Nursing Care of the Postmenopausal Woman, 3rd Edition
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It’s not all bad news The reality is that although the transi- tion to menopause brings about physio- logical changes that can adversely affect a woman’s sexual functioning, sexual desire does not end when a woman is no longer menstruating. In fact, for some women, the freedom from worry over conception increases their sexual desire. Women can continue to enjoy sexual activity through- out menopause. The frequency of intima- cy may decline, but as long as a woman stays healthy, enjoyment can increase with age. Some women at midlife report better emotional well-being and higher levels of enjoyment with sexual activity. One study found that even though most menopausal women report decreased desire and arousal, most still report that sex is moderately to extremely important to them (Bildircin et al., 2020). A wom- an’s perceptions of what is important can change as she ages. Her emphasis may now be placed more on love, closeness, and companionship (Bildircin et al., 2020). Women who use lubricants, estrogen creams, or both and remain sexually ac- tive can benefit in several ways. Sexual activity can improve sleep, reduce anxi- ety, enhance feelings of self-worth, and decrease feelings of depression (Bildircin et al., 2020). If a woman who is experienc- ing postmenopause likes who she is be- coming, her attitude will have a positive effect on her sexual function. This chap- ter has discussed some treatments for hormonal and vaginal lubrication issues; however, women with more severe sexual problems with sexual functioning should be referred to sexual counselors.
| NURSING CONSIDERATION
Many women notice changes in their sexual function during the transition to menopause. Nurses should understand the physiologic and psychologic changes that may occur to assist the woman in recognizing and addressing symptoms during this time. TAKING A SEXUAL HISTORY Women have the right to receive non- judgmental, open, honest, and direct communication regarding sexual health and concerns (Cason, 2022). Low libido is a major concern during the menopausal years, but many women do not confide in healthcare professionals about this issue (Kinsberg & Faubion, 2019). Healthcare providers often feel uncomfortable talking about sex. However, it is the nurse’s re- sponsibility to accurately assess the sexu- al aspect of a woman’s health and provide an avenue for exchange of health infor- mation. Making treatment options known and imparting accurate knowledge of these modalities is imperative. A nurse who wants to take an adequate sexual history must understand their own sexuality and be aware of any sexual bias. Taking a sexual history is a major respon- sibility, and for a woman who is experienc- ing the physiological changes, emotional passages, and psychosocial concerns that take place during the menopausal tran- sition, obtaining all the pertinent health information is vital. When obtaining a sexual history, it is important to create an environment of trust and a forum for safe information exchange. The nurse should promote well-being and illness preven- tion and meet the changing health and care needs of women who are transition- ing to menopause.
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