Menopause, depression, and loss of sexual desire: a psychodynamic contribution

Menopause is a phase of life during which physiological and psychological symptoms may occur. Most women traverse the menopausal transition without significant morbidity. The descriptive literature on menopause indicates that the nature of psychological and physical morbidity is a function of a variety of bio-psychosocial influences. There are distinct subgroups of women who are more likely to become symptomatic during this phase. Rosemary Basson has reconceptualized the female sexual response cycle. Her model allows the clinician to better understand and treat the reciprocal, interacting influences of depression, menopausal changes, and decreases in sexual desire on sexual functioning. Psychodynamic theories about menopause have moved away from the early models which predicted a universally negative experience. It is now believed that past psychological and medical problems, trauma, and the quality of interpersonal relationships are important predictors for the development of symptoms. Psychodynamic psychotherapy, in conjunction with psychoeducation, pharmacotherapy and hormone replacement therapy (HRT) may all be helpful in the treatment of symptoms.