Discussing sexual health with aging patients in primary care: Exploratory findings at a Canadian urban academic hospital

Abstract

Sexuality is an important component of overall health and quality of life, yet evidence suggests many aging adults are not discussing sexual health with their physician. The objective of this study was to understand practices of primary care physicians in discussing sexual health with aging patients. An electronic survey was distributed to primary care physicians and family medicine residents at an urban academic hospital in Ontario, Canada. The survey captured the self-reported prevalence of discussions of sexual health with patients aged 50 and above as well as patient, physician and contextual factors influencing the likelihood of discussion. Descriptive statistics were used to summarize the results. Among the 37 physicians who responded to the survey (response rate of 24%), physicians were more likely to discuss sexual health with patients aged 50–75 years than with patient s>75 years with both males (p<0.0001) and females (p<0.0001). Most frequently discussed issues with males were erectile dysfunction and sexually transmitted infection, while atrophic vaginitis, bleeding, and pain during intercourse were most often discussed with females. Factors limiting discussion include lack of time, multiple patient comorbidities and a perceived disinterest in sexual activity. 54% of respondents report having adequate knowledge to discuss and manage later life sexual health issues. Proactively discussing sexuality with aging adults may reveal underlying illness and facilitate future help-seeking behaviours. We suggest that primary care physicians have a responsibility to routinely initiate such discussions in clinical practice.