Breaking the ‘conspiracy of silence’: How to address sexual dysfunction in a gynecological/ obstetric out-patient setting

Abstract

Background: This study set out to examine if, and to what extent, women would like gynecologists to ask about sexual function during a standard out-patient interview. A secondary aim was to find out if women would like information about sexual function to be documented in the general or the restricted medical journal. Methods: Participants were 494 women ages 18-79 attending gynecological and obstetric out-patient clinics at the St. Olav’s University Hospital in Trondheim, Norway. The participants completed a self-reported questionnaire with ten questions, assessing their attitudes towards enquiry and documentation about sexual function during an out-patient appointment with a gynecologist. Demographic questions included age, cultural background and type of clinic the women were visiting. Comparisons between the different variables in our study were conducted using nonparametric tests as appropriate. The main outcome measure was whether the women accepted to be asked about sexual function during a visit to gynecological/ obstetric out-patient clinics. Results: Mean age of patients was between ages 30 and 40. The most common age interval was 18-29. The large majority (87%) of participants would accept that the gynecologist asks questions about sexual function during an out-patient appointment. More than 90% would also accept that their gynecologist asked more detailed questions about sexual function. Type of clinic does not affect willingness to receive questions about sexual function. We found a non-significant tendency for older women to be less accepting to questions about sexual function. About 52% of participants would like information about sexual function problems to be saved in a restricted medical journal, while 48% accepted that information was saved in the general medical journal. Conclusion: Most women attending gynecologic and obstetric out-patient clinics at the St. Olav’s University Hospital accept that gynecologists ask about sexual function in general and about specific dysfunctions, if they had admitted to having a problem. Information about sexual function problems should be documented in the restricted medical journal, at the very least the patient should be asked before information is documented in the general medical journal.