Talking to women about sexual dysfunction: Just do it!

Female sexual dysfunction is not rare. In the United States, 44% of women are reported to experience some form of sexual dysfunction and 12% of these women report distress associated with dysfunction.¹

Despite this high prevalence, many women never talk to their providers about their sexual difficulties or concerns and many providers fail to broach the topic with their patients. Unease with the topic, time restraints on the provider, and lack of training on how to discuss the subject with sensitivity and expertise, all conspire to keep women silent about sexual difficulties that can interfere, sometimes significantly, with their quality of life.

“We know that women want their providers to bring up the topic but won’t typically ask, even if they have questions or concerns,” said Stephanie S Faubion, MD, Director, Office of Women’s Health, Mayo Clinic, Rochester, Minnesota. “Women are even concerned that they might embarrass their providers!”  For providers, Dr Faubion underscored their concern over lack of training and skills in dealing with issues of sexual dysfunction as well as the ever-present lack of time. What can providers do to improve communication with their patients about sexual difficulties they may be experiencing?

Tips for talking to women about sexual dysfunction

“The most important thing clinicians can do is simply to ask,” emphasized Dr Faubion. “Just opening the door with a question and genuine interest gives the patient permission to discuss their concerns.”  In a recent review, Faubion and Parish provide specific tips on how to introduce the topic during office visits and the questions to ask women to screen for sexual dysfunction (Table 1).¹

These questions highlight that female sexual dysfunction may involve a complex interaction of biological, psychological, sociocultural, and relationship factors, all of which need to be addressed to understand a particular woman’s difficulties (Table 2). 

Overall, Dr Faubion emphasizes the importance of introducing sexual health as a normal issue to discuss during a routine clinical assessment and suggests introducing the topic by a statement such as “many women in your situation (fill in the blank) experience concerns about their sexual health. What about you?”

To strike the right tone for women to feel comfortable talking about their sexuality, she emphasizes the need for providers to approach the discussion without judgements and assumptions about sexuality and sexual actions. She also emphasized the need to assure patients of confidentiality.

Reference

1.    Faubion SS, Parish SJ. Sexual dysfunction in women: Can we talk about it: Cleveland Clinic Journal of Medicine. 2017;84(5):367-376.