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Minerva Obstetrics and Gynecology 2022 Feb 02

DOI: 10.23736/S2724-606X.22.05001-1


lingua: Inglese

Menopause and female sexual dysfunctions (FSDs)

Laura CUCINELLA 1, 2 , Ellis MARTINI 1, Lara TIRANINI 1, 2, Federica BATTISTA 1, 2, Pietro MOLINARO 1, 2, Arianna CASIRAGHI 3, 4, Selene COMINOTTI 5, Manuela PICCININO 1, Roberta ROSSINI 1, Rossella E. NAPPI 1, 2

1 Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia, Italy; 2 Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; 3 School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; 4 Urogynecology Unit, Division of Gynecology and Obstetrics, IRCCS San Raffaele Scientific Institute, Milan, Italy; 5 Department of Obstetrics and Gynecology, Filippo Del Ponte Hospital, University of Insubria, Varese, Italy


Biological and psycho-relational factors contribute equally to the development of sexual symptoms and associated distress, a key element to diagnose female sexual dysfunctions (FSDs) in menopausal women. Consultation at midlife represents an optimal time to discuss sexual life, and healthcare providers (HCPs) have to be proactive in rising the conversation, as patients may not report their sexual concerns spontaneously. An accurate sexual history is essential to characterize the primary symptom, determine the impact on patient’s quality of life and identify risk and precipitating factors. Among FSDs, hypoactive sexual desire disorder (HSDD) is very frequent at midlife together with genitourinary syndrome of menopause (GSM), a chronic condition negatively affecting the full sexual response. A multidimensional approach targeted to the patient’s characteristics, goals and expectations is mandatory and should start from educative counselling and correction of modifiable risk factors. When specific treatments are required, they should include non-pharmacological and pharmacological options, often prescribed in combination to address concomitantly the biological and psychosocial components of FSDs.

KEY WORDS: Menopause; Female sexual dysfunctions (FSDs); Hypoactive sexual desire disorder (HSDD); Genitourinary syndrome of menopause (GSM); Vulvovaginal atrophy (VVA)

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