Psychological and sexual aspects of the menopause

Female psychiatric morbidity appears to be highest during the middle years, with an apparent increase around the time of the menopause. Oestrogen replacement therapy may improve psychological symptoms, but the effects of testosterone and progestogens are less clear. There appears to be an adverse effect of both increasing age and the menopause on sexuality, with no clear benefit of oestrogen therapy. Exogenous testosterone may have a role in the treatment of sexual dysfunction.