What We Don't Talk about When We Don't Talk about Sex: Results of a National Survey of US Obstetrician/Gynecologists

Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA.
Journal of Sexual Medicine (Impact Factor: 3.15). 03/2012; 9(5):1285-94. DOI: 10.1111/j.1743-6109.2012.02702.x
Source: PubMed


Sexuality is a key aspect of women's physical and psychological health. Research shows both patients and physicians face barriers to communication about sexuality. Given their expertise and training in addressing conditions of the female genital tract across the female life course, obstetrician/gynecologists (ob/gyns) are well positioned among all physicians to address sexuality issues with female patients. New practice guidelines for management of female sexual dysfunction and the importance of female sexual behavior and function to virtually all aspects of ob/gyn care, and to women's health more broadly, warrant up-to-date information regarding ob/gyns' sexual-history-taking routine.
To determine ob/gyns' practices of communication with patients about sexuality, and to examine the individual and practice-level correlates of such communication.
A population-based sample of 1,154 practicing U.S. ob/gyns (53% male; mean age 48 years) was surveyed regarding their practices of communication with patients about sex.
Self-reported frequency measures of ob/gyns' communication practices with patients including whether or not ob/gyns discuss patients' sexual activities, sexual orientation, satisfaction with sexual life, pleasure with sexual activity, and sexual problems or dysfunction, as well as whether or not one ever expresses disapproval of or disagreement with patients' sexual practices. Multivariable analysis was used to correlate physicians' personal and practice characteristics with these communication practices.
Survey response rate was 65.6%. Sixty-three percent of ob/gyns reported routinely assessing patients' sexual activities; 40% routinely asked about sexual problems. Fewer asked about sexual satisfaction (28.5%), sexual orientation/identity (27.7%), or pleasure with sexual activity (13.8%). A quarter of ob/gyns reported they had expressed disapproval of patients' sexual practices. Ob/gyns practicing predominately gynecology were significantly more likely than other ob/gyns to routinely ask about each of the five outcomes investigated.
The majority of U.S. ob/gyns report routinely asking patients about their sexual activities, but most other areas of patients' sexuality are not routinely discussed.

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    • "Female sexual dysfunction is prevalent in the general population, but not routinely assessed in medical care [1] [2].Manystudies,acrossa variety of disease types and patient populations, have investigated the relationship between gynecologic cancer and sexual function in women. Plausible biopsychosocial mechanisms have been proposed, mostly from observational studies, to explain the pathways through which cancer and its treatment can impair female sexual function [3, Gynecologic Oncology xxx (2015) xxx–xxx "
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    ABSTRACT: Objectives: To describe patterns of response to, and assess sexual function and activity elicited by, a self-administered assessment incorporated into a new patient intake form for gynecologic oncology consultation. Methods: A cross-sectional study of patients presenting to a single urban academic medical center between January 2010 and September 2012. New patients completed a self-administered intake form, including six brief sexual activity and function items. These items, along with abstracted medical record data, were descriptively analyzed. Logistic regression was used to assess the association between sexual activity and function and disease status, adjusting for age. Results: Median age was 50 years (range 18-91, N=499); more than half had a final diagnosis of cancer. Most patients completed all sex-related items on the intake form; 98% answered at least one. Among patients who were sexually active in the prior 12 months (57% with cancer, 64% with benign disease), 52% indicated on the intake form having, during that period, a sexual problem lasting several months or more. Of these, 15% had physician documentation of the sexual problem. Eighteen women were referred for care. Providers reported no patient complaints about the inclusion of sexual items on the intake form. Conclusions: Nearly all new patients presenting for gynecologic oncology consultation answered self-administered items to assess sexual activity and function. Further study is needed to determine the role of pre-treatment identification of sexual function concerns in improving sexual outcomes associated with cancer diagnosis and treatment.
    Gynecologic Oncology 01/2015; 137(1). DOI:10.1016/j.ygyno.2015.01.451 · 3.77 Impact Factor
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    • "Typically, older men have an advantage over older women as it pertains to assessing their sexual problems. Sobecki and colleagues [34] highlighted that men are counseled more than women about the impact of medical treatment on sexual functioning as part of the decision-making process regarding their need to adhere to a particular medication regimen. According to the aforementioned authors, health care physicians feel more comfortable talking about sex with men simply due to the availability of FDA-approved erectile dysfunction drugs designed for them. "
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    ABSTRACT: Sexual desire is a major component of sexuality at any age, and inhibited desire is one of the main sexual dysfunctions reported by older women. Nonetheless, in medical settings, for a variety of reasons discussed herein, its assessment-as well as the assessment of older women's sexual health in general-is typically avoided or conducted by asking a single sex question. In this paper, we have reviewed the literature (most of which is preliminary in nature) regarding the main psychosocial and health factors that could impact older women's sexual desire, as well as potential obstacles to the assessment and treatment of this geriatric sexual issue. It is certainly advisable that medical care providers who are uncomfortable discussing older women's sexual concerns be prepared to make appropriate referrals to clinicians who possess the proper training to accurately assess and treat sexual challenges (and female sexual interest problems in particular) in this neglected patient population.
    BioMed Research International 06/2014; 2014:107217. DOI:10.1155/2014/107217 · 3.17 Impact Factor
  • Journal of WOCN 09/1984; 11(5):202. DOI:10.1097/00152192-198409000-00042 · 1.18 Impact Factor
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