title: Obstacles to the discussion of sexual problems in menopausal women: a qualitative study of healthcare providers.
abstract: The aim of this study was to explore issues that challenge menopausal women in discussions of their sexual problems with a physician. This was done from the perspective of healthcare providers. In a descriptive exploratory qualitative study, using a semi-structured interview and purposive sampling, a sample set of 12 midwives and 13 general practitioners aged 25-70 years were selected in order to elicit meaning behind their experiences about the subject under study. Data analysis was carried out using qualitative content analysis. Results were used to identify a number of obstacles that hindered women from seeking help for sexual problems from GPs and midwives. These obstacles included the following: (1) traditional and cultural beliefs; (2) religious belief; (3) individuals' beliefs and (4) access to services. More research is needed to explore effective strategies to overcome these problems. Impact statement Current knowledge on the subject: In the literature, many reasons have been identified for the unwillingness of Iranian women to discuss their sexual problems with health providers. These include lack of time, feelings of shame and an expectation that a doctor cannot help. However, no qualitative study has addressed barriers held by menopausal women for seeking treatment for sexual problems. The contribution made by the results of this study: The results of this study add to the growing body of research on reasons that determine why most postmenopausal women rarely visit a doctor unless they were in tremendous physical or emotional pain. Also, menopausal women thought that an unmarried health provider would be less understanding about sexual and marital problems and they felt guilty about sharing such issues with them. Patients' opinions on the nature of menopause (a pathological vs. physiological process) affect the way in which the symptoms of menopause and sexual problems are handled by patient. The implications are of these findings for clinical practice and further research: The results of this study can be used to formulate guidelines to cultural sensitivity appropriate to Iranian society.
authors.affiliation: a Department of Midwifery and Reproductive Health, Nursing and Midwifery School , Mashhad University of Medical Science , Mashhad , Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Ghazanfarpour
authors.affiliation: b Department of Midwifery, School of Nursing and Midwifery , Mashhad University of Medical Sciences , Mashhad , Iran.
authors.forename: Talat
authors.initials: T
authors.lastname: Khadivzadeh
authors.affiliation: c Department of Midwifery, School of Nursing and Midwifery,Evidence-Based Care Research Centre , Mashhad University of Medical Sciences , Mashhad , Iran.
authors.forename: Robab
authors.initials: R
authors.lastname: Latifnejad Roudsari
authors.affiliation: d Research Center for Health Science and Department of Public Health, School of Health , Hamadan University of Medical Sciences , Hamadan , Iran.
authors.forename: Seyed Mohammad
authors.initials: SM
authors.lastname: Mehdi Hazavehei
mesh_terms: D003144:Communication Barriers; D005260:Female; D006801:Humans; D007492:Iran; D008593:Menopause / Q000523:psychology*; D024382:Professional Role / Q000523:psychology*; D019529:Sexuality / Q000208:ethnology* / Q000523:psychology
keywords: Obstacles to discussions sexual problems; healthcare providers; menopausal women; qualitative study