Bringing sex back into the relationship in midlife couples.

Sexual health and sexual well-being are important components of the overall quality of life at midlife, a turning point carrying several biopsychosocial changes. As people age, they are likely to observe a significant increase in sexual difficulties in both sexes affecting every domain of sexual response, and a decline in the frequency of engaging in sexual activity. Women may report hypoactive sexual desire disorder (HSDD) and genitourinary syndrome of menopause (GSM), two very common biologically driven midlife conditions that are often comorbid and may also be influenced by a multitude of individual and contextual risk factors. An appropriate and timely diagnosis is important to avoid chronification of sexual dysfunction that may become refractory to treatment. The therapeutic algorithm comprises a multidisciplinary approach, including pharmacologic and non-pharmacologic management. Individualized treatment is the key to providing integrated care with positive attitudes for the aging couples in order to expand the 'sexspan' of both partners. This article reports our point of view on the topic of midlife sexuality in the context of a stable relationship, as presented at the 19th World Congress on Menopause in Melbourne (Australia) on 22 October 2024.