Talking about genital problems with women aged over 70

A comprehensive understanding of the bio-medical and psychosocial mechanisms that underlie age-related deterioration of sexual function and behavior should be the primary goal of any concerned health care provider (HCP) in geriatric medicine. Many older women continue to be interest in sex and some of them look forward to have an agreeable discussion on sexual health in order to express their feelings and needs, especially if the HCP explores their concerns. However, discussing sex means to talk about genital problems with women aged over 70 and this may represent a challenge in daily practice because of several intrapersonal and interpersonal barriers to effective communication (education, attitudes, misconceptions, values). In addition, a poor knowledge of the major determinants of sexuality in elderly women leaves the “Pandora’s box” unopened and HCPs avoid a consultation perceived as too complex to deal with, due also to lack of confidence, time constraints, and other contextual factors [ ]. The PLISSIT (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) model, an acronym for the levels of intervention in office-based sexual counselling, represents a relevant guide for HCPs, who can remain in their comfort zone of knowledge, providing at the same time stepped information [ ]. Actually, there is nothing to worry about in dealing with elderly women’s sexual matters if HCPs keep in mind at least the following two pearls of wisdom and formulate very simple open-ended questions taking into account the impact of age and menopause.