• Singapore’s first set of guidelines to address high prevalence of poor sexual function in women
• Comprehensive framework covers screening, assessment, education, and management across all stages of reproductive health
• Emphasises integrating sexual health discussions into routine care

28 March 2025, Friday, Singapore – KKH-led MCHRI¹ today launched Singapore’s first set of Guidelines on Sexual Health² for Women of Reproductive Age at the MCHRI Asia Pacific Maternal and Child Health Conference and IPRAMHO³ International Meeting 2025 held at KK Women’s and Children’s Hospital (KKH).

Unveiled by Mdm Rahayu Mahzam, Minister of State, Ministry of Health and Ministry of Digital Development and Information, the Guidelines aims to address the burden of sexual health² issues in women, including the high prevalence of poor sexual function⁴.

“Sexual health during reproductive years is crucial to a woman’s well-being across her lifespan. It influences overall health, shapes reproductive choices, and lays the foundation for health outcomes in later life stages. Our research⁵ shows that half of Singapore’s women of reproductive age face sexual health difficulties which can impact emotional health, relationships stability, quality of life, and fertility. Yet these issues often remain under-recognised and under-treated,” said Dr Tan Tse Yeun, Senior Consultant, Department of Reproductive Medicine, KKH, and Co-Chairperson of the Guidelines on Sexual Health for Women of Reproductive Age.

The Guidelines for healthcare professionals provides a comprehensive framework that covers screening, assessment, education, and management across all stages of reproductive health, including preconception, pregnancy, and postnatal periods.

It also emphasises integrating sexual health discussions into routine care and recommends specific tools for quick assessment and intervention, such as the Female Sexual Function Index-6 (FSFI-6)⁶ and the PLISSIT (Permission, Limited Information, Specific Suggestions, Intensive Therapy) model⁷.

A key feature is the holistic approach to sexual health, addressing medical, psychological, and sociocultural factors. In addition, the Guidelines highlights recommendations for managing sexual health in the context of chronic illnesses, mental health conditions, and past trauma. It also provides guidance on often-overlooked aspects, such as the impact of contraceptives on sexual function and the importance of pelvic floor health.

Importantly, the Guidelines stresses upon the need for open communication about sexual health between healthcare providers and patients. It encourages healthcare professionals to integrate these discussions into routine care, to create a supportive environment where women feel comfortable discussing their sexual health concerns.

(Refer to Annex A for details of the Guidelines.)

KKH Studies: Unmet sexual health needs in women of reproductive years

Two recent KKH studies, conducted in 2024, revealed unmet sexual health needs in women of reproductive age:

The first study⁵, involving 787 women, aged between 21 and 45 years, found:

• 57 per cent were not aware of symptoms of female sexual health issues.
• 54 per cent of respondents reported poor sexual function across various aspects of desire, arousal, lubrication, orgasm, satisfaction, and pain.
• Women's awareness and approach to sexual health issues were generally poor:
• 94 per cent agreed that awareness and education on female sexual health issues are important.
• However, only 43 per cent of the women would seek medical help if they experienced such issues.

91 per cent of the women surveyed believed that healthcare professionals should initiate sexual health issues when appropriate. The same per centage also supported having guidelines to help healthcare professionals with these conversations. However, this proves to be a challenge.

A second study⁸ on 477 healthcare professionals who treat women of reproductive age found:

• 81 per cent were unaware of available screening tools.
• About 63 per cent rarely or only sometimes screened for sexual health issues or counselled patients on lifestyle habits that could optimise sexual health.
• 10 to 12 per cent felt confident or very confident in diagnosing or managing sexual health issues.
• 82 per cent agree that a set of standardised Sexual Health Guidelines would be beneficial for both practitioners and women of reproductive age.

“Our two recent studies reveal a paradox in women's sexual health: despite recognition of its importance, Asian women – even those who are highly educated professionals and mothers – remain hesitant to seek help and often do not know where to turn, expecting healthcare professionals to initiate discussions. Yet, many healthcare professionals feel ill-equipped to address these issues and rarely broach the topic proactively. With most surveyed women and healthcare professionals supporting the need for a set of Guidelines, there is clear urgency to provide better education, support, and more open communication in women's sexual health care," said Dr Jean-Jasmin Lee, Consultant, Family Medicine Service, KKH and Co-Chairperson of the Guidelines on Sexual Health for Women of Reproductive Age.

Setting the foundation for good lifelong health

“At KKH, we are committed to improving women's health outcomes across all stages of their lives. Since 2018, we have been launching annual Guidelines addressing pertinent issues affecting women and children’s health. Our recent studies revealed a critical need in women's sexual health. By introducing Singapore’s first Guidelines for Sexual Health in Women of Reproductive Age, we are continuing our pioneering approach of providing evidence-based guidance to improve population health for generations to come,” said Professor Tan Kok Hian, Head and Senior Consultant, Perinatal Audit and Epidemiology Unit, KKH, and Lead Principal Investigator of IPRAMHO.

The other Guidelines which are tailored for the multi-ethnic Asian population, cover areas such as gestational diabetes; perinatal nutrition, exercise and mental health; and activities and feeding in early childhood. The new set of Guidelines will be made available to healthcare professionals through all partners - College of Family Physicians, College of Obstetricians and Gynaecologists Singapore, Health Promotion Board, Obstetrical & Gynaecological Society of Singapore, Perinatal Society Singapore, Singapore Medical Association, Singapore Physiotherapy Association, Singapore Urological Association, SingHealth Psychology Committee of Practice, Society for the Study of Andrology and Sexology, Singapore.

¹ SingHealth Duke-NUS Maternal and Child Health Research Institute.
² World Health Organization (WHO): Sexual health is a state of physical, emotional, mental, and social well-being related to sexuality.
³ Integrated Platform for Research in Advancing Metabolic Health Outcomes of Women and Children is one of the main programmes by MCHRI.
⁴ Sexual function is measured through validated questionnaires and clinical assessments in six areas: arousal, desire, lubrication, orgasm, satisfaction and pain.
⁵ Phaik Ling Quah, Mi-Li Jean-Jasmin Lee, Caroline Shiling Chua, Xinyi Cheong, Chee Wai Ku, See Ling Loy, Tse Yeun Tan, Kok Hian Tan. (2025). Prevalence of female sexual function and knowledge, attitudes and practices in women of reproductive age: The Sexual Health in Reproductive Age Women (SH-WOMEN) study. Singapore Journal of Obstetrics & Gynaecology, 56 (1)
⁶ Isidori AM, Pozza C, Esposito K, Giugliano D, Morano S, Vignozzi L, et al. Development and Validation of a 6-Item Version of the Female Sexual Function Index (FSFI) as a Diagnostic Tool for Female Sexual Dysfunction. The Journal of Sexual Medicine. 2010 Mar;7(3):1139–46.
⁷ Annon JS. The PLISSIT model: A proposed conceptual scheme for the behavioral treatment of sexual problems. J Sex Educ Ther [Internet]. 1976;2(1):1–15. Available from: http://dx.doi.org/10.1080/01614576.1976.11074483.
⁸ Phaik Ling Quah, Mi-Li Jean-Jasmin Lee, Caroline Shiling Chua, Xinyi Cheong, Chee Wai Ku, See Ling Loy, Tse Yeun Tan, Kok Hian Tan. (2025). Healthcare Professional's knowledge, attitudes and perceptions of female sexual health in the reproductive age: The Healthcare Professional's knowledge, attitudes and perceptions of female sexual health (SH-HCP) study. Singapore Journal of Obstetrics & Gynaecology, 56 (1).