Female sexual dysfunction: what the practice nurse needs to know
For many women, practice nurses are the first point of contact for sexual or reproductive health concerns. Angela Gregory provides are overview of the basics of female sexual dysfunction
The World Health Organization regards ‘sexual and reproductive health and wellbeing as essential if people are to have responsible, safe and satisfying sexual lives and that sexual health requires a positive approach to human sexuality’. General practice nurses are ideally placed to educate and address sexual concerns. Practice nurses are not expected to be experts in this field or to carry out specialist assessment, examination and treatment, but there are opportunities to initiate discussion, identify potential sexual issues, provide simple advice and treatment, signpost to online resources and refer to medical colleagues or specialist services. Two common sexual complaints – sexual desire/interest concerns and sexual/genital pain – are discussed with an emphasis on the importance of recognising and treating the silent symptoms of the menopause and pelvic floor dysfunction due to their significant impact on female sexual function.
Practices nurses are an important part of a multidisciplinary team and are involved in most aspects of patient care including health screening, sexual health screening, helping patients manage long term conditions, contraception and women's health, including cervical cytology and menopause management. Therefore, for many women, they are the first potential point of contact regarding sexual and reproductive concerns. Barriers identified by healthcare professionals for not discussing sexual issues are related to a ‘lack of time, personal discomfort, lack of training and worry it will cause offence’ (Dyer and das Nair, 2013). For those who assert they are embarrassed or lack experience, it has been shown that these barriers are of less concern in those who perform such consultations daily or weekly compared to those who do so infrequently (Temple-Smith et al, 1999). In the UK, availability of NHS provision for specialist menopause centres, psychosexual input and specialist pelvic physiotherapists varies widely, so practice nurses should be encouraged and supported to help their patients address any sexual health concerns.
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