What changed — and why it actually matters

For years, sexology lived in an uncomfortable no-man’s land—too medical for psychology, too personal for medicine, too taboo for routine healthcare.

In 2025, that started to shift.

Not through louder sex-positive messaging or viral conversations, but through guidelines, approvals, and implementation frameworks that quietly moved sexual health closer to standard care. Still imperfect. Still uneven. But no longer invisible.

Here are the ten developments that genuinely changed the field this year—and why they matter in real clinical life.

1. New oral gonorrhoea treatments received FDA approval (December 2025)

What changed: In December 2025, new oral antibiotics for uncomplicated gonorrhoea received FDA approval, with zoliflodacin (Nuzolvence) becoming the first new gonorrhoea treatment in decades.

Why it matters: Gonorrhoea has been tightening clinicians into a corner for years due to antibiotic resistance. This approval isn’t just a pharmacological milestone—it’s a public-health relief valve.

Oral treatments reduce barriers to care, stigma around injections, and delays caused by specialist-only access. In sexual health practice, feasibility directly affects whether people seek treatment early or disappear quietly.

2. Low sexual desire in women finally received consensus treatment guidance

What changed: International expert groups published the first consensus recommendations for assessing and treating hypoactive sexual desire disorder (HSDD) in women, using a truly biopsychosocial framework.

Why it matters: This finally ends the exhausting cycle where women get bounced from specialist to specialist—each claiming the problem is “just” their specialty, or not.

Standardised guidance means women can now walk into a GP’s office and reasonably expect evidence-based care, not dismissal disguised as reassurance that “it’s just stress.”

3. Menopause-related sexual pain became guideline-level care

What changed: Genitourinary Syndrome of Menopause (GSM) guidelines consolidated diagnosis and treatment pathways, explicitly including sexual pain, dryness, and function as core outcomes.

Why it matters: In Singapore’s ageing population—where women may live 20–30 years post-menopause—normalising sexual pain as “part of ageing” is no longer acceptable.

These guidelines shift care from endurance to intervention and give clinicians permission to raise sexual concerns proactively, rather than waiting for patients to overcome shame.

4. Long-acting PrEP expanded from approval to implementation

What changed: While injectable cabotegravir has been approved for years, 2025 focused on implementation—with clearer service-delivery models, clinic workflows, and funding guidance. Additionally, lenacapavir, a twice-yearly injectable PrEP option, was approved in mid-2025.

Why it matters: This reframes adherence as a systems issue, not a moral one.

Daily pills were never realistic for many people due to stigma, privacy concerns, or unstable routines. Long-acting PrEP aligns HIV prevention with real lives—not idealised behaviour.

5. Vaginismus research moved beyond false binaries

What changed: Randomised controlled trials strengthened evidence for combined pelvic floor biofeedback and dilator therapy, rather than treating vaginismus as either psychological fear or muscle dysfunction.

Why it matters: This validates what experienced clinicians have known for years: vaginismus is a learned bodily response shaped by fear, pain, and muscle guarding—not something solved by “relaxing” or “trying harder.”

Integrated care reduces blame and shortens recovery pathways.

6. Vulvodynia research became more honest about systemic failure

What changed: 2025 research shifted focus from chasing a single cause of vulvodynia to documenting care fragmentation, delayed diagnosis, dismissal, and clinician knowledge gaps.

Why it matters: Many patients spend years being told “everything looks normal.” Naming systemic failure allows healthcare systems to design better pathways instead of quietly individualising suffering.

7. WHO doubled down on asymptomatic STIs and service delivery

What changed: WHO updates emphasised targeted screening, decentralised services, task-sharing, and digital delivery—especially for asymptomatic STIs.

Why it matters: Asymptomatic infections often surface in sexology as anxiety, relational conflict, or fertility distress rather than physical symptoms. Improving upstream detection reduces long-term psychological and relational harm.

8. Sexual health screening became more routine in women’s healthcare

What changed: Guidelines increasingly normalised brief sexual health check-ins during routine care using validated tools and stepped-care frameworks.

Why it matters: Routine screening removes the burden from patients to initiate vulnerable conversations. It reframes sexual wellbeing as part of overall health—like sleep or pain—not something raised only at breaking point.

9. Sexual medicine integrated further into mainstream specialties

What changed: Urology, gynaecology, psychiatry, and primary care guidelines increasingly embedded sexual function rather than outsourcing it.

Why it matters: When sexual health is “everyone’s responsibility,” patients are less likely to be bounced between providers—or told no one handles this issue.

10. The deeper shift: sexual distress became legitimate healthcare

What changed: Across research and policy, sexual distress is increasingly treated as a real health concern—not a personal failing or lifestyle preference.

Why it matters: Here’s what’s actually changed beneath all these technical developments: people no longer have to justify caring about their sexual wellbeing.

A necessary reality check

Of course, guidelines don’t magically become accessible care.

In Singapore—and across much of Asia—we still face cultural discomfort, limited trained providers, insurance constraints, and patients unsure whether they’re “allowed” to ask. Western guidelines also require cultural adaptation to avoid importing values without context.

But at least now, we have maps to follow.

And that matters.

Need evidence-based support for sexual health concerns?

Whether you’re navigating low desire, painful sex, relationship challenges, or sexual wellbeing after medical treatment, my team at Eros Coaching provides clinical sexology and relationship counselling grounded in the frameworks discussed here—not generic advice.

References 

American Urological Association, Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction, & American Urogynecologic Society. (2025). Genitourinary syndrome of menopause: Clinical guideline.

Food and Drug Administration. (2025). FDA approves new oral treatments for uncomplicated gonorrhea.

Jokar, F., et al. (2025). Effectiveness of biofeedback with dilator therapy for sexual function in women with primary vaginismus: A randomized controlled trial. Journal of Sexual Medicine.

Lountzi, A. Z., Abhyankar, P., & Durand, H. (2025). Vulvodynia research and care experiences: A scoping review. BMJ Sexual & Reproductive Health.

National Institute for Health and Care Excellence. (2025). Cabotegravir for preventing HIV-1 (TA1106).

Rowen, T. S., et al. (2025). Evaluation and management of hypoactive sexual desire disorder in women: Consensus recommendations. Journal of Sexual Medicine.

World Health Organization. (2025). Updated guidance on sexually transmitted infections and service delivery.

About Dr. Martha Tara Lee