Sexuality and The Midlife Woman

Abstract
Both physical and psychological factors affect the sexual interest and behavior of women at midlife. Hot flashes and genitourinary atrophy are the major menopausal complaints and may affect the ease and comfort of sexual exchange, although hormone replacement therapy can be helpful in reducing these symptoms. Changes in the sexual response cycle occur as well and may be attributable to the psychological and/or physical effects of aging, the partner's physical or psychological difficulties and/or the hormonal changes associated with the climacteric. Many women note a decline in sexual desire during the climacteric years, although orgasmic response is usually unimpaired. Hysterectomy, the second most commonly performed major surgical operation, can either enhance or diminish sexual comfort, depending on the women's preoperative distress and expectations. Often, sexual difficulties can be avoided at midlife by alterations in the sexual script.