Introduction

Sexual response is a complex psychological and physiological event. It is truly psychosomatic, involving the body and the mind. It is influenced by hormones, the wholeness of the body and neurological factors. It is influenced by the experience of being held and loved as babies and children, by the sum total of all the experiences, good and bad, in life, by mood, health, stress, the nature of the relationship with the lover, and societal and personal belief systems.

A woman's sexual response changes as she ages. In addition to the effects of ageing itself, other factors in her life will have an impact. Experiences of infertility, conception, delivery, parenting, menopause, gynaecological procedures and cancer are but a few of them. Here, I attempt to look at some of these factors. There is a wealth of literature about some aspects but it is a difficult subject to quantify. When confronted with any patient, I believe it is important to see that person as a unique individual and this is even more important when the person presents a sexual problem. Generalisations are only helpful if we can first focus on the person in front of us.

Evidence

Studies to look at sexual problems are difficult to perform. The response rate is often low, possibly because inhibited people may be less likely to respond. Cross-sectional studies look at a group at a point in time.