Sexual Medicine Programs for Women Across the Life Span: Lessons Learned from a New Initiative in a US-Based Academic Medical Center
Authors: Pettigrew J , Coons H , Hunter W 
Published: July 2022

ABSTRACT

Introduction
In a self-report study of women presenting to a gynecological clinic, 9 out of 10 women reported a sexual health concern (Nusbaum 2003). These concerns are best addressed using a biopsychosocial approach to assessment, treatment and prevention drawing on medical, behavioral and psychological science. At an academic health center in the United States, The Women's Sexual Health Consultation Service was launched in 2019 to provide evaluation, education, treatment and prevention interventions using an integrated practice model. The interdepartmental program currently includes an Advanced Practice Nurse from the Department of Obstetrics and Gynecology as well as two clinical health psychologists from the Department of Psychiatry all with expertise in women's health and women's sexual medicine. Our interprofessional team collaborates closely with providers in women's primary care, medical, gynecologic and radiation oncology, urogynecology, colorectal surgery, among others.

Objective
Review lessons learned from interdepartmental program design, funding, implementation, and evaluation of the Women's Sexual Health Consultation Service in an academic health center, summarize the types of sexual health concerns among women who presented to the integrated service, and highlight recommendations to generalize and/or adjust the program model to other types of health settings.

Methods
Review the program implementation and evaluation process for the Women's Sexual Health Consultation Service, summarize the data on the women seen for care from April 23 2019 through June, 2021 (e.g., the number of unduplicated patients evaluated, their age, sexual health concerns, and treatment offered, etc), and outline program challenges and strategies to sustain and expand the initiative during and following the COVID-19 pandemic through virtual and in-person care.

Results
The Women's Sexual Health Consultation Service saw 198 women from April 23 2019 through June, 2021. Patients ranged in age from 21 to 72 (mean: 45 years). While most patients (33%) referred themselves to this program, other women were referred by obgyns, medical oncologists, women's primary care providers and gynecologic oncologists. Primary sexual health concerns included one or more of the following issues: pain (100), low desire (76), difficulty with orgasm (19), difficulty with arousal (12) and other (55). Additional findings will be presented on the types of treatment offered as well as patient and referring provider satisfaction with the new integrated sexual health consult service.

Conclusions
Our interdepartmental Women's Sexual Health Consultation Service implemented a highly successful program that integrates sexual medicine, behavioral health, health psychology and sexual therapy to ensure access to state-of-the-art interprofessional education and care for women across the life span in all their diversities. We were able to sustain and expand this program through telehealth and in-person visits during the COVID-19 pandemic, and anticipate further growth in patient referrals and treatment modalities moving forward. Providers across disciplines also routinely refer to and collaborate with the program. Several components of the model are generalizable or adjustable to other women's health settings.

Disclosure
No