267 Nursing Care of the Postmenopausal Woman, 3rd Edition
cy, and reproduction. Sexual health is the state of physical, emotional, mental, and social well-being in relation to sexu- ality (World Health Organization [WHO], 2022b), and sexual concerns are fre- quently under evaluated and undertreat- ed during the menopausal period (Kings- berg & Faubion, 2019). Sexual function and response often change with age in both sexes (Kingsberg & Faubion, 2019; Perez-Herrezuelo et al., 2020). Sexual ac- tivity, function, and behavior are all facets of sexuality and are important markers of quality of life in older adults. Sexual ac- tivity is associated with decreased risk of chronic diseases and mental and physical well-being (Ricoy-Cano et al., 2020). Sex can have numerous health benefits when engaged in freely. It can extend the life span (Cason, 2022). Sexuality is how a person experiences erotic sensations or pleasures and how that person expresses themselves as a sexual being. Sexual in- timacy is a basic need for emotional and physical closeness to another person. Healthy sex can lead to feelings of hap- piness and life satisfaction (Cason, 2022; WHO, 2022b). Many women and their caregivers may shy away from talking about sexual concerns and leave prob- lems unevaluated and untreated. Sexual health is important to a woman’s overall feeling of well-being, and disruptions in sexual function may cause an interruption in both physical and emotional health (Kingsberg & Faubion, 2019). With women living longer after meno- pause, they are thinking more about qual- ity-of-life issues, and this includes sexual health. Women have the right to have in- timate and sexual lives that are voluntary, noncoercive, not dictated, and pleasur- able. A woman’s sexuality is influenced by ethical, cultural, moral, and spiritual fac-
tors. The ways in which a woman views herself in society, in her community, and in her family all influence sexuality. The way in which a woman learns of sexuality and romantic relationships is also a factor. Components of female sexual practices and behaviors include fantasy, stimula- tion, erotica, open communication, and noncoital interactions. Understanding and accurately assessing sexual behav- iors are integral factors in caring for the menopausal woman (Cason, 2022; WHO, 2022a). Gender roles (masculine versus fem- inine) and the perception of body im- age play integral roles in sexual identity (Ricoy-Cano et al., 2020). Many forces, including the environment, the social milieu, morality, economics, and demo- graphics, shape sexuality. Role expecta- tions, gender identification, stereotyping, cultural implications, personal values, and religion are but a few influences that mold and determine a woman’s sexuality. A woman’s decisions regarding childbear- ing further add to her sexual journey (Ri- coy-Cano et al., 2020). An important consideration in female sexuality is a woman’s sexual orientation. Sexual orientation is defined as the at - traction an individual develops to a part- ner. Sexual orientation and sexual identity are components of overall sexuality. It is important for nurses to remember that different women have different styles of sexual expression. No two women are the same, and care plans and treatment must be individualized. Sexual lifestyles are another compo- nent of sexual practices and behaviors. To understand sexuality, adequate knowl- edge and comprehension of sexual life- styles is necessary. Many authors have defined sexual lifestyles. Categories may
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