Intended for healthcare professionals

Practice Practice Pointer

How to support the sexual wellbeing of older patients

BMJ 2023 ; 380 doi: https://doi.org/10.1136/bmj-2022-072388 (Published 27 March 2023) Cite this as: BMJ 2023;380:e072388
  1. Sharron Hinchliff , professor of psychology and health 1 ,
  2. Rebecca L Mawson , GP and academic training fellow 2 4 ,
  3. Sue Malta , senior researcher 3 ,
  4. Gilli Cliff , PMHCT employment coach and patient advocate 5
  1. 1 Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
  2. 2 The Academic Unit of Primary Medical Care, University of Sheffield, Sheffield
  3. 3 Sexual Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Australia
  4. 4 GPwER SRH, Valley Medical Centre, Stocksbridge, Sheffield
  5. 5 South Yorkshire Housing Association Limited, Sheffield
  1. Correspondence to: S Hinchliff s.hinchliff{at}sheffield.ac.uk

What you need to know

  • Create a culture of openness by using open and inclusive language so that older patients are given permission to discuss sexual issues

  • Consider asking about sexual wellbeing when a patient consults about a chronic condition

  • Mention the potential sexual side effects of drugs during medication reviews or when prescribing new medications

At your age? That is the response many older adults think they might receive after plucking up the courage to ask their GP for help with a sexual issue. Patients often need support with their sexual wellbeing as they age, but seeking help for a sexual problem is not always easy: the journey is mired in uncertainty (“can anything be done?”), embarrassment (“the GP is the same age as my daughter”), and fear of being judged negatively because of ageism (“what if they think I’m past it?”). GPs too can experience their own barriers to providing help.

In this article we offer some pointers for how to support the sexual wellbeing of older patients, with a focus on the consultation. A typical case might be a patient aged 55 whose vaginal soreness is leading to a loss of sex drive, and despite waiting to see if it gets better on its own, has found no improvement. Within months the problem has got worse, her relationship has started to suffer, and she is fearful of the underlying cause. The impact on sexual wellbeing is palpable and the distress drives her to seek help from her GP.

Sexual wellbeing and ageing

Sexual wellbeing refers to the quality of, and satisfaction with, our sexual relationships with others and ourselves. 1 Many older adults view sexual wellbeing as a quality-of-life component and are more likely than previous generations to expect their healthcare professional to support them in this area. 2 3 However, with age related bodily changes …

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