Practices and attitudes of Israeli obstetrician-gynecologists regarding female sexual health: results from a national survey

Background Sexual health is an often-overlooked component of clinical care that has significant implications for patients' quality of life.Aim To evaluate the practices, attitudes, and barriers faced by Israeli obstetrician-gynecologists (OB-GYNs) in addressing female sexual health, and to identify factors that influence engagement.Methods During April-December 2024, a cross-sectional survey was conducted that assessed Israeli OB-GYNs' socio-demographics, frequency of initiating discussions, perceived training adequacy, and barriers to addressing sexual health.Outcomes The primary outcomes were the frequency of initiating discussions on sexual health and the perceived adequacy of training in addressing sexual dysfunction.Results Among 504 participants, 19.1% routinely initiated discussions on sexual health, while 45.8% rarely did. Female compared to male OB-GYNs (P = 0.002), and infertility compared to other specialists (P = 0.003) were more likely to engage in these discussions. Barriers included limited clinic time (57.5%), insufficient knowledge of treatment options (48.2%), a lack of strategies for initiating discussions (27.0%), and discomfort discussing these issues (15.9%). OB-GYNs aged 60 years and older, compared to 20-29 years, and those who graduated in Israel, rather than abroad (P < 0.001 for both), were more likely to report feeling comfortable addressing sexual health topics. OB-GYNs in central Israel and Jewish participants were more likely to feel comfortable, compared to their southern and Muslim counterparts (P < 0.001 for both). Training was rated as poor or very poor by 43.2% for discussing sexual health and 60.2% for treating sexual dysfunction. Compared to their counterparts, poor training was reported by OB-GYNs under age 60 years, with degrees from abroad, and with less experience. The respective odds ratios were 2.70 (95% CI 1.47-4.96, P = 0.001), 1.799 (95% CI 1.24-2.60, P = 0.002), and 1.72 (95% CI 1.04-2.82, P = 0.033). Most respondents supported integrating sexual health education into medical curricula (69.5%) and OB-GYN residency programs (89.1%).Clinical implications Significant gaps in the training and practices of Israeli OB-GYNs underscore the need for enhanced education tailored to address cultural and demographic factors.Strengths and limitations The large, diverse sample provides valuable insights. However, the self-reported data may have introduced bias, and the cultural diversity may limit generalizability.Conclusion Substantial gaps were reported in the training and practices of Israeli OB-GYNs regarding female sexual health. These findings underscore the need for enhanced education and structured training programs, tailored also to address cultural and demographic factors, to improve patient care.