(142) Double Pause: Understanding Couple Intimacy Through Health Care Provider Lens – A Qualitative Survey
Authors: Giraldi A , Jannini E , Vignesh S O , Aguilera A , Hassan T 
Published: March 2024

Abstract

Introduction
At midlife and beyond, both men and women face organic changes that can affect their sexual functioning. Women may suffer from vaginal dryness, irritation/itching, inadequate lubrication, and dyspareunia due to ovarian exhaustion. Whilst erectile dysfunction, ejaculatory dysfunctions, and testosterone deficiency may affect sexual activity in men.

Objective
To understand the perceptions and changes in sexual intimacy in middle-aged couple (40 years and above) and their evolution over time. To explore the supportive role of partner and health care professionals (HCPs) during this evolution.

Methods
30 HCPs in the space of sexual health and couple intimacy across six countries (the United States, the United Kingdom, Italy, France, Germany and Spain) participated in this survey. An in-depth interview (45–60 minutes) was conducted about key issues that middle-aged couple face about sexual/couple intimacy, the language used to initiate conversations with patients, how issues evolve over time, as well as the role that a partner and HCP can play in providing support, guidance, and treatment.

Results
Interviews with HCPs showed that despite some progress, couple intimacy continues to be a taboo topic. HCPs play a crucial role in initiating conversations amongst the 40 and above aged group, especially before pausing their sexual activities. Many HCPs have developed their own personal style to explore the couple intimacy topic but they believe they need more education. To effectively address sexual dysfunction in couples, a comprehensive, gender-sensitive approach is crucial. This involves recognizing and addressing the unique challenges each gender faces, particularly considering the healthcare providers’ biases that disproportionately affect women compared to men. However, distinct challenges do not imply an individualistic approach to treatment, as HCPs recognize the benefits of involving both partners. While HCPs offer some resources to help patients understand intimacy issues, patients can also encounter unreliable information on social media and within society, particularly when there is inaccurate information available. Misconceptions about intimacy treatments can be a significant barrier to solving the issue, with the disparity in HCPs’ conversations with women compared to men being a significant contributing factor. HCPs face several challenges when approaching the subject of couple intimacy with patients, ranging from time constraints to a lack of psychological training. Additionally, their professional networks are often limited to referrals, and inadequate training of practitioners can further complicate their clinical duties

Conclusions
To effectively address sexual dysfunction in couples, a comprehensive, gender-sensitive approach is crucial. This involves recognizing and addressing the unique challenges each gender faces, particularly considering the HCP’s biases that disproportionately affect women compared to men.

Disclosure
Yes, this is sponsored by industry/sponsor: Viatris Inc.
Clarification: Industry initiated, executed and funded study.
Any of the authors act as a consultant, employee or shareholder of an industry for: 1Mental Health Centre Copenhagen and University of Copenhagen, Denmark.