Guidelines on sexual health for women of reproductive age in Singapore

Introduction: Sexual health is integral to women’s overall well-being, yet sexual dysfunction among women of reproductive age remains under-recognised and undertreated. These guidelines provide evidence-based recommendations for the screening, assessment, education, and optimisation of sexual health in this population. Methods: A multidisciplinary workgroup developed these guidelines using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE)-ADOLOPMENT framework, supplemented by the appraisal of existing international guidelines using the Appraisal of Guidelines for Research & Evaluation II instrument. Two systematic reviews evaluated evidence on sexual health screening and interventions in women aged 21–45 years. The recommendations were adopted, adapted, or developed de novo based on certainty of evidence, balance of benefits and harms, patient values, resource considerations, and local applicability, and are classified as either evidence-informed or consensus-based with source attributions documented in a master recommendation table. Consensus was achieved through iterative discussion and formal voting across 2 rounds, with all recommendations reaching 100% agreement among the 20-member workgroup. Results: These guidelines cover 4 core domains: (1) Screening—promoting proactive sexual health discussions and the use of validated assessment tools; (2) Assessment—differentiating transient concerns from persistent dysfunction while considering medical, psychosocial, and relational contributors; (3) Education—enhancing sexual health literacy, promoting safe practices, and normalising variation; and (4) Optimisation—managing underlying medical conditions, promoting pelvic health, and facilitating timely specialist access. Special considerations for preconception, antenatal, postnatal, and other high-risk groups are included. Conclusion: These guidelines provide a structured, evidence-based framework to support sexual health among women of reproductive age. Implementation may enhance early identification and promote holistic, patient-centred management of sexual dysfunction, supporting positive sexual and overall health outcomes.