VIDEO: Few ob.gyns. asking in detail about sexual behavior

 

AUSTIN, TEX. – Patients in an urban practice were comfortable discussing sexual practices, even less traditional behaviors such as use of sex toys and “hook-up” apps, with their providers, according to results of a recent survey. The survey also found that ob.gyns. often weren’t asking about sexual behaviors at all.

“We wanted to find out what sexual behaviors our patients were participating in, and if their providers were asking them about those behaviors,” said Casuarina Hart, MD, chief ob.gyn. resident at Icahn School of Medicine at Mount Sinai, New York.

The survey also sought to determine whether patients were comfortable with being asked detailed questions about their sexual behavior, she said at the annual clinical and scientific meeting of the American College of Obstetricians and Gynecologists.

A total of 207 anonymous paper-and-pencil surveys were completed by patients who attended Mount Sinai ob.gyn. clinics, as well as private practices where ob.gyns. had Mount Sinai affiliations. “Our patients were very diverse,” Dr. Hart said in a video interview. About a quarter were white, a quarter were African American, and one-third were Hispanic. The average age of respondents was 33 years.

Dr. Hart's interview:

In addition to asking about participation in vaginal, oral, and anal sex, Dr. Hart and her coauthors asked about “more interesting sexual behaviors, from the use of sex toys to different ‘hook-up’ apps,” she said.

Among this group of urban respondents, participation in vaginal and oral sex was about at the national average. Anal sex participation, though, was 6%-8% higher than the national average, said Dr. Hart. This difference is important, she said, because there is “different screening and counseling for those patients.”

When Dr. Hart and her colleagues looked at the next phase of the survey, they found that fewer than half of patients said that providers were asking about sexual behaviors – and only about half were asking about condom use. When it came to being asked about participation in anal sex and oral sex, about one in five patients reported that their providers had broached the topics.

 

The investigators found that age had little to do with reported participation in sexual behaviors – with two exceptions. Patients who reported using sex toys were, on average, older than were those who never used them (34.3 vs. 30.7 years, P = .01). Conversely, those who used ‘hook-up’ apps were younger than were never-users (28.3 vs. 33.7 years, P = .0002).

“I found that less than 60% of my patients were regularly using condoms, and less than 50% of patients were ever asked by their provider about condom use. That was the most shocking finding that I had,” said Dr. Hart.

“The biggest thing is, patients are comfortable,” said Dr. Hart. “Around 90% of patients are comfortable discussing anything from sex toys, vaginal sex, to anal sex – but providers aren’t asking about them. And they really should,” to optimize screening for sexually transmitted diseases and cancer, and to provide thorough counseling about safe sex practices, she said.

What about the physician perspective? Maria Kon, MD, a Mount Sinai ob.gyn., and her collaborators received responses to a survey from 90 physicians, finding that most did not routinely ask about sexual orientation, sexual problems, or satisfaction. Further, one in four respondents reported disapproving of their patients’ sexual practices.

 

Asking about sexual practices is important not just in the context of reproductive health and disease prevention, but also to the “well-being of a woman in general, which is very important if you want to be a good doctor,” Dr. Kon said in a video interview.

Dr. Kon's interview:

Links to the online survey were sent to ob.gyn. residents, fellows, and attending physicians in New York. Three-quarters of respondents were female, and almost half (46%) were aged 25-30 years; 59% were in postgraduate year 1-4. Most were white (69%) and heterosexual (87%).

“Years of training improve the level of comfort” in discussing specific sexual practices, Dr. Kon and her colleagues wrote in the poster accompanying their presentation at the meeting. “What we found, actually, is that people who are in practice longer were more comfortable talking about certain topics, but not all of them,” said Dr. Kon.

The investigators found that respondents who were in their 5th postgraduate year and beyond were significantly more comfortable discussing sex with elderly patients, talking about masturbation and sex toys, and talking about dyspareunia or libido problems (P value for being either “comfortable” or “very comfortable,” .0104, .0422, and .003, respectively). On the other hand, experience didn’t make a difference in the level of comfort with addressing a transgender person.

