(119) Provider Habits Regarding Screening for Sexual Dysfunction in Pregnancy at a Tertiary Medical Center in Chicago, IL
Authors: Casinelli E , Walker K , Lynn M 
Published: May 2023

Abstract

Introduction
A national survey of Ob/Gyns illustrates the majority do not routinely inquire about sexual dysfunction, pleasure, or satisfaction despite female sexual dysfunction (FSD) being an issue affecting an estimated 43% of women throughout their lifetime. Moreover, many studies have shown an increase in sexual dysfunction in pregnancy, including a Brazilian study showing 73.3% of women experience sexual dysfunction in their third trimester. No specific guidance exists for providers regarding the timing of screening nor the proper methods of education for sexual dysfunction in pregnancy. The International Society for the Study of Women’s Sexual Health (ISSWSH) detailed that certain sexual dysfunction disorders have numerous publications, yet lack of concise screening resources to aid the clinician in detection and management.

Objective
This study evaluated screening and education practices for sexual dysfunction in pregnancy at a tertiary medical center in a low-risk population.

Methods
From 2018 to 2021, an average of 1284 women received prenatal care at our institution annually. This study randomly reviewed 113 charts from patients receiving prenatal care with our low-risk providers. We conducted a retrospective chart review, collecting data including: pre-existing conditions, Edinburgh Postpartum Depression Screen (EPDS) scores, and characteristics of both the provider and the type of sexual dysfunction present.

Results
Of 113 pregnant women in our sample, 19% (N=21) were screened for sexual dysfunction throughout the course of their pregnancy and postpartum visits. There were no notable differences in screening habits based on patient age, Gravida, Para, BMI, marital status, or pregnancy complications. At any time, the median EPDS score for those screened for FSD was consistently greater compared to those who were not screened. Patients were more commonly screened by attendings (71%, N=15) rather than residents (29%, N=6) or APNs (10%, N=2). Patients were most commonly screened postpartum (N=13). No women were screened in the third trimester. Of the 21 who were screened, 76% (N=16) screened positive for sexual dysfunction. The majority of those with FSD had myofascial pain (N=9). A quarter had dyspareunia (N=4). Of those with FSD, 19% (N=3) were educated on sexual dysfunction postpartum.

Conclusions
Our chart review revealed that less than 20% of patients were screened for sexual dysfunction over the course of their pregnancy, including the postpartum period. We found no evidence of education provided on sexual dysfunction in pregnancy. Of those screened, the prevalence of sexual dysfunction was 76%. There were no notable changes in screening habits based on the specific patient characteristics studied or demographics, however screening tended to be more prevalent in patients with increased EPDS scores. At our institution, attending physicians more frequently screen for FSD over resident physicians or APNs in our practice. Postpartum was the most popular time to screen. Prenatal sexual dysfunction occurs most prominently in the third trimester, but we found no evidence of screening being performed during this time.

Disclosure
No