Patient reported improvement in sexual health outcomes following care in a sexual health clinic for women with cancer

Improving Sexual Health Across the Life Span Through Integrated Care in Obstetrics and Gynecology

“…Over 60% of patients who have undergone chemotherapy for gynecologic cancers report impaired sexual function, and 83% of patients treated for breast cancer report sexual side effects and decreased sexual satisfaction. 14,15 Low sexual desire may also represent a symptom of depression or anxiety, and both diminished desire and anorgasmia may be iatrogenic effects of selective serotonin reuptake inhibitor and hormone medications, including combined hormonal contraception and spironolactone, which is commonly prescribed to women for acne or polycystic ovary syndrome. 16 Roughly 40% of women on these classes of medications report sexual side effects.…”

“…A proactive style, where the provider enquires about sexual functioning in the past, is "permission granting" to patients to discuss such problems in the future. 14,[19][20][21][22][23] In addition, research on women with early breast cancer indicated a strong preference for providers to ask about sexual health early and often by incorporating this into routine screening performed over the course of care. 24 All too often, however, health care providers and trainees do not feel adequately prepared to discuss sexual health concerns with patients; primary care providers and OB/GYN's cite a perception of a lack of effective therapies as a barrier to initiating assessment of sexual health concerns.…”

“…For the large numbers of women living with or surviving cancer, many experience ongoing sexual sequelae. Over 60% of patients who have undergone chemotherapy for gynecologic cancers report impaired sexual function, and 83% of patients treated for breast cancer report sexual side effects and decreased sexual satisfaction 14,15 …”

“…It has been identified that patients want their health care providers to initiate conversations regarding sexual concerns. A proactive style, where the provider enquires about sexual functioning in the past, is “permission granting” to patients to discuss such problems in the future 14,19–23 . In addition, research on women with early breast cancer indicated a strong preference for providers to ask about sexual health early and often by incorporating this into routine screening performed over the course of care 24 …”

“…While the evaluation and treatment of sexual health concerns often requires additional consultation outside of OB/GYN practices, integrating sexual medicine services within primary and/or specialty OB/GYN settings has a broad range of positive patient and provider outcomes. Patients benefit from multidisciplinary evaluation of their symptoms, shared treatment goals and coordinated interventions, markedly improved access to care through warm harm handoffs to physical therapists, psychologists, sex therapists, psychiatrists, or psychiatric nurse practitioners, among other providers, follow-up treatment within the OB/GYN practice, shared documentation to improve interprofessional communication and evaluation of patient outcomes, less stigma and acceptability coming to the OB/GYN office in contrast to seeking care in a traditional mental health practice, etc… Furthermore, research indicates that women are more satisfied with one-stop, integrated approaches to their health care 5,14 . The following section describes models of integrated sexual medicine practices in OB/GYN and other health care settings.…”