A Survey on the Experience of Singaporean Trainees in Obstetrics/Gynecology and Family Medicine of Sexual Problems and Views on Training in Sexual Medicine.

Zhongwei Huang,Adaikan P Ganesan,Susan Logan,Derek Shangxian Choong

doi:10.1016/j.esxm.2019.12.001

Abstract

IntroductionAsian patients may have more difficulty seeking help for their sexual problems because of a largely conservative culture. Residents from both obstetrics and gynecology (OBGYN) and family medicine (FM) departments are ideally placed to address sexual problems.AimThis survey explored the experience of residents from OBGYN and FM in managing sexual problems and their views on training in sexual medicine (SM).MethodAn anonymized questionnaire collecting data on trainee characteristics, exposure to male and female sexual problems, and training in SM was sent to all FM and OBGYN residents in Singapore. These residents had completed their medical registration with the Singapore Medical Council and were at various stages of specialty training in both FM and OBGYN residency programs in Singapore.Main Outcome MeasureTrainees’ exposure to male and female sexual problems and their views on training in Sexual Medicine.ResultsThe overall response from the survey was 63.5% (122/192)—54% (70/129) and 69% (52/75) of FM and OBGYN residents responded, respectively. 63% were female, with 22% being senior residents, and 55% attended Singaporean medical schools. About one quarter (30/122) of the respondents encountered patients with sexual problems at least monthly. Most would refer these patients directly to specialists, psychologists, and sex therapists. More than 80% of residents were not confident in managing sexual problems in either sex (89% for male problems; 83% for female problems). Among the recognized categories, only 30% felt confident to manage erectile dysfunction, 26% for vaginismus, while less than 10% felt confident to manage libido, arousal, or orgasm disorders. 95% of the residents agreed that SM should be part of both training curricula, with 70% and 25% suggesting at junior and senior residency, respectively. 93% of them were interested to obtain further knowledge and skills in SM through their core training curriculum and from seminars.ConclusionsThis survey reported a significant number of residents in OBGYN and FM departments are regularly exposed to patients with sexual problems but lack the skills to manage them. OBGYN residents were more familiar with managing female sexual problems while FM residents tend to have more experience in male sexual problems. Almost universally, the residents in FM and OBGYN were very keen to acquire skills in SM, and the results support the incorporation of appropriate knowledge and skills into both national residency program curricula.Huang Z, Choong DS, Ganesan AP, et al. A Survey on the Experience of Singaporean Trainees in Obstetrics/Gynecology and Family Medicine of Sexual Problems and Views on Training in Sexual Medicine. J Sex Med 2019;8:107–113.

Highlights

Asian patients may have more difficulty seeking help for their sexual problems because of a largely conservative culture
Only 30% felt confident to manage erectile dysfunction, 26% for vaginismus, while less than 10% felt confident to manage libido, arousal, or orgasm disorders. 95% of the residents agreed that sexual medicine (SM) should be part of both training curricula, with 70% and 25% suggesting at junior and senior residency, respectively. 93% of them were interested to obtain further knowledge and skills in SM through their core training curriculum and from seminars
This survey reported a significant number of residents in obstetrics and gynecology (OBGYN) and family medicine (FM) departments are regularly exposed to patients with sexual problems but lack the skills to manage them

Summary

Introduction

Asian patients may have more difficulty seeking help for their sexual problems because of a largely conservative culture. Results from a cross-sectional study on family medical practices in Western populations suggest that up to 75% of the population may suffer from at least one specific sexual problem.[10] Qualitative research from the United States reports that patients would like to discuss sexuality-related issues with their health-care providers but were often reluctant to do so because of fear of embarrassment or dismissal of their concerns.[11,12] A study had shown that Asian men tend to accept sexual disorder as part of ageing, and instead of seeking appropriate treatment, they seek alternatives such as alcohol consumption to maintain their gender role.[13] Another qualitative study in Hong Kong demonstrated that Asian women with sexual problems tend to seek medical help only when their male partners have sexual problems. Women often report sexual issues as “marital dissatisfaction” rather than as specific problems.[3]

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