March 2002 · Vol. 14, No. 3Break the silence:
Discussing sexual dysfunction
Long a taboo subject among women and many physicians, a new openness about sexual dysfunction is emerging. As the gatekeepers of female reproductive health, Ob/Gyns can play a pivotal role in evaluating and managing these complaints.
Barbara
S.
Levy,
MDDr. Levy is clinical assistant professor of OBG at the University of Washington School of Medicine in Seattle and at Yale University School of Medicine in New Haven, Conn. She also serves on the OBG Management board of editors.
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Key points
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Forty-three percent of U.S. women report being dissatisfied with their sexual functioning.
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Female sexual dysfunction is divided into 4 categories: libido, arousal, orgasm, and pain.
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Factors that contribute to sexual dysfunction are distortion or inflammation of pelvic structures, pelvic or abdominal trauma or surgery, medications, depression, and chronic medical conditions.
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A biopsychosocial model of inquiry is recommended for assessing sexual complaints, emphasizing 4 areas: physical, psychologic, relational, and situational.
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In a recent U.S. survey, 43% of female respondents reported being dissatisfied with their sexual functioning, a significantly higher percentage than among male respondents.1 Even more disturbing were separate findings: 71% of adults 25 and older believed their physician would dismiss any sexual concerns they might bring up, while 68% avoided discussing sexual dysfunction with their doctors for fear of embarrassing them.2
A lack of desire for sex is the most common sexual complaint.
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