tailieunhanh - Obstetrics and Gynecology Clinics of North America, guest edited by J. Chris Carey

Sexual dysfunction is one of the most common conditions seen in a primary care provider’s office. Large surveys indicate that one fourth or more of patients report sexual distress or dysfunction. Yet the diagnosis is rarely made, even though most patients who have a sexual problem report that they wish their physician would ask about it. Why do physicians not uncover sexual problems? Many physicians state that they do not know what to do when they uncover a sexual problem. They are afraid that addressing the problem will take too much time and that they do not have anything to offer the patient. They do not have a referral. | ELSEVIER VUADtRt OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA ELSEVIER SAUNDERS Obstet Gynecol Clin N Am 33 2006 xi-xii OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA Foreword William F. Rayburn MD Consulting Editor This issue of the Obstetrics and Gynecology Clinics of North America guest edited by J. Chris Carey MD deals with the important subject of sexual dysfunction. Most people women and men view their sexuality as an important quality-of-life issue. Obstetrician-gynecologists are perceived by many women as the initial contact for exploring all aspects of their health including their sexuality. If physicians do not respond to these concerns patients may become discouraged about discussing their sexuality and may have their fears and doubts reinforced. Additionally accompanying gynecologic disease processes and therapeutic interventions associated with impaired sexual response may go overlooked. Physicians should perceive their patients sexual health as being an integral part of life changes. Certain events in a woman s life can prompt her to be concerned about her sexual health. Examples of such events include development of secondary sexual characteristics sexual activity and intercourse need for and use of contraception sexual function pregnancy menstruation or menopause surgery or medications that affect future childbearing and changes in a marital or intimate relationship. A nonjudgmental interview should be conducted in a comfortable and private office setting. It is best not to elicit a complete sexual history with the patient in a hospital gown or while she is on an examination table. An obstetrician-gynecologist s immediate task is to reduce the patient s immediate anxiety and to gather sufficient information to make a diagnosis. A rushed response to even the most innocent question of a sexual nature may reinforce that patient s concerns or may contribute to her feelings of 0889-8545 06 - see front matter 2006 Elsevier Inc. .