Chicago Press; 1994
Nusbaum, M. R. H., Helton, M. R. and Ray, N. The changing nature of women's sexual health concerns through the midlife years. Ann. Fam. Med., submitted
Malatesta, V. J.Sexuality and the older adult: an overview with guidelines for the health care professional. J. Women Aging 1989; 1:93–118CrossRefGoogle Scholar
Hvas, A.[Positive experiences in connection with menopause.]Ugeskr. Laeger 2002; 164:2614–17Google Scholar
Avis, N.Perception of the menopause. Womens Eur. Menopause J. 1996; 3:80–84Google Scholar
Locke, M.Menopause: Lessons from anthropology. Psychosom. Med. 1998; 60:410–19CrossRefGoogle Scholar
Nusbaum, M. R., Hamilton, C. and Lenahan, P. Sexual health care needs of midlfe women. J. Women Health Gend. Based Med., submitted
Abramov, L.Sexual life and sexual frigidity among women developing acute myocardial infarction. Psychosomat. Med. 1976; 38:418–25CrossRefGoogle ScholarPubMed
Banister, E. M.Women's midlife confusion: “why am I feeling this way?”. Issues in Ment. Health Nurs. 2000; 21:745–64CrossRefGoogle Scholar
Hunter, M. S.Predictors of menopausal symptoms: psychosocial aspects. Baillieres Clin. Endocrinol. Metab. 1993; 7:33–45CrossRefGoogle ScholarPubMed
Mansfield, P., Koch, P. B. and Voda, A. M.Midlife women's attributions for their sexual response changes. Health Care Women Int. 2000; 21:543–59Google ScholarPubMed
Avis, N., Stellato, R., Crawford, S., Johannes, C. and Longcope, C.Is there an association between menopause status and sexual functioning?J. Am. Geriatr. Soc. 1972; 20:151–8Google Scholar
Huerta, R., Mena, A., Malacara, J. M. and Diaz de Leon, J.Symptoms at perimenopausal period: its association with attitudes toward sexuality, life-style, family function, and FSH levels. Psychoneuroendocrinology 1995; 20:851–64CrossRefGoogle ScholarPubMed
Bancroft, J.Endocrinology of sexual function. Clin. Obstet. Gynaecol. 1980; 7:253–81Google ScholarPubMed
Basson, R.Androgen replacement for women. Can. Fam. Physician 1999; 45:2100–107Google ScholarPubMed
Davis, S.The clinical use of androgens in female sexual disorders. J. Sex Marital Ther. 1998; 24:153–63CrossRefGoogle ScholarPubMed
Warnock, J., Bundren, J. C. and Morris, D. W.Female hypoactive sexual disorder: case studies of physiologic androgen replacement. J. Sex Marital Ther. 1999; 25:175–82CrossRefGoogle ScholarPubMed
Cutler, W., Garcia, C. R. and McCoy, N.Perimenopausal sexuality. Arch. Sex. Behav. 1987; 16:225–34CrossRefGoogle ScholarPubMed
McCoy, N., Culter, W. and Davidson, J. M.Relationships among sexual behavior, hot flashes, and hormone levels in perimenopausal women. Arch. Sex. Behav. 1985; 14:385–94CrossRefGoogle ScholarPubMed
Dennerstein, L., Smith, A. M., Morse, C. A. and Burger, H. G.Sexuality and the menopause. J. Psychosomat. Obstet. Gynecol. 1994; 15:59–66CrossRefGoogle ScholarPubMed
Hackbert, L. and Heiman, J. R.Acute dehydroepiandrosterone (DHEA) effects on sexual arousal in postmenopausal women. J. Womens Health Gend. Based Med. 2002; 11:155–62CrossRefGoogle ScholarPubMed
Levine, S. Sexuality in Midlife. New York: Plenum Press; 1998
Cawood, E. and Bancroft, J.Steroid hormones, the menopause, sexuality and well-being of women. Psychol. Med. 1996; 26:925–36CrossRefGoogle Scholar
Garth, D., Cooper, P. and Day, A.Hysterectomy and psychiatric disorder: I. Levels of psychiatric morbidity before and after hysterectomy. Br. J. Psychiatry 1980; 140:335–42Google Scholar
Rhodes, J., Kjerluff, K., Laugenberg, P. and Guzinski, G.Hysterectomy and sexual functioning. J. Am. Med. Assoc. 1999; 282:1934–41CrossRefGoogle ScholarPubMed
Basson, R., Berman, J., Burnett, A., et al.Report of the international consensus development conference on female sexual dysfunction: definitions and classifications. J. Urol. 2000; 163:888–93CrossRefGoogle ScholarPubMed
AIDS Action. What's New. www.aidsaction.org. Accessed January 3, 2003
Nusbaum, M. R. H., Hamilton, C. and Lenahan, P.Health issues and sexuality. Am. Fam. Physician 2003; 67:347–54Google Scholar
Woodrum, S. T. and Brown, C. S.Management of SSRI-induced sexual dysfunction. Ann. Pharmacother. 1998; 32:1209–15CrossRefGoogle ScholarPubMed
Annon, J. S. The Behavioral Treatment of Sexual Problems, Vol. 1. Oahu, Hawaii: Enabling Systems Inc.; 1974
Nurnberg, H., Lauriello, J., Hensley, P. L., Parker, L. M. and Keith, S. J.Sildenafil for sexual dysfunction in women taking antidepressants. Am. J. Psychiatry 1999; 156:1664CrossRefGoogle ScholarPubMed
Caruso, S., Intelisano, G., Lupo, L. and Agnello, C.Premenopausal women affected by sexual arousal disorder traeted with sildenafil: a double blind, cross-over, placebo-controlled study. Br. J. Obstet. Gynaecol. 2001; 108:623–8Google Scholar
Andersson, K. E. and Wagner, G.Physiology of penile erection. Physiol. Rev. 1995; 75:191–236CrossRefGoogle ScholarPubMed
Goldstein, I., Lue, T. F., Padma-Nathan, H., Rosen, R., Steers, W. D. and Wicker, P. A.Oral sildenafil in the treatment of erectile dysfunction. N. Engl. J. Med. 1998; 338:1397–404CrossRefGoogle ScholarPubMed
Heiman, J. R. and LoPicolo, J. Becoming Orgasmic: A Sexual and Personal Growth Program for Women. New York: Prentice Hall; 1988
Palmore, E.Predictors of the longevity difference: a 25-year follow up. Gerontologist 1982; 22:513–18CrossRefGoogle ScholarPubMed
O'Hanlan, K., Cabaj, R., Schatz, B., Lock, J. and Nemrow, P.A review of the medical consequences of homophobia with suggestions for resolution. J. Gay Lesbian Med. Assoc. 1997; 1:25–39CrossRefGoogle Scholar
Harrison, A.Primary care of lesbian and gay patients: educating ourselves and our students. Fam. Med. 1996; 28:10–23Google ScholarPubMed
Deevey, S. Lesbain health care. In: C. I. Fogel and N. F. Woods (eds.). Women's Health Care: A Comprehensive Handbook. Thousand Oaks, CA: Sage Publications; 1995. pp. 189–206
Nusbaum, M. R. H. Sexual Health. Monograph no. 267 Leawood, KS: American Academy of Family Physicians; 2001

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Sexual health
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University
  • Book: Women's Health in Mid-Life
  • Online publication: 21 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545672.005
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Sexual health
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University
  • Book: Women's Health in Mid-Life
  • Online publication: 21 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545672.005
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Sexual health
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University
  • Book: Women's Health in Mid-Life
  • Online publication: 21 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545672.005
Available formats
×