Couplepause: Treating Sexual Dysfunction in Men and Women

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Starting at midlife, men and women face organic changes that can affect sexual functioning.
  • For women, ovarian exhaustion causes estrogen deficiency, leading to menopause, which may include vaginal dryness, irritation/itching, inadequate lubrication, and dyspareunia. Hypoactive sexual desire disorder also can result from biopsychosocial factors.
  • For men, erectile dysfunction prevalence increases with age, and the development of testosterone deficiency.

These are real organic issues with significant psychological implications.

  • Both members of a couple may experience age-related changes concurrently and interdependently.
  • In such cases, it is unhelpful, and sometimes detrimental, to treat the symptoms for only one member of the couple without also treating the other.
  • Therefore, as an evolution of the couple-oriented approaches of Masters and Johnson and others, we introduce the concept of couplepause and the need for a new diagnostic and therapeutic paradigm that addresses the sexual health needs of the aging couple as a whole rather than treating the individual patient in isolation.

The authors reviewed publications relating to couples-based approaches to sexual dysfunction, male perceptions of female sexual dysfunction, female perceptions of male sexual dysfunction, interactions between male and female sexual dysfunctions, sexual dysfunction and midlife changes in homosexual couples, and impact of pharmacologic treatments for sexual dysfunctions on the couple's sexual health. It is foolish and counterproductive to isolate the problems one partner presents with in isolation.

  • Taking a couple-oriented approach to evaluate and manage couplepause in the latter half of life can dramatically and simultaneously help both members of the couple to improve sexual satisfaction and intimacy.

"Couplepause: A New Paradigm in Treating Sexual Dysfunction During Menopause and Andropause," Reviews in Sexual Medicine, In Press Corrected Proof, https://www.sciencedirect.com/science/article/pii/S2050052117301415
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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