The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.
SMJ // Article
Original Article
Primary Care Clinicians’ Knowledge and Perspectives about Sexual Dysfunction
Abstract
Objectives: Female sexual dysfunction (FSD) refers to problems with desire, arousal, orgasm, or pain, affecting approximately 12% of US women. Although FSD can be managed in primary care, most primary care clinicians do not regularly treat it. This survey of primary care clinicians practicing at a large US health system assessed perspectives on managing sexual dysfunction compared with other conditions, knowledge of prevalence of sexual dysfunction, and which specialty should be responsible for treating FSD.Methods: We described the distribution of clinicians’ survey responses. Of the 527 invited, 80 completed the survey (response rate: 15%). Most were women (68%), physicians (52%), and had >15 years of experience (43%).
Results: The majority (88%) reported treating FSD is as important as treating other conditions that affect quality of life. Two-thirds reported disorders of desire, arousal, and orgasm could be managed in primary care, and 64% believed that pain with intercourse, typically addressed by Obstetrics/Gynecology, should be handled in primary care. Most primary care clinicians believed that treating FSD was at least as important as treating other conditions, yet up to one-third believed this responsibility should be left to a different specialty.
Conclusions: Educational interventions targeting primary care clinicians may increase the number who take on FSD management.
Posted in: Menopause: Management, Risks, & Benefits of Therapy2 Sexual Disorders And Gender Dysphoria1
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References
1. Shifren JL, Monz BU, Russo PA, et al. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol 2008;112:970–978.
2. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999;281:537–544. .
3. Reed BD, Harlow SD, Sen A, et al. Prevalence and demographic characteristics of vulvodynia in a population-based sample. Am J Obstet Gynecol 2012;206:170.e1–e9.
4. Kingsberg SA, Wysocki S, Magnus L, et al. Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE (REal Women’s Views of Treatment Options for Menopausal Vaginal ChangEs) survey. J Sex Med 2013;10:1790–1799.
5. Nappi RE, Kokot-Kierepa M. Vaginal Health: Insights, Views & Attitudes (VIVA)—results from an international survey. Climacteric 2012;15:36–44.
6. Santoro N, Komi J. Prevalence and impact of vaginal symptoms among postmenopausal women. J Sex Med 2009;6:2133–2142.
7. Simon JA, Athavale A, Ravindranath R, et al. Assessing the Burden of Illness Associated with Acquired Generalized Hypoactive Sexual Desire Disorder. J Womens Health (Larchmt) 2022; 31:715–725.
8. DiBonaventura M, Luo X, Moffatt M, et al. The Association Between Vulvovaginal Atrophy Symptoms and Quality of Life Among Postmenopausal Women in the United States and Western Europe. J Womens Health (Larchmt) 2015;24:713–722.
9. Parish SJ, Hahn SR, Goldstein SW, et al. The International Society for the Study of Women’s Sexual Health Process of Care for the Identification of Sexual Concerns and Problems in Women. Mayo Clin Proc 2019;94:842–856.
10. Panken EJ, Fantus RJ, Chang C, et al. Epidemiology and Diagnosis of Erectile Dysfunction by Urologists Versus Non-Urologists in the United States: An Analysis of the National Ambulatory Medical Care Survey. Urology 2021;147:167–171.
11. Harsh V, McGarvey EL, Clayton AH. Physician attitudes regarding hypoactive sexual desire disorder in a primary care clinic: a pilot study. J Sex Med 2008;5:640–645.
12. Morris J, Clark C, Reed L, et al. Healthcare provider knowledge, attitudes, and preferences in management of genitourinary syndrome of menopause in the Mid-South. Menopause 2021; 28:1239–1246.
13. Stanley EE, Pfoh E, Lipold L, et al. Gap in Sexual Dysfunction Management Between Male and Female Patients Seen in Primary Care: An Observational Study. J Gen Intern Med 2025; 40:847–853.
14. Millman AL, Rebullar K, Millman RD, et al. Female Sexual Dysfunction—Awareness and Education Among Resident Physicians. Urology 2021;150:175–179.
15. Abdolrasulnia M, Shewchuk RM, Roepke N, et al. Management of female sexual problems: perceived barriers, practice patterns, and confidence among primary care physicians and gynecologists. J Sex Med 2010;7:2499–2508.
16. Mansell D, Salinas GD, Sanchez A, et al. Attitudes toward management of decreased sexual desire in premenopausal women: a national survey of nurse practitioners and physician assistants. J Allied Health 2011;40:64–71.
17. Goldstein I, Lines C, Pyke R, et al. National differences in patient-clinician communication regarding hypoactive sexual desire disorder. J Sex Med 2009;6:1349–1357.
18. Kingsberg SA, Larkin L, Krychman M, et al. WISDOM survey: attitudes and behaviors of physicians toward vulvar and vaginal atrophy (VVA) treatment in women including those with breast cancer history. Menopause 2019;26:124–131.
19. Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med 2007;120:151–157.
20. Bacon CG, Mittleman MA, Kawachi I, et al. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med 2003;139:161–168.
21. Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151: 54–61.
22. Mayer D, Lynch SE. Bremelanotide: New Drug Approved for Treating Hypoactive Sexual Desire Disorder. Ann Pharmacother 2020;54:684–690.
23. Jaspers L, Feys F, Bramer WM, et al. Efficacy and Safety of Flibanserin for the Treatment of Hypoactive Sexual Desire Disorder in Women: A Systematic Review and Meta-analysis. JAMA Intern Med 2016;176:453–462.
24. Faubion SS, Rullo JE. Sexual Dysfunction in Women: A Practical Approach. Am Fam Physician 2015;92:281–288.
25. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins— Gynecology. Female Sexual Dysfunction: ACOG Practice Bulletin Clinical Management Guidelines for Obstetrician-Gynecologists, Number 213. Obstet Gynecol 2019;134:e1–e18.
26. Merriam S, Kling JM, Thomas HN, et al. Female Sexual Dysfunction: A Primer for Primary Care Health Professionals. MedEdPORTAL 2023;19:11312.
27. Cooper CP, Saraiya M. Opting out of cervical cancer screening: physicians who do not perform pap tests. Am J Prev Med 2014;47:315–319.
28. Haas JS, Sprague BL, Klabunde CN, et al. Provider Attitudes and Screening Practices Following Changes in Breast and Cervical Cancer Screening Guidelines. J Gen Intern Med 2016;31:52–59.
29. Sayuk GS, Wolf R, Chang L. Comparison of Symptoms, Healthcare Utilization, and Treatment in Diagnosed and Undiagnosed Individuals With Diarrhea-Predominant Irritable Bowel Syndrome. Am J Gastroenterol 2017;112:892–899.
30. Nalamachu SR, Robinson RL, Viktrup L, et al. Multimodal Treatment Patterns for Osteoarthritis and Their Relationship to Patient-Reported Pain Severity: A Cross-Sectional Survey in the United States. J Pain Res 2020;13:3415–3425.
