Assessment

See Table 30-1.

Menopause and sexual dysfunction: Menopause ^ vaginal atrophy and lack of adequate lubrication ^ painful intercourse ^ decreased sexual desire

Many antidepressants alter sexual response by increasing the availability of serotonin and decreasing dopamine.

Estrogen improves overall sense of well-being— probably secondarily improves sexual desire.

TABLE 30-1. Abuse Assessment Screen

1. Have you ever been emotionally or physically abused by your partner or someone important to you?

2. Within the last year, have you been hit, slapped, kicked, or otherwise physically hurt by someone?

3. Since you've been pregnant, have you been hit, slapped, kicked, or otherwise physically hurt by someone?

4. Within the last year, has anyone forced you to have sexual activities? Has anyone in the past forced you to have sexual activities?

5. Are you afraid of your partner or anyone you listed above?

Source: Nursing Research Consortium on Violence and Abuse, 1989. Reproduced, with permission, from Seltzer VL, Pearse WH. Women's Primary Health Care, 2nd ed. New York: McGraw-Hill, 2001: 659.

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