Results From Sexual Health Discussion Survey

Discussing FSD with Your Health Care Provider

Camille Stengel BA(hons) and Lisa Martinez RN, BSNM, JD

Female sexual dysfunction, known as FSD, is a relatively common health issue for women. The Mayo Clinic states that as many as four in ten women may suffer from FSD.1 Studies have shown that FSD and other sexual problems have been linked to a “dimished quality of life, low physical satisfaction, low emotional satisfaction, and low general happiness”2. Other health experts agree that “[f]emale sexual dysfunctions (FSDs) are very prevalent, multifaceted problems that continue to be under-recognized and undertreated”3 The Women’s Sexual Health Foundation (TWSHF) believes that awareness, education, and communication need to be raised about FSD to both women suffering and to their medical practitioners.

Most healthcare providers do not address FSD with their female patients during regular medical visits. One study concluded that over half of their respondents were not queried about their sexual health during their visit with their practitioner.4 In order to investigate this matter further, TWSHF designed a survey that inquired about perceptions, emotional responses, and possible discussion of FSD during visits with their medical practitioner.  The 18 item survey was posted on TWSHF’s website. The survey contained demographic information and questions on women's beliefs specific to communication with their provider and care relating to female sexual health problems. A total of 391 women responded to the survey. Women from ages 21 to 80 took the survey, and most of the women were well educated (college or above).

Throughout the questionnaire, 45% of respondents referred to their gynecologist when asked about how their “healthcare provider” communicated with them about their sexual health, with an additional 20% referencing their family doctor. Although 72% of women would be comfortable if their healthcare provider initiated a conversation about any sexual health problem(s), and 73% preferred that their healthcare provider initiated this discussion, less than 9% of the respondents stated their healthcare provider always initiated questions about sexual health difficulties during an annual office visit. Furthermore, 72% answered that they believed their healthcare provider would be comfortable with them initiating a discussion concerning their sexual health problem(s).
As well, 32% of respondents did not believe that their healthcare provide would be knowledgeable of the appropriate tests that would need to be administered in able to assess their sexual health problems. Another study inquiring about sexual health discussions in health care found that “clinicians avoid discussing sexual concerns even when a problem is suspected, citing lack of knowledge and skills as a common reason”5. Female patients were hesitant to discuss sexual health because of fear of their practitioners’ lack of education on the subject, and practitioners affirmed this fear by being unknowledgeable.

Another possible reason for these participant conclusions is because of the lack of discussion of FSD. 51% of women stated that their healthcare provider had never initiated any sort of questions about sexual health problems with them during their visit. Similar responses are seen in other studies related to women discussing their sexual health with their health care professional.6 One study concluded that during a patient visit, “the physician seemed embarrassed about the topic” and as a result the patient felt “inhibited in discussing their sexual concerns”7. Embarrassment, however, is not the only factor at play that inhibits a lack of in depth discussion about FSD. TWSHF survey found that 19% of participants answered that when they did discuss sexual health concerns with their medical practitioner they had been told that their sexual health problems were psychological. Such an answer is not only simplifying a complicated problem, it is also belittling the patients’ sexual concerns by telling her it is just “all in her head”.

Although FSD is common, and women would prefer that their healthcare provider discuss and assess sexual health difficulties with them, this is rarely done on a routine basis. Medical practitioners need to be aware of the commonality of FSD in women and learn techniques to stimulate discussion about such issues in a way that does not alienate the patient. One study found that “ubiquity-style questions may make patients more comfortable about answering a sexual problem question by noting the universality of various sexual experiences”8. As well, medical practitioners need to become better versed in different symptoms, ailments, and solutions for FSD.

Education of women is needed to empower them to navigate the healthcare system to effectively have their sexual healthcare concerns addressed, in particular when these concerns are related to medical conditions. Such education can be achieved through further research about FSD in the academic and medical communities, and presenting the findings in a way accessible to the public. Such knowledge on both women and on medical practitioner’s part is crucial, for not only “physicians are clearly a resource for women seeking sexual health information”9 but “sexuality is an important part of one’s health [and] sexual activity and good health appear to be related”10 Professionals in every practice pertaining to sexual well being, from physicians to counselors, can play a vital role in educating and supporting women navigating through the healthcare system.

REFERENCES

1 Mayo Clinic Staff. Female Sexual Dysfunction. www.mayoclinic.com. Published by the Mayo Foundation for Medical Education and Research. 25 April 2008.

2 Sadovsky R, and Nusbaum M. Sexual Health Inquiry and Support Is a Primary Care Priority. Journal of Sexual Medicine. 2006; 3:3-11.

3 Bachmann G. Female Sexuality and Sexual Dysfunction: Are We Stuck on the Learning Curve? Journal of Sexual Medicine. 2006 July; 3(4): 639.

4 Nusbaum M, Gamble G, and Pathman D. Seeking Medical Help for Sexual Concerns: Frequency, Barriers, and Missed Opportunities. Journal of Family Practices. Aug 2002; 51(8): online version.

5 Sadovsky R, and Nusbaum M. Sexual Health Inquiry and Support Is a Primary Care Priority. Journal of Sexual Medicine. 2006; 3:3-11.

6 See Laumann, Paik, and Rosen 1999; Nusbaum, Gamble and Pathman 2002; Nusbaum and Hamilton 2002; Sadovsky and Nusbaum 2006; and Sadovsky et al 2006.

7 Ibid.

8 Sadovsky et al. Sexual Problems Among a Specific Population of Minority Women Aged 40-80 Years Attending a Primary Care Practice. Journal of Sexual Medicine. 21 Aug 2006. 3(5). 795-803.

9 Nusbaum M, Gamble G, and Pathman D. Seeking Medical Help for Sexual Concerns: Frequency, Barriers, and Missed Opportunities. Journal of Family Practices. Aug 2002; 51(8): online version.

10 Sadovsky R, and Nusbaum M. Sexual Health Inquiry and Support Is a Primary Care Priority. Journal of Sexual Medicine. 2006; 3:3-11.