 

“Gender has no effect on the level of comfort,” the investigators wrote. They found no significant differences in any of these domains between male and female respondents.

The survey also asked ob.gyns. whether they would like more education about sexual behavior, and the answer was “yes.” About four in five respondents wanted to know more about the topics raised in the survey, which also asked about comfort in talking about sexual orientation and gender identity. About the same number think that their sexual history taking could be more detailed.

In terms of how ob.gyns. responding to the survey would like to receive more information and education, almost all (94%) said they would appreciate receiving more formal lectures about sexual practices. One third said they would like to educate themselves about trends in sexual behavior.

“Based on the survey responses, it seems that people would prefer for official lectures to be included in the curriculum,” said Dr. Kon, noting that required medical school sexual education is currently brief, with a focus on pregnancy and disease prevention and abortion. “In residency, we really don’t have much education either,” she said, adding that more formal education, as in grand rounds, “would highly benefit us as doctors who can relate to patients, who are comfortable talking to women about their health and well-being.”

Dr. Kon and Dr. Hart reported no relevant disclosures.

koakes@mdedge.com

SOURCE: Hart C et al. and Kon M et al. ACOG 2018. Abstracts 26Q and 11M.

 

AUSTIN, TEX. – Patients in an urban practice were comfortable discussing sexual practices, even less traditional behaviors such as use of sex toys and “hook-up” apps, with their providers, according to results of a recent survey. The survey also found that ob.gyns. often weren’t asking about sexual behaviors at all.

“We wanted to find out what sexual behaviors our patients were participating in, and if their providers were asking them about those behaviors,” said Casuarina Hart, MD, chief ob.gyn. resident at Icahn School of Medicine at Mount Sinai, New York.

The survey also sought to determine whether patients were comfortable with being asked detailed questions about their sexual behavior, she said at the annual clinical and scientific meeting of the American College of Obstetricians and Gynecologists.

A total of 207 anonymous paper-and-pencil surveys were completed by patients who attended Mount Sinai ob.gyn. clinics, as well as private practices where ob.gyns. had Mount Sinai affiliations. “Our patients were very diverse,” Dr. Hart said in a video interview. About a quarter were white, a quarter were African American, and one-third were Hispanic. The average age of respondents was 33 years.

Dr. Hart's interview:

In addition to asking about participation in vaginal, oral, and anal sex, Dr. Hart and her coauthors asked about “more interesting sexual behaviors, from the use of sex toys to different ‘hook-up’ apps,” she said.

Among this group of urban respondents, participation in vaginal and oral sex was about at the national average. Anal sex participation, though, was 6%-8% higher than the national average, said Dr. Hart. This difference is important, she said, because there is “different screening and counseling for those patients.”

When Dr. Hart and her colleagues looked at the next phase of the survey, they found that fewer than half of patients said that providers were asking about sexual behaviors – and only about half were asking about condom use. When it came to being asked about participation in anal sex and oral sex, about one in five patients reported that their providers had broached the topics.

 

The investigators found that age had little to do with reported participation in sexual behaviors – with two exceptions. Patients who reported using sex toys were, on average, older than were those who never used them (34.3 vs. 30.7 years, P = .01). Conversely, those who used ‘hook-up’ apps were younger than were never-users (28.3 vs. 33.7 years, P = .0002).

“I found that less than 60% of my patients were regularly using condoms, and less than 50% of patients were ever asked by their provider about condom use. That was the most shocking finding that I had,” said Dr. Hart.

“The biggest thing is, patients are comfortable,” said Dr. Hart. “Around 90% of patients are comfortable discussing anything from sex toys, vaginal sex, to anal sex – but providers aren’t asking about them. And they really should,” to optimize screening for sexually transmitted diseases and cancer, and to provide thorough counseling about safe sex practices, she said.

