The Systemic Nature of Sexual Functioning in the Postmenauposal Woman: Crossroads of Psychiatry and Gynecology

Jeanne Leventhal Alexander, Krista Kotz, Lorraine Dennerstein, Susan R. Davis

    Research output: Contribution to journalReview ArticleResearchpeer-review

    4 Citations (Scopus)


    How is sexual function affected by menopause? Changes in circulating levels of estrogen and androgens during the peri- and postmenopausal years have a far-reaching impact on sexual symptoms in some women. Many factors influence whether or not a woman experiences a symptom and whether or not she finds it distressful. Likelihood of experiencing sexual symptoms depends on age and menopausal status. For those women who do experience sexual symptoms, and where these symptoms can be attributed to reduced levels of gonadal hormones, the use of estrogen or estrogen plus testosterone replacement therapy can be successful in improving sexual function. However, it is important to recognize that in addition to this biologic etiology of new-onset sexual symptoms in the postmenopausal woman, several nonbiologic domains influence sexual functioning as well. These domains could be thought of as being interpersonal, sociocultural or psychosocial, and psychological in nature. A woman's sexual function depends on the dynamic interplay of these factors. The clinician should identify sexual problems that are of new onset with the menopausal transition and causing distress to the woman; separate biologic from nonbiologic causes of symptoms; and design a treatment plan based on the dynamic interplay of these factors.

    Original languageEnglish
    Pages (from-to)53-57
    Number of pages5
    JournalPrimary Psychiatry
    Issue number12
    Publication statusPublished - Dec 2003

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