Women's Sexual Health the Focus of Upcoming NAMS Meeting

Tara Haelle

September 28, 2018

SAN DIEGO — Women's sexual health, including topics as delicate as trauma-informed care in the #MeToo era, risks related to vaginal rejuvenation laser treatments, and the current political climate in the United States, will be discussed at the upcoming North American Menopause Society (NAMS) 2018 Annual Meeting.

"Female sexuality, even in 2018, is a taboo topic, but we consider sexual health one of the key theme topics" of the meeting, said NAMS President Sheryl Kingsberg, PhD, from University Hospitals Cleveland Medical Center.

"With the recognition that women have a right to their sexual health, it's important to make our membership comfortable with the dialogue about it," she told Medscape Medical News.

"We want to teach them the communication skills and the content," she explained, which includes the common sexual problems women present with and the elements of healthy sexual function.

The conference kicks off with an all-day premeeting symposium devoted to women's sexual health, which will open with a review of the history of sexual desire given by Kingsberg, including the timeworn search for an aphrodisiac and the ways music factors into desire.

The six multidisciplinary speakers at the premeeting symposium were invited specifically to support a biopsychosocial approach to women's sexuality, because that's how providers need to think about these issues in clinic-based counseling, Kingsberg explained.

Biopsychosocial Approach to Women's Sexuality

"In lectures, these topics are arbitrarily separated, but in real life, you're going to have to incorporate the biological components and the psychosocial aspects of arousal and orgasms or orgasm disorder," she said.

Sexual dysfunction can be framed as a "loss of wanting to want," she said. And treatment needs to focus on the desire for desire as much as achieving sexual satisfaction. "An aphrodisiac is not necessarily supposed to just make you feel aroused," she said. "It's supposed to trigger your brain to anticipate, to have hunger."

There will be particular focus on innovative developments in menopausal health, including discussion about precision and personalized medicine, said Gloria Richard-Davis, MD, from the University of Arkansas Medical Sciences in Little Rock, who is chair of the NAMS scientific program committee.

Richard-Davis said she is looking forward to the keynote address on telomere length, longevity, and the psychologic aspects of aging, which will be delivered by Elissa Epel, PhD, from the University of California, San Francisco.

"Most of us think of the aging process as just sort of expected time lapse, but what Dr Epel contends is that there are clearly things we can do that affect our telomere length and our longevity," she told Medscape Medical News. "Stay tuned for some tidbits and pearls on how to live a longer, happier life." And Epel will discuss "what sex has to do with it, so that's really exciting."

The political nature of the Kenneth W. Kleinman Endowed Lecture — Diagnosing American Democracy 2018: Suturing Divides With the Art of Constructive Disagreement, delivered by Matt Motyl, PhD, from the University of Illinois at Chicago — might surprise some people.

Part of our role as a physician or provider is "to recognize how the political climate affects health," said JoAnn Pinkerton, MD, from the University of Virginia Health System in Charlottesville, who is executive director of NAMS.

One plenary symposium will address the role that stress plays in the cardiovascular health of women.

"Cardiovascular disease is the number one cause of death among menopausal women, yet most women are more fearful of breast cancer," Pinkerton told Medscape Medical News. "Cancer and untreated hypertension can lead to heart failure."

Another symposium will center on bone health, including osteoporosis prevention and the increasing rate of hip fracture in the United States.

"Up to 30% of women die within a year of a hip fracture; these are life-changing events," she reported. Some women end up at higher risk for hip fracture partly because they fear the adverse effects of medications that can help manage osteoporosis, she added. A plenary on bone health will examine new and improved medications and who might be candidates for them.

The plenary on obesity and weight loss will examine the responsibility of physicians to help patients manage their weight.

"I think it's critical that we, as providers, begin to take a more active role in getting patients to a healthier lifestyle," particularly given the contribution of obesity to chronic disease and healthcare expenditures, Richard-Davis explained. "Cardiovascular disease, diabetes, hypertension all get worse with obesity."

Trauma-Informed Care

The usual Friday morning breakfast with experts has been replaced with a #MeToo discussion about trauma-informed care, which couldn't be more timely.

As menopause specialists, we help women "who have had childhood adverse events or adverse sexual events, such as rape and abuse," Pinkerton told Medscape Medical News.

This hour-long session will set the stage for next year. We're thinking of doing a plenary on "the science and treatment options and how we approach trauma-informed care," she said.

Kingsberg reports owning stock in Viveve and consulting and/or servings on the advisory board for Acerus, Amag, Duchesney, Emotional Brain, Endoceutics, Materna, Palatin, Pfizer, Sermonix, Strategic Scientific Solutions, Symbiomix, TherapeuticsMD, and Valeant. Richard-Davis reports consulting for Pfizer. Pinkerton has disclosed no relevant financial relationships.

Follow Medscape OBGYN on Twitter @MedscapeObGyn and Tara Haelle @TaraHaelle

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