Abstract Introduction Omitting the sexual history (SHx) prevents key diagnoses and ignores the therapeutic impact of sexual activity on vital organs. The extensive evidence showing physician–patient disconnection regarding sexual issues was reviewed. Objective The objective is to emphasize the importance of including the sexual history in medical practice, recognizing that sexual activity is not only reproductive but also pleasurable, evolutionary, and therapeutic. Additionally, the study aims to draw attention to over 20 potential diagnoses missed when the SHx is omitted and to demonstrate that active sexual activity helps preserve vital organs such as the brain, heart, bones, and muscles. The alarming prevalence of asexuality in postmenopausal women is highlighted: 45% at age 40, 60% at 50, 75% at 60, 90% at 70, and 98% at 80 years. Methods A systematic literature review and analysis of over 2,000 sexual histories from postmenopausal women treated over more than 15 years at two centers were conducted. The study reviewed extensive evidence showing physician–patient disconnection regarding sexual issues. More than 20 clinical diagnoses can be revealed through a detailed sexual history. Results Clinical experience and literature review reveal a high prevalence of sexual dysfunction in postmenopausal women, including: hypoactive sexual desire disorder, dyspareunia, vulvodynia, vaginismus, hypoactive arousal disorder, anorgasmia, orgasmic dysfunction, sexless marriages, asexuality, hyperactive arousal dysfunction, and hypersexuality of various etiologies, including vestibulodynia. These diagnoses are found in over 47% of women overall, and in 75%-80% of postmenopausal women. Despite growing scientific evidence, many physicians still fail to incorporate sexual health into routine clinical evaluations. Conclusions Addressing sexual health in postmenopausal women is essential to their overall well-being. Medical and residency training programs must integrate the evaluation of sexual health as a priority in the care of women (especially those who are peri- and postmenopausal). Disclosure No
Ibanez et al. (Mon,) studied this question.