Female sexuality and sexual dysfunction: Are we stuck on the learning curve?

Introduction. Female sexual dysfunctions (FSDs) are very prevalent, multifaceted problems that continue to be under-recognized and undertreated. Improved recognition and management depend on physicians' inclination and ability to communicate with female patients about their sexual function. Many women hesitate to share sexual complaints due to concerns about physicians' time constraints or their interest in addressing it. Direct questioning by physicians about sexual function is often critical to patients' reporting of sexual concerns. Aim. To obtain pilot data on physicians' knowledge, perceptions, and practices regarding FSDs, which may help uncover means of facilitating future dialog between physicians and patients. Methods. A self-reply questionnaire was used to survey physicians and other health professionals attending the 2004 annual meetings of four major specialty societies. Main Outcome Measures. Survey questions were included on the prevalence of FSDs; dialog on sexual function/activity; obstacles to appropriate evaluation and management of FSDs; effectiveness of current treatment options; and referral patterns. Results. A total of 1,946 attendees completed the survey. Most respondents (60%) estimated that one- to three-quarters of their patients had FSDs. Low sexual desire was the most prevalent FSD observed. A total of 58% of participants reported initiating the first discussion of FSDs in one-quarter or less of patients. Obstacles to discussing sexual health included limited time and training, embarrassment, and absence of effective treatment options. Approximately 60% of participants rated both their knowledge of and comfort level with FSDs as only fair or poor. Eighty-six percent rated current treatment options as fair or poor. Conclusion. Healthcare professionals are aware of the high prevalence of FSDs but infrequently initiate a discussion of sexual function with their female patients or conduct a comprehensive evaluation for FSDs. Additional medical education and training are needed to improve the identification and management of FSDs in women.