Why Being Prepared to Talk About Sex With Postmenopausal Women Matters: A Sexologist’s Perspective [ID 1001]

INTRODUCTION: Omitting the sexual history (SHx) in medical practice leads to missed diagnoses and neglects the therapeutic potential of sexual activity on vital systems such as the brain, heart, bones, and muscles. This is especially critical in postmenopausal women, where sexual health is often overlooked despite its effect on well-being. METHODS: A systematic literature review was conducted, along with the analysis of over 2,000 sexual histories collected from postmenopausal women across two Miami centers over 15 years. The review focused on identifying missed diagnoses due to SHx omission and quantifying the clinical relevance of incorporating sexual health in routine evaluations. RESULTS: The data reveal a high prevalence of sexual dysfunction in postmenopausal women, including hypoactive sexual desire disorder, dyspareunia, vaginismus, vulvodynia, arousal and orgasmic disorders, asexuality, hypersexuality, and sexless partnerships. These diagnoses were present in over 47% of all women studied, and in 75–80% of postmenopausal women. Literature also highlights widespread physician discomfort or avoidance in discussing sexuality, resulting in diagnostic and therapeutic gaps. Prevalence of asexuality increased sharply with age, reaching over 90% by age 70 and nearly 98% at 80. CONCLUSIONS/IMPLICATIONS: Sexual health is a fundamental aspect of postmenopausal care. Its evaluation must be prioritized in medical training and routine clinical assessments. Physicians across all specialties must be equipped to take an SHx, identify dysfunctions, and refer appropriately. Incorporating SHx improves diagnostic accuracy, treatment quality, and supports holistic care for aging women.