How do Nigerian Gynaecologist in a Tertiary Health Facility Manage Infertile Patients for Sexual Dysfunction?
Abstract:
This study was conducted to evaluate the approaches gynaecologists in Osun East Senatorial district; South west Nigeria uses to screen and manage their infertile women for sexual dysfunction. Forty gynaecologists and their resident doctors managing infertile women at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, were interviewed (June -December 2020) using an in-depth-interview guide and semi-structured questionnaires. All the forty doctors assessed the sexual functioning of infertile patients. The Assessment was usually done at the first time of seeing the patient and at other times when patients start a discussion about it or when a patient’s complaints are directly related to it. Ways of eliciting sexual concerns were by asking on the frequency of sexual intercourse per week, about ejaculatory intercourse, sexual satisfaction, and dyspareunia. None of them used any standardized assessment tools to screen infertile women. Most are not aware of any standardized tools for sexual functions assessment because they had no training in sexual dysfunction in both undergraduate and postgraduate training as it was not in their curricula. While they welcome the introduction of the tools in training and in the case file of patients, they believed that routine screening using these tools would increase the waiting time and would be an added burden on the doctors. This study showed that gynaecologists and residents are poorly equipped to address sexual problems and sexual dysfunction among infertile women. It is imperative that the curricula of medical training be updated to include assessing sexual functioning tools for better care.References:
[1]
Kottmai,
l. A., Ruether-Wolf, K.V., Bitzer, J. (2014). Do Gynecologist talk about sexual
dysfunction with their patients? Journal of Sex & Medicine; 11:208-2054.
[2] Lara, L.A., Coelho,
Neto, MdeA, Martins WdeP, Ferriani, R.A., Navarro, P.A., (2016). Assessment of sexual
function in infertile women in a gynecological care setting. J Sex Med; 13
(06) :938–944.
[3] Laumann, E.O.,
Paik, A, Rosen, R.C., (1999). Sexual dysfunction in the United States—Prevalence
and predictors. JAMA; 281:537–44.
[4]
Audu, B.M., (2002). Sexual Dysfunction among Infertile Nigerian
women. J, Obstet Gynaecol.; 22:655-7.
[5]
Owonikoko, K.M., Bobo, T.I., Tijani, A.M., Atanda, O., (2018). Adversities of
Being an Infertile Woman in Ogbomoso - A Semi Urban Town in Nigeria. Annals of Infertility
& Reproductive Endocrinology:1(1):1006.
[6]
Okonofua, F.E., Harris,
D., Odebiyi, A., Kane, T., Snow, R.C., (1997).
The social meaning of infertility in Southwest Nigeria. Health Transition Review
7, 205-220.
[7]
Orji,
E.O. and Ogunniyi, S.O., (2001): Sexual behaviour of infertile Nigerian Women. Journal
of Obstetrics and Gynaecology, Vol. 21, (No. 3). 303-305.
[8] Berner M, Schmidt
E, Weinhäupl C, Günzler C, Kriston L, Zahradnik HP. (2010) [Incidence, diagnosis,
and management of female sexual dysfunction in gynecological practice—A representative
survey in Germany.] Geburtsh Frauenheilk; 70:281–7. In German.
[9]
Meystre-Agustoni, G, Jeannin, A, de Heller, K, Pécoud,
A, Bodenmann, P, Dubois-Arber, F., (2011). Talking about sexuality with the physician:
Are patients receiving what they wish? Swiss Med Wkly ;141: w13178.
[10] Sohn, W.2003). Pleasure
and pain in sexual relations. The basis and reasons for sex counseling by the general
practitioner]. MMW Fortschr Med ;145(46):37–40.
[11] Paul’s, R.N.,
Kleeman, S.D., Segal, J.L., Silva, W.A., Goldenhar, L.M., Karram, M.M., (2005).
Practice patterns of physician members of the American Urogynecologic Society regarding
female sexual dysfunction: Results of a national survey. Int Urogynecol. J;
16:460–7.
[12] Wimberly, Y.H.,
Hogben, M., Moore-Ruffifin. J., Moore, S.E., Fry Johnson, Y., (2006). Sexual history-taking
among primary care physicians. J Natl Med Assoc; 98:1924–9.
[13] Lewis, C.E., Freeman,
H.E., (1987). The sexual history-taking and counseling practices of primary care
physicians. West J Med; 147:165–72.
[14] Sobecki, J.N., Curlin, F.A., Rasinski, K.A., Lindau, S.T., (2012). What
we don’t talk about when we don’t talk about sex (1): Results of a national survey
of U.S. obstetrician/gynecologists. J Sex Med; 9:1285–94.
[15]
Alder, J, Christen, R, Zemp, E, Bitzer, J., (2007)
Communication skills training in obstetrics and gynaecology: Whom should we train?
A randomized controlled trial. Arch Gynecol Obstet; 276:605–12.
[16] Abdolrasulnia, M.,
Shewchuk, R.M., Roepke, N., et al., (2010). Management of female sexual problems:
perceived barriers, practice patterns, and confidence among primary
care physicians and gynecologists. J Sex Med ;7(07):2499–2508.
[17] Higgins, A, Barker
P, Begley, C.M., (2009). Sexuality and mental health nursing in Ireland: weaving
the veil of socialized inhibition. Nurse Educ Today ;29(03):357–364.
[18] Nusbaum, M.R., Gamble,
G, Skinner, B, Heiman, J., (2000). The high prevalence of sexual concerns among
women seeking routine gynecological care. J Fam Pract ;49(03):229–232.
[19] Nusbaum, M.R., Singh,
A.R., Pyles, A.A., (2004). Sexual healthcare needs of women aged 65 and older. J,
Am Geriatr Soc ;52(01):117–122.
[20] Lindau, S.T.,
Schumm, L.P., Laumann, E.O., Levinson, W, O, Muircheartaigh, C.A., Waite, L.J.,
(2007). A study of sexuality and health among older adults in the United States.
N Engl J Med; 357:762–74.
