Management of female sexual problems: perceived barriers, practice patterns, and confidence among primary care physicians and gynecologists.
BACKGROUND
Although approximately 40% of women report female sexual problems--and particularly sexual desire disorders, there are numerous practical, professional, and personal barriers to their diagnosis and management by treating clinicians.


OBJECTIVE
To identify practice patterns, perceptions, and barriers to the diagnosis and management of female sexual problems among U.S. practicing primary care physicians (PCPs) and obstetrician/gynecologists (OB/GYNs).


METHODS
A random sample of practicing U.S. PCPs and OB/GYNs were sent a case-vignette survey by e-mail and fax. Response to the survey was considered consent. A regression model was analyzed to assess predictors of confidence.


METHODS
Frequency and variability in diagnostic tests ordered and treatment recommendations provided for a patient with diminished sexual desire. Percent of physicians who reported they were confident in treating hypoactive sexual desire disorder (HSDD) and percent who reported significant barriers to initiating a dialogue about sexual health with female patients.


RESULTS
A total of 505 responses were analyzed (8.8% response rate). Of respondents, 21% of OB/GYNs and 38% of PCPs stated they were not at all confident in treating HSDD. The majority of physicians would order a thyroid panel (PCP = 63%, OB/GYN = 53%) to assess a patient's diminished desire and recommended counseling and stress management to treat a patient with sexual complaints (PCP = 48%, OB/GYN = 54%). Regression results identified time constraints, the perceived lack of effective therapies, perceptions regarding patient-physician gender discordance, years in practice, number of patients seen per week, and perceptions regarding continuing medical education and practice experience as significant and independent predictors of confidence in treating HSDD patients.
Abdolrasulnia
Maziar
M
CE Outcomes, LLC, Birmingham, Alabama 35211, USA. Mazi@ceoutcomes.com
Shewchuk
Richard M
RM
Roepke
Nancy
N
Granstaff
U Shanette
US
Dean
John
J
Foster
Jill A
JA
Goldstein
Andrew T
AT
Casebeer
Linda
L
D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006176:Gynecology / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D008487:Medical History Taking; D015233:Models, Statistical; D015999:Multivariate Analysis; D058007:Physicians, Primary Care / Q000523:psychology / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012649:Self Concept; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D014481:United States; D016387:Women's Health