Views of family physicians on heterosexual sexual function in older adults

Abstract

BackgroundSexual functioning among older adults has received little attention in research and clinical practice, although it is an integral part of old age. As older adults tend to consume health services and to visit family physicians more frequently, these care-providers serve as gatekeepers in the case of sexual concerns. The present study evaluated the perceptions of family physicians regarding sexuality in older adults.MethodQualitative interviews with 16 family physicians were conducted. We used in-depth, semi-structured interviews.ResultsThree main themes emerged: 1. Family physicians described having difficulty in raising questions about sexuality to older patients. 2. Family physicians tended towards the biological side of the spectrum, focusing on the patient’s medical problem and asking physiological questions. 3. Family physicians mainly related to medication administered to their male patients, whereas a minority also described the guidance they provided to older individuals and couples.ConclusionsThe study shows that family physicians tend not to initiate discourse with older patients on sexuality, but rather discuss sexuality mostly in conjunction with other medical conditions. Implications for research and practice are discussed.

When sex meets age: Family physicians’ perspectives about sexual dysfunction among older men and women: A qualitative study from Israel

“…Family physicians’ perceived the men’s problems as simple and easily solved using medication, while the women’s problems were perceived as more complex, requiring a solution including both medication as well as emotional support. This is in spite of the fact that other studies indicate that men’s sexual function is related to their psychological state [10,15,28–30]. The physicians’ perspectives reflect the patients’ attitudes; there is a clear public preference for treatment in the form of medication.…”

“…It was also was found that physicians who treat women with gynaecological symptoms identify a difficulty in sexual function, but very few physicians discuss this matter with the women [27]. These findings emphasize that also among women, there are medical reasons for sexual function difficulties, but these problems receive less attention and treatment [10].…”

“…Despite the existing knowledge about the importance older people give to staying sexually active [9], physicians do not perceive their patients’ sexuality as part of their field of expertise; they report a lack of knowledge and a lack of confidence regarding the subject [10,11]. Moreover, higher levels of ageist attitudes were found to be directed towards older women compared to older men [12].…”

“…Older men and women are often afraid to involve physicians in their sexual problems and therefore choose to deal with these problems alone or to ignore them [13–18]. When family physicians raise sexual issues, it usually occurs with older men, rather than with older women [10], despite studies, which indicate a higher sexual dysfunction rate among older women [3].…”

Prevalence and Nature of Sexual Violence in Older Adults in Europe: A Critical Interpretive Synthesis of Evidence

“…Yet, research showed that both primary care physicians and nurses working in long term care tend not to address sexual health proactively when with older adults, as they feel it is not a legitimate topic to discuss with this age group and are afraid to offend their patients [57,58]. Additionally, primary care physicians tend to look at sexual health in older age in the context of dysfunctions or diseases [59] and consequently discuss sexuality mostly in conjunction with other medical conditions [60]. It seems health care workers, although theoretically recognising that sexuality plays an important role in the lives of older adults, are responding to stereotypes of the 'asexual older adult' [57,58], an image that is often portrayed in the media and has become a wide societal image [61][62][63].…”