Menopause and aging, quality of life and sexuality

SUMMARY Quality of life and sexuality are key factors to be considered in the management of the aging individual. The aging process sets new standards for quality of life and sexuality. The symptoms and diseases associated with aging also have a variable impact. Likewise, most therapeutic interventions in the aging individual are likely to impact on quality of life or sexual function. In women, the climacteric process adds to the effects of aging. The ensuing hormonal decline has a profound impact on the functionality of the whole organism and causes symptoms that significantly affect quality of life and sexuality. These considerations raise the issue of the importance of enquiring about quality of life and sexuality as part of the routine work-up of the aging patient. The presence of immediate or imminent discomfort demands attention, objective documentation and appropriate intervention. The presence of relevant climacteric symptoms that disrupt quality of life or sexuality might be considered as a hallmark of a biological vulnerability of the individual, which might predict the likelihood of developing degenerative diseases. The administration of individualized hormonal therapies in these patients clearly improves quality of life and sexuality and should therefore be recommended whenever necessary, at the dose and for the time that are necessary to improve symptoms and to give back to the patient a satisfying quality of life and sexual function. The value of the different therapeutic interventions that have the potential to impact on the development or progression of chronic diseases, such as cancer, cardiovascular disease or osteoporosis, should be weighed both for efficacy and cost-effectiveness, but also for the potential to alter (or improve) quality of life and sexual function.