Slides and Transcript
Slide 1 of 9
In this section, we’ll be talking about communicating about sexual function. It’s really a clinical imperative.
Slide 2 of 9
Open communication between the patient and the provider is first the responsibility of the patient. This is in part driven by how people feel about their sex life. In a US poll of adults 25 years or older, 85% indicated they would bring up sexual problems with their provider even if there might not be a treatment.
References:
- Marwick, C. (1999). Survey says patients expect little physician help on sex. JAMA, 281(23), 2173–2174. https://doi.org/10.1001/jama.281.23.2173
- Clayton, A. H. (2014, April 18). Overcoming barriers to discussing sexual dysfunction. Current Psychiatry/MDedge. https://tinyurl.com/58p93j7e
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Slide 3 of 9
This is because a satisfying sex life was found to be important in 91% of married men and 84% of married women. 94% of people reported that sexual enjoyment adds to their quality of life and that sexual difficulties cause emotional and relationship problems.
References:
- Marwick, C. (1999). Survey says patients expect little physician help on sex. JAMA, 281(23), 2173–2174. https://doi.org/10.1001/jama.281.23.2173
Slide 4 of 9
However, if the patient does not bring up the topic of sexual function, the responsibility is on the provider to address it. How can you do that? One, initiate the discussion. Make it part of the routine exam either as part of questions about habits or quality of life, and indicate that you talk about this with patients routinely.
References:
- Kingsberg, S. A., Schaffir, J., Faught, B. M., Pinkerton, J. V., Parish, S. J., Iglesia, C. B., Gudeman, J., Krop, J., & Simon, J. A. (2019). Female sexual health: Barriers to optimal outcomes and a roadmap for improved patient-clinician communications. Journal of Women's Health, 28(4), 432–443. https://doi.org/10.1089/jwh.2018.7352
- Clayton, A. H. (2014, April 18). Overcoming barriers to discussing sexual dysfunction. Current Psychiatry/MDedge. https://tinyurl.com/58p93j7e
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Slide 5 of 9
It’s important to elicit patient preferences because if it’s important to the patient it should be important to you, and you should consider those preferences in any potential intervention. You want to identify problems in desire, arousal, orgasm, pain and satisfaction, and you want to address modifiable factors and potentially prescribe specific treatments to patients.
References:
- Kingsberg, S. A., Schaffir, J., Faught, B. M., Pinkerton, J. V., Parish, S. J., Iglesia, C. B., Gudeman, J., Krop, J., & Simon, J. A. (2019). Female sexual health: Barriers to optimal outcomes and a roadmap for improved patient-clinician communications. Journal of Women's Health, 28(4), 432–443. https://doi.org/10.1089/jwh.2018.7352
- Clayton, A. H. (2014, April 18). Overcoming barriers to discussing sexual dysfunction. Current Psychiatry/MDedge. https://tinyurl.com/58p93j7e
Slide 6 of 9
When looking at provider-patient communications about concerning sexual problems. In a survey about where patients were asked, if you wanted to talk to your doctor about a sexual problem you were having, how concerned would you be that each of the following might happen during your doctor’s visit? And they were very or somewhat concerned in over 75% of the people that there would be no medical treatment for their problem. In about 70%, patients said they thought their doctor would dismiss their concerns saying it was all in their head.
References:
- Marwick, C. (1999). Survey says patients expect little physician help on sex. JAMA, 281(23), 2173–2174. https://doi.org/10.1001/jama.281.23.2173
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Slide 7 of 9
And when asked about would your doctor be uncomfortable talking about the problem because it was sexual in nature, nearly 70% of the polled individuals responded. So the provider needs to indicate that there is not discomfort on their part and that you want to know about their problems because there are potential interventions that might help them.
References:
- Marwick, C. (1999). Survey says patients expect little physician help on sex. JAMA, 281(23), 2173–2174. https://doi.org/10.1001/jama.281.23.2173
Slide 8 of 9
So the key points in this section: Open communication is important. Patients may hesitate to bring up sexual dysfunction due to fear the provider would dismiss their sexual dysfunction concerns, would be uncomfortable with the topic or that there would be no interventions available. Whatever the patient concerns, the provider must introduce the topic of sexual function and make the patient feel safe to discuss it.
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