Sexual Wellness

Couplepause: Addressing Sexual Wellness Together

July 22, 2022

By: Rachel Noonan, PharmD

When long-term couples approach an end to their hormonal honeymoon and the phases of menopause and andropause begin to have a marked negative impact on sexual function and intimacy, the combined disruption can have a significant effect on the health of the relationship. Some patients believe the decline in their quality of life is inevitable. Others feel hopeless, thinking their partner no longer desires the connection they once shared. Clouded by misinformation, patients tend to shoulder the burden of aging alone.

It doesn’t have to be this way. Patients aren’t experiencing hormonal shifts in a vacuum, but in the context of their relationships. Taking a couple-oriented approach to these developments is called couplepause. Couplepause is a novel way of thinking where menopause and andropause symptoms are addressed together. Recognizing the significance of attending to the couple as a whole has created a paradigm shift in perspective, revolutionizing how providers practice.

During couplepause, the problem is cyclical. If one person experiences sexual dysfunction, that struggle echoes across the partnership. A patient’s discomfort causes stress and emotional strain for their counterpart, likely exacerbating insecurities they may be facing individually. The potential for expressions of this disharmony during intimacy only grows, creating new challenges for the couple.

Lack of education regarding the natural changes menopause and andropause creates an even greater rift between partners. As a provider, familiarizing patients with the normalcy of their journey will build understanding. Promoting open dialogue about the realities of aging and the steps couples can take together strengthen their connection and trust in you.

To create space for meaningful patient connection, begin by asking after your patient’s health and happiness regarding their relationships. Studies show patients are not initiating conversations about their sexual health independently; open-ended questions encourage participation. By bringing difficult subjects to light, the opportunity for targeted clinical assessment and varied therapy may arise. Normalizing these complaints and experiences will ease the burden of secrecy and shame. 

There are limitations to this approach. Current research predominantly investigates heterosexual relationships characterized by their long length and stability. Patient privacy is also of great concern. Not all couples will be open to joint counseling; consent is mandatory to conduct these conversations with care.

Intimacy satisfaction and relationship contentment won’t happen overnight. Couples must be willing to do the work. Cultivating a safe and open environment with your patients, models communication patterns essential for growth. In time, your combined efforts will find room to bloom.

References

  1. Bachmann GA, Leiblum SR. The impact of hormones on menopausal sexuality: a literature review. Menopause. 2004 Jan-Feb;11(1):120-30. doi: 10.1097/01.GME.0000075502.60230.28. PMID: 14716193.
  2. Corona G, Petrone L, Mannucci E, Magini A, Lotti F, Ricca V, Chiarini V, Forti G, Maggi M. Assessment of the relational factor in male patients consulting for sexual dysfunction: the concept of couple sexual dysfunction. J Androl. 2006 Nov-Dec;27(6):795-801. doi: 10.2164/jandrol.106.000638. Epub 2006 Jun 28. PMID: 16809271.
  3. Covey, Stephen R. The 7 Habits of Highly Effective People: Restoring the Character Ethic. New York: Free Press, 2004.
  4. Elena Colonnello, Erika Limoncin, Giacomo Ciocca, Andrea Sansone, Daniele Mollaioli, Giancarlo Balercia, Hartmut Porst, Hui Zhang, Xi Yu, Yan Zhang, Emmanuele A. Jannini, The Lost Penis Syndrome: A New Clinical Entity in Sexual Medicine, Sexual Medicine Reviews,Volume 10, Issue 1,2022, Pages 113-129, ISSN 2050-0521, https://doi.org/10.1016/j.sxmr.2021.08.001.
  5. Fisher WA, Donahue KL, Long JS, Heiman JR, Rosen RC, Sand MS. Individual and Partner Correlates of Sexual Satisfaction and Relationship Happiness in Midlife Couples: Dyadic Analysis of the International Survey of Relationships. Arch Sex Behav. 2015 Aug;44(6):1609-20. doi: 10.1007/s10508-014-0426-8. Epub 2014 Nov 5. PMID: 25370356.
  6. Granville L, Pregler J. Women’s Sexual Health and Aging. J Am Geriatr Soc. 2018 Mar;66(3):595-601. doi: 10.1111/jgs.15198. Epub 2018 Jan 24. PMID: 29363110.
  7. Jannini EA, Nappi RE. Couplepause: A New Paradigm in Treating Sexual Dysfunction During Menopause and Andropause. Sex Med Rev. 2018 Jul;6(3):384-395. doi: 10.1016/j.sxmr.2017.11.002. Epub 2018 Jan 19. PMID: 29371146.
  8. E. Maseroli, E. Fanni, E. Mannucci, M. Fambrini, E.A. Jannini, M. Maggi, L. Vignozzi. Which are the Male Factors Associated with Female Sexual Dysfunction (FSD)? The Journal of Sexual Medicine, Volume 13, Issue 6, Supplement, 2016, Page S252, ISSN 1743-6095, https://doi.org/10.1016/j.jsxm.2016.04.029.
  9. Parish SJ, Hahn SR, Goldstein SW, Giraldi A, Kingsberg SA, Larkin L, Minkin MJ, Brown V, Christiansen K, Hartzell-Cushanick R, Kelly-Jones A, Rullo J, Sadovsky R, Faubion SS. The International Society for the Study of Women’s Sexual Health Process of Care for the Identification of Sexual Concerns and Problems in Women. Mayo Clin Proc. 2019 May;94(5):842-856. doi: 10.1016/j.mayocp.2019.01.009. Epub 2019 Apr 4. PMID: 30954288.

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