Her Whole Life: Why Women's Sexual Health Can't Be Told in Chapters

"Sexual health is a state of physical, emotional, mental and social well-being related to sexuality — not merely the absence of disease, dysfunction or infirmity." — WHO Working Definition, developed in consultation with WAS

One Story, Not Four

When a young girl first navigates puberty, nobody tells her that the conversations she is denied — or given — in that moment will echo through every stage of her life. When a woman sits in a fertility clinic, struggling with the weight of an infertility diagnosis, her distress is rarely framed as a sexual health issue. When a postmenopausal woman finds that intimacy has become painful, she is far more likely to hear "that's just part of aging" than to receive evidence-based care and compassion.

This is what it means for women's sexual health to be told in chapters: each stage treated as a separate, disconnected clinical event. A problem to be managed. A phase to be moved on from.

This International Women's Day, 8 March 2026 — under the United Nations theme Rights. Justice. Action. For ALL Women and Girls — the World Association for Sexual Health is inviting a different conversation. One that treats women's sexual health not as a series of isolated moments, but as a continuous, evolving story shaped by biology, culture, access, relationships, and rights. A story that begins at birth and never truly ends.

Sexual Health Across the Lifespan Is Interconnected

Research published in the International Journal of Sexual Health (IJSH) — WAS's own peer-reviewed journal — makes the case powerfully. Writing from a life course perspective, Sladden, Philpott, and colleagues (2021) argue that sexual health, sexual rights, and sexual pleasure are three interlinked and indivisible dimensions of well-being, actively contributing to overall health throughout life — and yet are often overlooked or even denied entirely for some women.

That denial starts early. Decades of evidence from the comprehensive sexuality education (CSE) community are unambiguous: by the time formal sexuality education reaches most children the window for foundational learning has already been open for years. Humans are sexual beings from birth, developing curiosity about bodies, boundaries, relationships, and identity long before puberty. UNESCO, UNFPA, and the broader CSE community have consistently argued that age-appropriate, rights-based sexuality education must begin in early childhood, both inside and outside formal schooling. The failure to do so does not protect children — it leaves them less equipped to protect themselves.

Stage One: Adolescence

For adolescent girls, the stakes of comprehensive sexuality education — or its absence — are profound. What a young person learns (or is forbidden from learning) about her own body, her rights, and her ability to navigate relationships shapes her capacity for healthy sexual expression for decades to come.

A 2025 open-access study published in IJSH, titled "Seeing Is Believing": Identifying the Sexual and Reproductive Health Priorities of Adolescent Girls and Young Women in Freedom Park, South Africa, gave adolescent girls the opportunity to define their own priorities. Their voices were clear: they needed safety, information, and the right to be heard — not just managed.

Earlier research in IJSH identified that adolescent sexual relationship rights have two distinct and measurable dimensions: the right to refuse unwanted sexual activity, and the right to express one's own sexual and engagement needs (Rohrbach et al., 2017). Both matter. Yet across the world — from high-income countries to low-resource settings — girls are still far more likely to receive messages about what not to do than about how to advocate for their own well-being.

This is a rights gap. And its consequences travel with women throughout their lives.

Stage Two: Reproductive Years

The reproductive years are often when women are most visible to healthcare systems — for contraception, pregnancy, and STI screening. And yet this visibility can paradoxically render certain dimensions of sexual health invisible. Women are seen as reproductive vessels to be monitored, rather than as whole people with sexual well-being needs.

This becomes starkest at the intersection of fertility and sexual health. A case-control study published in IJSH (Demirci & Ersoy, 2020) found that infertile women scored significantly lower on measures of sexual function than fertile women. The process of fertility treatment — with its clinical intrusions, hormonal interventions, and profound emotional toll — affects not just the body but the entire landscape of intimacy. And yet this dimension of care is still rarely addressed proactively in fertility medicine.

Women navigating infertility are managing grief, relational strain, and disrupted sexual identity simultaneously. The research is there. The clinical gap remains.

Beyond infertility, the reproductive years expose another persistent silence: the chronic under-recognition of women's sexual pleasure. Dyspareunia — painful sex — is not only a feature of menopause; it is far too common in young women and rarely addressed proactively. 

Low desire, difficulty with orgasm, and the physical cost of sexual activity are routinely normalized or dismissed. Research published in IJSH by Laan, Klein, Werner, van Lunsen, and Janssen (2021) makes the case starkly: while women and men do not differ in their capacity for sexual pleasure, sexual activity in most cultures is less pleasurable and associated with greater cost for women. The so-called orgasm gap is not a biological given — it is a product of inequality. Naming it as such is the first step toward closing it.

Stage Three: Midlife and Menopause

If adolescence represents the rights gap in the early stages of a woman's sexual health journey, menopause represents the dismissal further along.

