Department of Obstetrics and Gynecology, Kaiser Franz Josef Hospital, Vienna, Austria.
J Sex Med. 2014 Aug;11(8):2048-54. doi: 10.1111/jsm.12603. Epub 2014 Jun 5.
Female sexual problems and dysfunctions have a high prevalence, ranging from 12% to 80%, depending on the definition being used, underlying comorbidities, and age. Despite the high prevalence, there are only scarce data about the approach gynecologists use to address female sexual dysfunction.
The aim of this study is to evaluate the approach of Swiss gynecologists to addressing sexual problems among their outpatients.
After a pilot study including 56 physicians, a modified 19-item self-administered questionnaire was sent to 856 Swiss gynecologists to evaluate their methods of management of patients with sexual issues and their attitudes regarding the integration of sexual health issues into the gynecological consultation.
Besides demographic information, the self-administered questionnaire included questions about addressing sexual health as part of consultation routine, estimated frequency of symptoms, reasons for not addressing sexuality, clinical conditions in which sexuality was addressed, and methods of management of sexual problems.
Of the 341 responding gynecologists (39.8% response rate), 40.4% reported having at least brief (at least 1-2 days) of training in sexual medicine, 7.9% of the respondents routinely explored sexual issues with more than 80% of their patients, 28.2% of the respondents offered appointments specifically for sexual issues, and 85% proposed referrals to specialized colleagues. Lack of motivation for therapy on the part of the patient was mentioned as the most common cause for persisting symptoms (63.3%). Dyspareunia was quoted as the most/second most prevalent type of female sexual dysfunction by 77.1% of the respondents.
We conclude that among Swiss gynecologists, sexual problems are regarded as an important issue in gynecological outpatient care, but addressing patients' sexuality is not yet part of routine practice. Swiss gynecologists seem to be most likely to consider hormonal changes (although not so much those due to oral contraceptives) to necessitate discussion of sexual health issues, while psychosocial transitions or stress seem to be considered less important.
女性性问题和性功能障碍的患病率很高，范围从 12%到 80%，具体取决于所使用的定义、潜在的合并症和年龄。尽管患病率很高，但关于妇科医生如何解决女性性功能障碍的信息却很少。
本研究旨在评估瑞士妇科医生处理门诊患者性问题的方法。
在包括 56 名医生的试点研究之后，向 856 名瑞士妇科医生发送了一份经过修改的 19 项自我管理问卷，以评估他们管理有性问题患者的方法以及他们对将性健康问题纳入妇科咨询的态度。
除人口统计学信息外，自我管理问卷还包括有关将性健康作为咨询常规一部分的问题、症状估计频率、不解决性行为的原因、解决性行为的临床条件以及管理性问题的方法。
在 341 名回复的妇科医生（39.8%的回复率）中，40.4%的人报告至少有过短暂（至少 1-2 天）的性医学培训，7.9%的医生会定期与超过 80%的患者探讨性问题，28.2%的医生提供专门用于性问题的预约，85%的医生建议向专业同事转诊。患者缺乏治疗动机是持续症状的最常见原因（63.3%）。77.1%的医生认为性交困难是最常见/第二常见的女性性功能障碍类型。
我们得出结论，在瑞士妇科医生中，性问题被认为是妇科门诊护理中的一个重要问题，但解决患者的性行为尚未成为常规实践。瑞士妇科医生似乎最有可能认为激素变化（尽管不那么认为是由于口服避孕药引起的）需要讨论性健康问题，而心理社会变化或压力则被认为不太重要。
