性健康和幸福以及更年期：EMAS 临床指南

Sexual health and wellbeing and the menopause: An EMAS clinical guide

——原载《欧洲更年期杂志》2024年第189卷：108055——

<Maturitas> Volume 189: 108055, 2024

【摘要】引言：性健康和幸福是生活质量的重要方面。然而，在医疗实践中，性病史往往被避免记录，导致管理和意识方面的空白。由于更年期会对性健康产生重大影响，因此必须对医疗保健提供者进行适当的性健康和幸福以及相关学科的培训，以实现最佳护理。目的：为更年期及以后的性问题的评估和管理提供循证临床指南。材料和方法：文献综述和专家意见共识。结果和结论：性问题的评估包括病史记录、检查和实验室调查（如有指示），偶尔使用特定的经过验证的问卷。性问题的管理需要采用生物心理社会措施的多维方法。医疗管理和性心理咨询包括药物和非药物干预，以及性治疗和心理教育。此外，如果围绝经期女性希望避免怀孕，应告知她们避孕的必要性。此外，性传播疾病可以在任何年龄感染。总之，性病史调查应纳入医疗实践，医疗保健提供者应接受适当的培训，以评估和管理更年期及以后的性问题。

【关键词】更年期；妇女健康；性健康和福祉；性多样性；性功能障碍；性问题

[Abstract] Introduction: Sexual health and wellbeing are significant aspects of quality of life. However, taking a sexual history is often avoided in medical practice, leaving a void in management and awareness. As the menopause can have a major impact on sexual health, it is imperative that healthcare providers are appropriately trained in sexual health and wellbeing and the aligned disciplines in order to achieve optimal care. Aim: To provide an evidence-based clinical guide for the assessment and management of sexual problems at the menopause and beyond. Materials and methods: Review of the literature and consensus of expert opinion. Results and conclusion: The assessment of sexual problems includes history taking, examination and laboratory investigation (if indicated), and occasionally the use of specific validated questionnaires. Management of sexual problems requires a multidimensional approach using biopsychosocial measures. Medical management and psychosexual counselling include pharmacological and non-pharmacological interventions, and sex therapy and psychoeducation. Furthermore, perimenopausal women should be advised about the need for contraception if they wish to avoid pregnancy. Also, sexually transmitted diseases can be acquired at any age. To conclude, taking a sexual history should be incorporated into medical practice and healthcare providers should be appropriately trained to assess and manage sexual problems at the menopause and beyond.

[Key words] Menopause; Women's health; Sexual health and wellbeing; Sexual diversity; Sexual dysfunction; Sexual problems

论文原文：Stavroula A. Paschou, Kleoniki I. Athanasiadou, Trish Hafford-Letchfield, et al (2024). Sexual health and wellbeing and the menopause: An EMAS clinical guide. Maturitas, Volume 189, November 2024, 108055.

https://doi.org/10.1016/j.maturitas.2024.108055

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