Sexual health and wellbeing and the menopause: An EMAS clinical guide.

Introduction: Sexual health and wellbeing are significant aspects of quality of life. However, taking a sexual history is often avoided in medical practice, leaving a void in management and awareness. As the menopause can have a major impact on sexual health, it is imperative that healthcare providers are appropriately trained in sexual health and wellbeing and the aligned disciplines in order to achieve optimal care.
Aim: To provide an evidence-based clinical guide for the assessment and management of sexual problems at the menopause and beyond.
Materials and Methods: Review of the literature and consensus of expert opinion.
Results and Conclusion: The assessment of sexual problems includes history taking, examination and laboratory investigation (if indicated), and occasionally the use of specific validated questionnaires. Management of sexual problems requires a multidimensional approach using biopsychosocial measures. Medical management and psychosexual counselling include pharmacological and non-pharmacological interventions, and sex therapy and psychoeducation. Furthermore, perimenopausal women should be advised about the need for contraception if they wish to avoid pregnancy. Also, sexually transmitted diseases can be acquired at any age. To conclude, taking a sexual history should be incorporated into medical practice and healthcare providers should be appropriately trained to assess and manage sexual problems at the menopause and beyond.
Competing Interests: Declaration of competing interest Stavroula A. Paschou: none declared. Kleoniki I. Athanasiadou: none declared. Trish Hafford-Letchfield: none declared. Sharron Hinchliff: none declared. Melissa Mauskar: Medical Advisory Board: Nuvig; Grant/research support: Incyte. Margaret Rees: none declared. James A. Simon: Grant/research support: AbbVie, Inc., Bayer Healthcare LLC., Dare´ Bioscience; Ipsen, Mylan/Viatris Inc., Myovant Sciences, Sebela Pharmaceuticals Inc.; Consultant/advisory boards: Bayer HealthCare Pharmaceuticals Inc., Besins Healthcare, California Institute of Integral Studies (CIIS), Dare´ Bioscience, Femasys Inc., Khyria, Madorra Pty Ltd., Mayne Pharma, Inc., Vella Bioscience Inc.; Speaker's bureaus: Astellas Pharma, Inc., Mayne Pharma, Inc., Myovant Sciences, Inc., Pfizer Inc., Pharmavite LLC., Scynexis Inc.; Stockholder (direct purchase): Sermonix Pharmaceuticals. Eleni Armeni: none declared. C. Tamer Erel: none declared. Ivan Fistonić: none declared. Timothy Hillard: Remuneration for talks or consultancy work over the last 5 years from: Theramex, Besins, Astellas, Shionogi. Angelica Lindén Hirschberg: consulting fees from Astellas and Gedeon Richter, research support from Besins and Avia Pharma. Blazej Meczekalski: none declared. Nicolás Mendoza: consulting fees from Exeltis, Organon, Theramex and Novonordisk. Alfred Mueck: Grant/research support: Besins/Dr.Kade Company; Consultancies and/or Lectures: Abbott, Bayer, Besins/Dr.Kade, Exeltis, Gedeon Richter, Hexal, Novartis, Jenapharm, MSD, Schaper and Brümmer, Serelys. Tommaso Simoncini: consulting fees from Abbot, Astellas, Gedeon Richter, Mitsubishi Tanabe, Sojournix, Estetra, Mithra, Actavis, Medtronic, Shionogi, Applied Medical. Speakers' honoraria from Abbott, Shionogi, Gedeon Richter, Intuitive Surgical, Applied Medical, Theramex. Petra Stute: Grant/research support: Schaer Pharma, EFFIK; Consultancies: Theramex, Astellas; Membership of speakers' bureau: Theramex, Jenapharm, Labatec, Exeltis, Besins Healthcare, Astellas, Gedeon Richter, Hexal, Pierre Fabre, Zeller. Dorenda van Dijken: none declared. Irene Lambrinoudaki: research grant from ITF Hellas.
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