The Attitudes, Perspectives, and Barriers Among Primary Care Physicians Towards Addressing Sexual Health of Perimenopausal-Aged Women

Background/Objective: Menopause is the natural cessation of menstruation that typically occurs in women between ages 45 and 50. Menopause can lead to numerous issues regarding sexual health such as vulvovaginal atrophy, low desire, issues with vaginal lubrication, and an inability to achieve climax. Despite these issues, very few physicians initiate conversations about sexual health. Female patients generally feel uncomfortable bringing up the topic without first being asked by their physicians, so it is imperative to assess the reasons why physicians rarely discuss the topic. Methods: Sixteen semi-structured interviews were conducted with family medicine physician faculty and residents regarding barriers to discussing sexual health with their patients. Interviews were transcribed, reviewed, and coded for common themes. Generalizable categories were identified from these themes. Results: Patient embarrassment and cultural/religious norms were the most stated barriers to discussing sexual health. Adherence to norms and the lack of sexual education among patients were the most stated potential reasons for these barriers. The use of standardized questions and increasing efforts to directly discuss sexual dysfunction were the most stated potential solutions to these barriers. Better medical education regarding female sexual health and developing routines to ask about sexual health were the most stated strategies to help family medicine physicians to better serve this population. Conclusion and Potential Impact: This study established, from a family medicine perspective, the barriers and respective potential solutions towards improving the sexual health of women of menopausal age. Patients with suboptimal sexual health can affect other aspects of their health. If barriers to discussing this topic with patients can be reduced, more sexual dysfunction diagnoses can be made, and family medicine physicians can better guide and treat patients to resolve these issues and improve overall quality of life.

The Impact of COVID−19 on Female Sexual Health

Introduction: Coronavirus disease (COVID−19), announced as a pandemic by the World Health Organization, recently has dominated people’s lifestyle. The impact of COVID−19 seems to be relevant to the sexual health as well. Methods: This prospective study was conducted on two occasions involving 764 female patients between March and April 2020—before and during the time of social quarantine. The sexual function was assessed using the Polish version of the Female Sexual Function Index (FSFI). Every patient filled out the survey concerning socio-demographic characteristics as well as the influence of SARS-CoV−2 pandemic on their lives. Results: The overall FSFI score before the pandemic was 30.1 ± 4.4 and changed to 25.8 ± 9.7 during it. Scores of every domain: desire, arousal, lubrication, orgasm, satisfaction and pain decreased as well (p < 0.001). There was statistically significant association between the workplace and the change of FSFI scores before and during COVID−19 pandemic (p < 0.01). We noticed the biggest decrease in FSFI score in the group of women who did not work at all (5.2 ± 9.9). Religion had a statistically important impact on level of anxiety (p < 0.01). Conclusion: The main finding of our study was the influence of COVID−19 pandemic on the quality of sexual lifestyle and frequency of intercourse among Polish women.