Postmenopausal Care and Sexual Function

How I Practice Video Series
Ann L. Honebrink, MD, FACOG


When I see women after menopause, I always bring up at least once a year the question of how their sexual function is going. How I’ll ask about it will vary from woman to woman and I try to use terms that I’ll expect them to be comfortable with. Many women aren’t really comfortable talking about their sex lives but just saying are you experiencing any more dryness or any difficulties having sex or how are things with your love life or there’s a variety of different ways to come to it but I try to be clear that I’m talking about how sex is going for them and how their relationship is if I know they’re in a long-term relationship. Most women do experience some change in sexual function and many couples have changes in libido. Often the male partner, if there is a male partner, will have had prostate problems and that will affect his sexual function so part of what I do is try to help normalize changes for that patient and her partner and let them know that this is a very common problem that comes for almost everybody to some extent as they get older. And how they deal with it is really up to them. There are tools that I have that can help with function. I can help give them some hints about what they might want to talk about in their relationship to try to let their partner know what they want or how they’re feeling and to address issues in the relationship that are affecting the sexual function but don’t really have anything to do with the aging process. But in general that there is help but it’s also something that is normal and you don’t need help if you don’t feel like you need help with it. And that the intimacy in the long-term relationship is really probably what’s most important to the couples. But once that’s done if they need help we talk about how there are estrogen receptors everywhere in the body but there’s probably a higher concentration in the lower part of the vagina and once estrogen’s been gone for a while function changes and there are many ways/vehicles that we can get estrogen into the vagina and other helpful things such as lubricants that can be used to help with sexual function. And if the patient elects to use them we follow up and make sure that they’re working and often patients are very grateful that we’ve brought up the issue because it’s not something that a lot of patients will bring up on their own. And that’s how I practice.


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