What about the physician perspective? Maria Kon, MD, a Mount Sinai ob.gyn., and her collaborators received responses to a survey from 90 physicians, finding that most did not routinely ask about sexual orientation, sexual problems, or satisfaction. Further, one in four respondents reported disapproving of their patients’ sexual practices.

 

Asking about sexual practices is important not just in the context of reproductive health and disease prevention, but also to the “well-being of a woman in general, which is very important if you want to be a good doctor,” Dr. Kon said in a video interview.

Dr. Kon's interview:

Links to the online survey were sent to ob.gyn. residents, fellows, and attending physicians in New York. Three-quarters of respondents were female, and almost half (46%) were aged 25-30 years; 59% were in postgraduate year 1-4. Most were white (69%) and heterosexual (87%).

“Years of training improve the level of comfort” in discussing specific sexual practices, Dr. Kon and her colleagues wrote in the poster accompanying their presentation at the meeting. “What we found, actually, is that people who are in practice longer were more comfortable talking about certain topics, but not all of them,” said Dr. Kon.

The investigators found that respondents who were in their 5th postgraduate year and beyond were significantly more comfortable discussing sex with elderly patients, talking about masturbation and sex toys, and talking about dyspareunia or libido problems (P value for being either “comfortable” or “very comfortable,” .0104, .0422, and .003, respectively). On the other hand, experience didn’t make a difference in the level of comfort with addressing a transgender person.

 

“Gender has no effect on the level of comfort,” the investigators wrote. They found no significant differences in any of these domains between male and female respondents.

The survey also asked ob.gyns. whether they would like more education about sexual behavior, and the answer was “yes.” About four in five respondents wanted to know more about the topics raised in the survey, which also asked about comfort in talking about sexual orientation and gender identity. About the same number think that their sexual history taking could be more detailed.

In terms of how ob.gyns. responding to the survey would like to receive more information and education, almost all (94%) said they would appreciate receiving more formal lectures about sexual practices. One third said they would like to educate themselves about trends in sexual behavior.

“Based on the survey responses, it seems that people would prefer for official lectures to be included in the curriculum,” said Dr. Kon, noting that required medical school sexual education is currently brief, with a focus on pregnancy and disease prevention and abortion. “In residency, we really don’t have much education either,” she said, adding that more formal education, as in grand rounds, “would highly benefit us as doctors who can relate to patients, who are comfortable talking to women about their health and well-being.”

Dr. Kon and Dr. Hart reported no relevant disclosures.

koakes@mdedge.com

SOURCE: Hart C et al. and Kon M et al. ACOG 2018. Abstracts 26Q and 11M.

 

AUSTIN, TEX. – Patients in an urban practice were comfortable discussing sexual practices, even less traditional behaviors such as use of sex toys and “hook-up” apps, with their providers, according to results of a recent survey. The survey also found that ob.gyns. often weren’t asking about sexual behaviors at all.

“We wanted to find out what sexual behaviors our patients were participating in, and if their providers were asking them about those behaviors,” said Casuarina Hart, MD, chief ob.gyn. resident at Icahn School of Medicine at Mount Sinai, New York.

The survey also sought to determine whether patients were comfortable with being asked detailed questions about their sexual behavior, she said at the annual clinical and scientific meeting of the American College of Obstetricians and Gynecologists.

A total of 207 anonymous paper-and-pencil surveys were completed by patients who attended Mount Sinai ob.gyn. clinics, as well as private practices where ob.gyns. had Mount Sinai affiliations. “Our patients were very diverse,” Dr. Hart said in a video interview. About a quarter were white, a quarter were African American, and one-third were Hispanic. The average age of respondents was 33 years.

Dr. Hart's interview:

In addition to asking about participation in vaginal, oral, and anal sex, Dr. Hart and her coauthors asked about “more interesting sexual behaviors, from the use of sex toys to different ‘hook-up’ apps,” she said.

