Why sexual health must be part of the conversation during Women’s Health Week and every week!
May 13, 2019
A guest blog by Dr. Sheryl A. Kingsberg, PhD, IF
Chief, Division of Behavioral Medicine, Department of OB/GYN, MacDonald Women’s Hospital
Professor, Departments of Reproductive Biology and Psychiatry, Case Western Reserve University School of Medicine
Today marks the launch of National Women’s Health Week, which seems like an excellent time to talk about sex. If you ever watch Netflix, surf social media, or read any major news outlet you could easily assume that women’s sexual health is finally receiving mainstream attention it deserves.
You would be wrong.
Despite the prevalence of sex in the media, women still face incredulous barriers to healthcare relating to their own sexual function. A prevailing taboo about discussing sexual health or even suggesting that sexual desire is an important part of a women’s healthcare continues to permeate our culture. In turn, it has created an alarming gap in the conversation about women’s health and prevents women from seeking solutions to their own sexual healthcare needs.
According to the frequently cited PRESIDE survey of 31,581 US women, 43 percent of women report sexual complaints about desire, arousal or orgasm and about 1 in 10 meet the criteria of a diagnosis of hypoactive sexual desire disorder. One review of the literature finds that the prevalence of sexual dysfunction in epidemiological studies ranges from 24–43% of women who complain of low sexual desire in the preceding year. The wide range in number is due in part to the lack of consistency around the diagnosis of “sexual dysfunction,” as well as the ongoing reliance on expert opinions and imprecise terms to detect these conditions.
Contributing to absence of discourse is also the discomfort women feel when discussing these topics, and the lack of attention paid to these issues by their healthcare providers.
In one study, fewer than half of physicians reported routinely inquiring about condom use and other sexual habits as part of routine medical exams. And even when women muster the courage to mention pain with sex, lack of desire, or other sexual dysfunction issues, few healthcare professionals have received proper training on how to effectively have these conversations or treat these conditions. Another study found the majority of providers reported that they seldom know where to refer patients who report sexual dysfunction.
Unmet medical needs
Today, female sexual dysfunction is treated in much of the same way clinical depression was 30 years ago. Women are told that these issues are ‘in their head,’ or that that they just need to live with it, or try harder to meet their partners’ needs. This has resulted in a significant healthcare gap.
In an era where most new treatments being developed target highly specific patient populations, female sexual dysfunction represents an unmet medical need that impacts millions of women across the globe. The market potential of solving these conditions is impossible to ignore.
Sexual wellness is projected to be a $37 billion industry by 2023, and it could be substantially higher if new treatments addressing woman’s sexual health needs are introduced. Sponsors who invest in sexual wellness research have the opportunity to tap into vast medical needs while facing little competition.
Demand for new treatments is important enough that the US Food and Drug Administration (FDA) designated hypoactive sexual desire disorder or female sexual interest/arousal disorder (FSAID) an unmet medical need, and has issued draft guidance on how to design phase III trials for drugs to treat this condition.
Along with developing treatments, we need to legitimize women’s sexual health and train healthcare professionals how to discuss sexual health as a general healthcare issue. Clinicians cannot expect their patients to bring these topics up, or to share intimate information in response to vague requests like “do you have any other concerns?”as they walk out the door.
Instead, clinicians need to set aside time in appointments to explain the importance of sexual health, and to ask ‘what concerns’ the patient might have posed as an open-ended question to spark more engaging dialogs. Taking time to ask these questions will help physicians better understand their patients’ unmet needs, and create a stronger bond and level of trust in the care relationship.
We have a long way to go, but the first step is recognizing there is a problem, and actively exploring ways to solve it. In honor of Women’s Health Week, let’s change our conversations about sexual health, and start treating it like a basic human right for all women that must be addressed.
 Laumann, E. O., Paik, A., & Rosen, R. C. (1999, February 10). Sexual dysfunction in the United States: Prevalence and predictors. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10022110
 Segraves R, Woodard T. Female hypoactive sexual desire disorder: History and current status. J Sex Med. 2006;3(3):408-418.
 N Haley, B Maheux, M Rivard, and A GervaisDepartment of Pediatrics, Université de Montréal, Quebec, Canada. “Sexual health risk assessment and counseling in primary care: how involved are general practitioners and obstetrician-gynecologists?”, American Journal of Public Health 89, no. 6 (June 1, 1999): pp. 899-902.
 Leonard, C., & Rogers, R. G. (2002). Opinions and practices among providers regarding sexual function. Primary Care Update for OB/GYNS, 9(6), 218-221. doi:10.1016/s1068-607x(02)00121-x