Increased authoritarianism in graduating students' attitudes emphasises clearly the need for future research and redesigning communication curricula. Furthermore, the influence of gender and relationship with religion on attitudes towards the doctor-patient relationship should be explored further, in order to eliminate disparities in the provision of patient-centred medical care.

Objectives Although the World Health Organization has declared that sexual health is an integral part of overall health, physicians seem to engage in taking the sexual health history less than their patients would desire. This study aimed at investigating the factors that predict physicians’ involvement in addressing sexual health issues, including their attitudes toward the doctor–patient relationship, as well as sexual issues. Methods Physicians participating in educational courses on erectile dysfunction were the study sample, and anonymously and optionally completed a battery of questionnaires. In addition to demographics and a questionnaire on their involvement in taking sexual histories, the beliefs about the doctor–patient relationship were measured by the Patient–Practitioner Orientation Scale, while the Physician Belief Scale was used as the measurement of the psychosocial aspects of patient care. Finally, participants completed the Derogatis Sexual Functioning Inventory––Attitude subscale, in order to determine the possible role of physicians’ sexual attitudes. Results Previous training in communication skills was found to be the strongest predictor for sexual history taking. Physicians addressing patients’ psychosocial concerns were found to be more likely to ask for sexual health problems and to consider their management as less difficult. Other identified predictors of their involvement in sexual history taking were their medical specialty—possibly reflecting their level of education in sexual medicine––and having liberal sexual attitudes; female physicians and general practitioners reported more difficulty in dealing with sexual problems. Conclusions Physicians’ training in communication skills seems to be fundamental for sexual history taking and the management of sexual problems, as it improves their level of comfort in dealing with sexual issues; exposure to sexual medicine courses, and psychosocial orientation, as well as physicians’ personal sexual attitudes, are also important factors affecting their involvement in sexual medicine.

Group PFMT under intensive supervision produced significantly better improvements in primary and secondary outcomes in the short-term compared to individual, unsupervised home application of PFMT.