(023) An Online Survey Study Investigating the Contribution of the Cervix to the Female Sexual Response and Patient-Reported Barriers to Sexual Counselling
Authors: Gilmore S , Giovannetti O , Tomalty D , Pattison A , Pukall C , Adams M 
Published: June 2023

Abstract

Introduction
The female sexual response is multifactorial and involves several anatomical locations which contribute to pleasurable sensations. Recently, the cervix has been discussed in terms of its role in the FSR, though there are still discrepancies regarding its contribution to these responses. Our pilot study showed that women are unfamiliar with the location of their cervix anatomically, but indicate feeling pleasure from deep penetration, and in the anatomical region of the cervix. If women experience pleasurable sensation from the cervix, then perhaps procedures that impact the cervix may impair overall pleasurable sexual responses in some women. In addition, there is some literature that describes barriers to sexual counselling for women, though these have not been thoroughly studied in the context of the FSR. Therefore, validation of the preliminary pilot data is needed, including confirmation of the importance of the cervix, in addition to defining barriers to sexual counselling.

Objectives
The objectives of this study were to determine whether women find cervical stimulation pleasurable and if it contributes to their sexual responses. This study also aimed to determine whether a medical history of gynecologic procedures is associated with negative impacts on sexual function, and what barriers women face when discussing sexual problems with their health care providers (HCPs).

Methods
A self-report survey was distributed via an online platform to over 500 participants. 308 responses were analyzed. IBM SPSS Statistics Version 26 was used for statistical analysis with CI (95%) and p-value (p≤ 0.05). Qualitative analysis was performed using Nvivo12.

Results
This study found that many women find cervical stimulation pleasurable, and that it is important to their overall sexual response. The responses also indicated that a subset of participants who underwent gynecologic procedures that impacted the cervix showed significant increases in levels of discomfort or pain during cervical stimulation (P&lt;0.001) and difficulty becoming lubricated (p=0.016). Qualitative analysis of participants narrative responses when asking them to describe the location(s) of their sexual responses indicated that participants were better able to describe the location(s) using labelled diagrams rather than in words. Accordingly, a quarter of the participants indicated that they do not feel effective at communicating about their sexual sensations, nor do they feel capable of describing these sensations using words. Participants noted several barriers to sexual counselling with almost half of the participants indicating they feel uncomfortable talking to male physicians about their sexual responses, and that they feel stigma surrounding sexual sensations.

Conclusions
This study indicates that the cervix plays an important role in the FSR, and that procedures that impact the cervix may result in decreased sexual functioning. The results from this study also suggest that women have difficulty communicating their sexual responses using words and feel unable to discuss the concerns regarding their sexual responses with HCPs. Future studies should develop effective resources for physicians to communicate complex topics about sexual functioning to patients. They should also aim to investigate the experiences of women who experience FSD after procedures impacting the cervix, studies for which are ongoing.

Disclosure
No.