Male Sexual Dysfunction
How to Screen?
Patients and physicians both come to the office with the same set of early life experience, attitudes and values about sexuality. Avoidance of discussing sexual concerns for fear of bringing up inappropriate or private concerns leads, for example, to less than one in ten men with erectile dysfunction being identified. However, a soon-to-be released study shows that among recently graduated family physicians, 17.0% of female physicians and 37.2% of male physicians raised the issue of male sexual difficulties/dysfunction with patients at least once a week.
Physicians may feel inadequately trained to deal with sexual problems; that these issues take too much time; or that other health issues are more pressing. Yet 80% of sexual problems can be managed in primary care with only 8% needing referral.6
Sexually transmitted disease is a leading killer of young, urban men; and a frequent cause of morbidity for women. Safe sex is sometimes discussed with women, but only rarely with young men. In large measure this is because of men not availing themselves of preventive health care as often as their sisters. Physicians routinely manage contraceptive matters for women and their partners, yet rarely use the opportunity to ask about sexual function of either women or men.
Brief screening questions as part of the social history and/or the genital functional inquiry are high yield for information about the patient that will affect overall health care:
- Are you in a relationship?
- Are you, or have you been sexually active?
- Have you had sex with men, women, or both?
- What are you and your partner doing about contraception?
- What are you and your partner doing about safer sex?
- Many people have sexual concerns, I wonder what yours might be?
Last Modified: September 5, 2006
