A case report - Multidisciplinary approach to sexual dysfunction in post-menopausal women in Singapore

Introduction & Rationale: This case highlights the multidisciplinary approach used in the management of sexual dysfunction in post-menopausal women. A 52-year-old Chinese female presented with an 8-month history of worsening dyspareunia, low libido and secondary anorgasmia. She was on continuous menopause hormone therapy (MHT) that was initiated 2 years prior. Her initial presenting complaints were hot flushes, sleep disruption, vaginal dryness and mood instability – all of which resolved with MHT. She was found to have secondary vaginismus contributed by stressors that perpetuated the sexual dysfunction cycle. Predisposing factors included mild stress incontinence since the birth of her second child 18 years ago and work-related stress. Psycho-social factors included anxiety about not being able to satisfy her husband’s sexual needs leading to his infidelity, and the impact on her marriage.