Study: How doctors differ in screening for female sexual dysfunction
Female Sexual Dysfunction (FSD) remains a significantly under-addressed issue in healthcare settings, particularly across the United States.
Despite its widespread nature, routine screenings for FSD are not consistently integrated into standard healthcare practices. Recent research indicates that only a small proportion of women, estimated between 14% and 40%, receive FSD screening during their regular health check-ups.
A detailed study was undertaken to explore the screening rates for FSD amongst healthcare providers during well-woman appointments.
This investigation also aimed to identify the factors influencing these screening rates and compared them to the frequency of other routine health checks, such as those for depression, cervical cancer, and breast cancer.
The study employed a retrospective methodology, analysing the experiences of women who attended gynaecological well-woman appointments at a major medical centre from November 2017 to January 2020.
Inclusion criteria required participants to be at least 18 years of age, female, English-speaking, and attending the OBGYN department. A focus on new patient appointments was intended to reduce biases, such as the likelihood of increased screening in repeat visits due to established rapport between patient and clinician.
Data were gathered from consultations with resident clinicians, attending clinicians, nurse practitioners (NPs), and certified nurse-midwives (CNMs). While the primary focus was on FSD screening, the study also looked at screening practices across various types of clinicians in relation to other health checks.
The analysis included 106 resident, 90 attending, 80 NP, and 95 CNM appointments. There were noticeable demographic differences between resident and nonresident patient groups, with the former more likely to be single, use hormonal contraceptives or nonhormonal intrauterine devices (IUDs), have anxiety, use cannabis, and have undergone minor procedures on the uterus. In contrast, nonresident patients were more likely to have a history of tobacco use.
FSD screening was found to be significantly more common among resident clinicians, covering assessments of issues such as painful intercourse, difficulties with orgasm/climax, and vaginal dryness.
However, only 39% of women were screened for FSD overall, a rate considerably lower than those for depression, cervical cancer, and breast cancer screenings.
Of those screened for FSD, 26.2% tested positive. Factors increasing the likelihood of FSD screening included care by a resident clinician, a known history of FSD, being over 40, recent sexual activity, and having had previous cervical procedures.
This study highlights the necessity for greater focus on FSD in clinical environments. Although resident clinicians demonstrated higher screening rates, the overall frequency of FSD screenings remains markedly low compared to other established health checks.
Recognising the vital role of sexual health in overall well-being, patients should be encouraged to feel comfortable discussing sexual health concerns with their healthcare providers. Such open communication is crucial for providing comprehensive care and improving quality of life.
References​1,2​
- 1.Berry WCE, Capbarat EV, Walker TV, et al. Associations between gynecologic clinician type and routine female sexual dysfunction screening. The Journal of Sexual Medicine. Published online August 8, 2023:1235-1240. doi:10.1093/jsxmed/qdad106
- 2.Rubin ES, Rullo J, Tsai P, et al. Best Practices in North American Pre-Clinical Medical Education in Sexual History Taking: Consensus From the Summits in Medical Education in Sexual Health. The Journal of Sexual Medicine. Published online October 1, 2018:1414-1425. doi:10.1016/j.jsxm.2018.08.008
