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ARHP Makes Recommendations for Providers From Wide-Ranging Consensus Meeting About Female Sexual Health
Recognizing the challenges faced by clinicians who provide female sexual health (FSH) care, ARHP convened a consensus meeting to draft guidance on best practices for frontline providers, with a focus on the topic of treating patients with female sexual dysfunction (FSD). Fourteen participated in our consensus meeting, including four medical doctors, two certified nurse midwives, a nurse practitioner, a psychologist, two health care consumers, and four ARHP staff members.
The meeting and a summary report were funded through an independent educational grant from Valeant Pharmaceuticals International.

This effort built upon the Handbook on Female Sexual Health and Wellness , an earlier collaboration between ARHP and the International Society for the Study of Women’s Sexual Health (ISSWSH).

Almost half of all women experience some form of FSD , including issues related to sexual desire, arousal, orgasm, and/or sexual pain. Women are two-to-three times more likely to experience declining sexual desire as they age than men.

In preparation for the meeting, ARHP polled its members regarding their experiences, knowledge, challenges and opportunities related to learning about, diagnosing and treating FSH. The survey found:

  • While the majority received limited training in FSH, they were comfortable discussing sexual desire, activity, and concerns with female patients.
  • The clear majority identified time constraints as a major barrier in addressing FSH issues. Others included: lack of available treatments; reimbursement and insurance difficulties; lack of knowledge; and shame or stigma associated with the topic.
  • Most wanted additional training, tools, and resources.

Concrete Recommendations for Clinicians

Among the actionable recommendations made were that providers should:

  • Strive to “check at the door” their own assumptions and biases. Providers should identify assumptions regarding patients’ relationship status, number of partners, sexual orientation, gender identity, and specific cultural beliefs, and seek to minimize their influence. Doing so will help them provide patients the best, least-judgmental, individualized care.
  • Assess whether FSH discussions will be welcome. Phrases such as “we see many different people for all different things” or “we ask these questions of everyone” may help universalize and normalize sensitive issues. Providers also should assess whether FSH issues should be discussed with a partner present, or with the female patient privately.
  • Manage time and cost constraints by scheduling follow-up visits and making specialist referrals.
  • Leverage electronic resources and diagnostic codes. Adding diagnostic codes, building questions about sexuality, relationships, and gender into electronic health records and charting, and scheduling electronic health records reminders can prompt providers to discuss SRH care and ensure reimbursement for doing so.
  • Ensure that provider resources position sex in a positive and affirmative manner. Present FSH as maintaining a satisfying sex life throughout the lifecycle, rather than as a sexual dysfunction.
  • Establish a safe space, and a climate of openness and respect. Some things providers specifically can do include: 1) engage with the patient calmly and focus on her—rather than on a computer or chart; 2) initiate conversations about sexual health when a patient is dressed, not during an exam; and 3) ask the patient to set the agenda for the appointment, but be prepared to sensitively initiate and prompt discussions about FSH issues.
  • Provide FSH education and training to a wide range of providers, including support staff.
  • Conduct research to demonstrate that FSH screening and treatment can be effectively and efficiently integrated into routine visits.

The consensus meeting also offered recommendations for organizations that support frontline providers , including developing resources—such as scripts, user-friendly technical information, and digital and print resources—that support providers in successfully addressing FSH issues with their patients. Participants also recommended developing and disseminating materials about established and emerging FSH treatments.

If you're interested in the entire report summarizing our consensus meeting, including the results of our member survey and the presentation slides, please click the red button below .
Thank you as always for your support and participation in our evidence-based, open-access educational programs.

Melissa Werner , MPH, MAT
ARHP Director of Education
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