Perspectives on Sexuality Among Patients with Hypopituitarism: Broadening the Medical Focus on Sexual Function to Include Sexual Wellbeing

Abstract

Hypopituitarism means a partial or complete inability to produce pituitary hormones, including those regulating gonadal function. The condition therefore leads to hormone deficiencies that may affect sexuality in various ways. This study aimed to explore patients' own experiences of hypopituitarism in relation to sexuality, and it is based on interviews with 19 men and women. A qualitative methodology inspired by Gadamer's philosophical hermeneutics was used. Analysis revealed that current healthcare practices, which focus primarily on sexual functioning, fail to address patients' existential concerns about loneliness, loving relationships and selfhood. Another important finding was that women felt that their sexual functioning and wellbeing tended to go unnoticed, while men said that healthcare professionals focused mainly on erectile function rather than problems with sexual wellbeing. Cultural and gender norms were apparent in these healthcare interactions, and proactive efforts to improve awareness is required in order to improve the quality of care provided to these patients. Healthcare professionals need time, space and support for reflection so that they may enhance their knowledge about the complexity of sexuality and discuss the results of research into hormone replacement in men and women. They also need support to develop critical awareness of how gendered norms about sexuality may negatively affect the care provided to persons with hypopituitarism.

Sexual well‐being needs of patients with chronic illness expressed in health care: A scoping review

“…F I G U R E 1 PRISMA flowchart for study selection. Adopted from PRISMA statement (Page et al, 2021) To explore the patient's perception of the impact of severe asthma on intimacy, establish their information needs and their perceived role of the HCP Albers et al, 2020;Cooper et al, 2018;Dellenborg et al, 2020;Egerod et al, 2018;Fourie et al, 2021;Holmes et al, 2019;Hyde et al, 2020;Josefsson & Gard, 2012;Kazmerski et al, 2016;Leonardi-Warren et al, 2016;Lindau et al, 2011;Ma et al, 2020;den Ouden et al, 2019;Petit-Steeghs et al, 2020;Savel et al, 2020;Traa et al, 2014;Traumer et al, 2019;Zhang et al, 2020 Being asked questions Hoorsan et al, 2021;Sandfort et al, 2013;Traumer et al, 2019 Bringing up the issue themselves Grondhuis Palacios et al, 2018;Hoorsan et al, 2021;Josefsson & Gard, 2012;Sandfort et al, 2013;Zhang et al, 2020 Good/comfortable relationship between HCPs and patients Abramsohn et al, 2013;Carlsson-Lalloo et al, 2016;Lindau et al, 2011;Traumer et al, 2019 Private conversation/private or safe space Abramsohn et al, 2013;Gong et al, 2021;Holmes et al, 2019;Ma et al, 2020 Direct/plain/open discussions Leonardi-Warren et al, 2016;McCallum et al, 2012;Traa et al, 2014 Discussion...…”