Among this group of urban respondents, participation in vaginal and oral sex was about at the national average. Anal sex participation, though, was 6%-8% higher than the national average, said Dr. Hart. This difference is important, she said, because there is “different screening and counseling for those patients.”

When Dr. Hart and her colleagues looked at the next phase of the survey, they found that fewer than half of patients said that providers were asking about sexual behaviors – and only about half were asking about condom use. When it came to being asked about participation in anal sex and oral sex, about one in five patients reported that their providers had broached the topics.

 

The investigators found that age had little to do with reported participation in sexual behaviors – with two exceptions. Patients who reported using sex toys were, on average, older than were those who never used them (34.3 vs. 30.7 years, P = .01). Conversely, those who used ‘hook-up’ apps were younger than were never-users (28.3 vs. 33.7 years, P = .0002).

“I found that less than 60% of my patients were regularly using condoms, and less than 50% of patients were ever asked by their provider about condom use. That was the most shocking finding that I had,” said Dr. Hart.

“The biggest thing is, patients are comfortable,” said Dr. Hart. “Around 90% of patients are comfortable discussing anything from sex toys, vaginal sex, to anal sex – but providers aren’t asking about them. And they really should,” to optimize screening for sexually transmitted diseases and cancer, and to provide thorough counseling about safe sex practices, she said.

What about the physician perspective? Maria Kon, MD, a Mount Sinai ob.gyn., and her collaborators received responses to a survey from 90 physicians, finding that most did not routinely ask about sexual orientation, sexual problems, or satisfaction. Further, one in four respondents reported disapproving of their patients’ sexual practices.

 

Asking about sexual practices is important not just in the context of reproductive health and disease prevention, but also to the “well-being of a woman in general, which is very important if you want to be a good doctor,” Dr. Kon said in a video interview.

Dr. Kon's interview:

Links to the online survey were sent to ob.gyn. residents, fellows, and attending physicians in New York. Three-quarters of respondents were female, and almost half (46%) were aged 25-30 years; 59% were in postgraduate year 1-4. Most were white (69%) and heterosexual (87%).

“Years of training improve the level of comfort” in discussing specific sexual practices, Dr. Kon and her colleagues wrote in the poster accompanying their presentation at the meeting. “What we found, actually, is that people who are in practice longer were more comfortable talking about certain topics, but not all of them,” said Dr. Kon.

The investigators found that respondents who were in their 5th postgraduate year and beyond were significantly more comfortable discussing sex with elderly patients, talking about masturbation and sex toys, and talking about dyspareunia or libido problems (P value for being either “comfortable” or “very comfortable,” .0104, .0422, and .003, respectively). On the other hand, experience didn’t make a difference in the level of comfort with addressing a transgender person.

 

“Gender has no effect on the level of comfort,” the investigators wrote. They found no significant differences in any of these domains between male and female respondents.

The survey also asked ob.gyns. whether they would like more education about sexual behavior, and the answer was “yes.” About four in five respondents wanted to know more about the topics raised in the survey, which also asked about comfort in talking about sexual orientation and gender identity. About the same number think that their sexual history taking could be more detailed.

In terms of how ob.gyns. responding to the survey would like to receive more information and education, almost all (94%) said they would appreciate receiving more formal lectures about sexual practices. One third said they would like to educate themselves about trends in sexual behavior.

“Based on the survey responses, it seems that people would prefer for official lectures to be included in the curriculum,” said Dr. Kon, noting that required medical school sexual education is currently brief, with a focus on pregnancy and disease prevention and abortion. “In residency, we really don’t have much education either,” she said, adding that more formal education, as in grand rounds, “would highly benefit us as doctors who can relate to patients, who are comfortable talking to women about their health and well-being.”

Dr. Kon and Dr. Hart reported no relevant disclosures.

koakes@mdedge.com

SOURCE: Hart C et al. and Kon M et al. ACOG 2018. Abstracts 26Q and 11M.