Sexual function changes with menopause — that is well established. Declining levels of sex hormones affect desire, lubrication, and comfort, while psychological, relational, and cultural factors layer upon those physiological shifts. The most commonly reported challenges include low sexual desire, vaginal dryness, and dyspareunia — painful intercourse — the latter being a hallmark of genitourinary syndrome of menopause (Vignozzi et al., 2019).

And yet, as the evidence consistently shows, declining function does not have to mean the end of a fulfilling sexual life. Treatment exists. Counselling works. Informed clinical care matters. What is missing, far too often, is the conversation itself — the clinician who asks, the system that makes room, the cultural permission to say: this matters to me, at this stage of my life, too.

Research published in IJSH underscores that sexual health and well-being remains a fundamental human right — not a luxury to be left behind at menopause, or in the decades that may follow. As life expectancy rises across much of the world, the post-menopausal period can span thirty years or more. The right to sexual well-being does not have an expiry date.

The Thread That Runs Through Everything

What connects each of these stages is the consistent, structural underprovision of rights-based, evidence-informed sexual healthcare for women.

The girl who wasn't taught to name her own needs. The woman whose fertility treatment never acknowledged the cost to her intimate life. The postmenopausal woman, told to simply accept her suffering. These are not separate failures. They are the same failure, repeated across a lifetime.

IWD 2026 calls for action to dismantle the structural barriers to equal justice — including discriminatory laws, weak legal protections, and harmful practices and social norms that erode the rights of women and girls. Sexual healthcare is inseparable from that project. When women cannot access honest, shame-free, evidence-based support for their sexual well-being — at any stage of life — that is a justice issue.

Join the Conversation: WAS Webinar, 19 March 2026

To mark Women's Month, WAS is bringing together leading specialists from across disciplines and regions for a landmark webinar:

Celebrating Women at Every Stage: Sexual Health Across the Lifespan

Thursday, 19 March 2026 | 17:00–18:30 SAST

Four informed speakers — each focusing on a distinct life stage — will weave these stories together into one global, rights-based, evidence-informed conversation:

• Liubov Kuzovkina (Ukraine) — Girls and Adolescents

• Linda Vignozzi (Italy), Professor of Endocrinology, University of Florence; President, ISSWSH — Reproductive Health

• Elna Rudolph (South Africa), Immediate Past President, WAS — Infertility and Sexual Health

• Faysal El Kak (Lebanon), President, WAS — Menopause and Sexual Health

  
  

This is a conversation about the whole story — and why it matters.

Register here

A Note to Clinicians, Researchers, and Advocates

If you work in sexual health — in any discipline, at any stage of the lifespan — you are part of this story. What the evidence consistently calls for is integration: care that treats each stage of a woman's sexual life as connected to the next, informed by rights, and delivered without shame.

WAS's mission is to promote sexual health for all — throughout the lifespan and across the world. That mission is never more urgent than when we remember just how many women are still navigating each stage of their lives without the care and information they are entitled to.

This International Women's Day, we are honoring the whole woman.

If you are not yet part of the WAS community, we warmly invite you to join us. Consider becoming a WAS individual member, or applying for your organization to become an organizational member of WAS — ensuring you can provide quality care to your patients, access the latest research in sexual health, and form part of a global community of professionals united by a commitment to sexual health and rights for all. Find out more about WAS membership.

References and Further Reading

• Demirci, N., & Ersoy, M. (2020). Does infertility affect the sexual function and sexual quality of life of women? A case control study. International Journal of Sexual Health, 32(1), 22–32. https://doi.org/10.1080/19317611.2019.1692983

• Laan, E. T. M., Klein, V., Werner, M. A., van Lunsen, R. H. W., & Janssen, E. (2021). In pursuit of pleasure: A biopsychosocial perspective on sexual pleasure and gender. International Journal of Sexual Health, 33(4). https://doi.org/10.1080/19317611.2021.1965689

• Rohrbach, L. A. (2017). Development and assessment of measures of adolescents' attitudes about sexual relationship rights. International Journal of Sexual Health, 29(2), 135–146. https://doi.org/10.1080/19317611.2016.1256364

• Sladden, T., Philpott, A., Braeken, D., Castellanos-Usigli, A., Yadav, V., Christie, E., Gonsalves, L., & Mofokeng, T. (2021). Sexual health and well-being through the life course: Ensuring sexual health, rights and pleasure for all. International Journal of Sexual Health, 33(4), 565–571. https://doi.org/10.1080/19317611.2021.1991071

• Stevens-Uninsky, M. et al. (2025). "Seeing is believing": Identifying the sexual and reproductive health priorities of adolescent girls and young women in Freedom Park, South Africa. International Journal of Sexual Health. Open Access.

• Vignozzi, L. et al. (2019). Sexual health in menopause. Medicina, 55(9), 559. https://doi.org/10.3390/medicina55090559

• World Association for Sexual Health. (2021). Declaration on Sexual Pleasure. https://www.worldsexualhealth.net

• World Health Organization. (2006). Defining Sexual Health: Report of a Technical Consultation on Sexual Health. WHO.