Reproductive and sexual health in males with cystic fibrosis: a case for health professional education and training.

Abstract

To survey the attitudes and clinical practice of health professionals to identify current practice and possible barriers to discussion of sexual and reproductive health issues in adolescent males with cystic fibrosis (CF). An interview schedule was developed to seek information about attitudes to reproductive and sexual health in males with CF and to elicit details of reported professional practice of health care providers from four CF centers in Massachusetts. Of 32 health professionals interviewed, 66% informed parents about male infertility soon after diagnosis in infancy; 22% of those not informing parents at this time waited until later childhood or adolescence; and 12% reported they did not discuss these issues with parents during childhood or adolescence. All respondents reported they discuss infertility with male adolescents. The mean age thought most appropriate to discuss infertility was 13.8 (+/-2.2) years, although most do so at 15.2 (+/-2.8) years (p <.05). Fifty percent report routinely discussing that sexual performance is not affected by CF; 38% discuss the importance of condom use; 50% discuss normal sexual performance; 13% offer semen analysis to adolescents; and 3% inform males about small-volume ejaculates. Reproductive options are discussed with adolescents by 19% of clinicians. The themes of embarrassment, insufficient time, the difficulty of finding the "right" time, and insufficient training were identified as barriers to these discussions. Greater training for health professionals in the reproductive and sexual health issues of CF is a step to more complete, timely, and comfortable discussion of this area of health care.