Asking About Sexual Health

Learning Objectives and CME/Disclosure Information

This activity is intended for healthcare providers delivering care to women and their families.

After completing this activity, the participant should be better able to:

1. Identify a question most likely to elicit a productive response from your patients
2. Choose an appropriate referral when indicated

Estimated time to complete activity: 0.25 hours

Faculty:

Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

Faculty: Susan J. Gross, MD, receives consulting fees from Genoox, Inc., and has financial interest in The ObG Project, Inc.

Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.

Method of Participation and Request for Credit

Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Dec 31 2019, participants must read the learning objectives and faculty disclosures and study the educational activity.

If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.

For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.

Read Disclaimer & Fine Print

CLINICAL ACTIONS:

Every patient, no matter their age, gender, health status, including disabilities or chronic illness, or relationship status should be asked about their sexual health. The following two questions can begin the conversation:
- Are you currently sexually active?
- Are there any concerns you currently have about your sex life that you would like to discuss?
Reiterate, before asking about sexual activity, that any information given will be held in strict confidence
Repeat back the concern, exactly as described by the patient, to ensure the patient was correctly understood
Keep responses as ‘matter-of-fact’ as possible to avoid giving a judgmental, alarming or dismissive impression
- Reacting with surprise or concern can be counterproductive as it may dissuade the patient from continuing the conversation
- “Legitimate” concerns and sexual values differ significantly

SYNOPSIS:

Sexual health and regular sexual activity have been correlated with lower morbidity and higher scores of happiness, saving patients years of pain, anxiety and personal distress. Furthermore, a proper sexual history is mandatory for sexual risk reduction counseling and is effective in preventing STDs.

KEY POINTS:

The Women’s Sexual Health Foundation administered an online survey of 3,807 healthy female volunteers to gather feedback regarding discussions pertaining to sexual health and reported that:
- 40% of women who participated did not talk to a clinician about a sexual problem, but more than 50% would have chosen to if the issue had been raised by their provider
- Over 70 % of respondents would be comfortable talking to their clinician about sexual problems, however they preferred that the health care provider initiate the discussion
Once a patient has expressed their concern, the healthcare provider needs to make a determination as to whether they can help the patient or if they should refer her to another professional. Consideration for referral may include the following:
- History of sexual abuse – a referral should be made to a therapist who specifically deals with sexual abuse
- Low desire, problems with arousal, anorgasmia or sexual health issues may benefit from a referral to a sexual medicine expert if complex or beyond the scope of the provider
- Relationship issues -Refer to couples therapist
- Body Dysmorphia – Refer to individual therapist who specializes in body dysmorphia
- Questioning Sexual Identity or Orientation – Refer to an individual counselor who specializes in these areas
- A side effect from another medication – Refer patient to prescribing physician