Sexual problems in the gynecology clinic: are we making a mountain out of a molehill?

This study aims to assess the prevalence of sexual problems in general gynecology and urogynecology clinics using a simple screening tool and to compare the prevalence between patients presenting with gynecology or urogynecology complaints.

Patients attending (uro)gynecology clinics completed three screening questions for sexual problems to be assessed. A fourth question was later introduced to address sexual problems which bother them. Student's t-test, chi-square test, and logistic regression were used.

Of 1,194 women, 37% had a sexual complaint. Seventeen percent volunteered this information as part of their main complaint, while the remaining only admitted it on questioning. The last 290 questionnaires included the question on "bother." Of these, 37% had a sexual complaint and only 45% found them bothersome. Multivariate analysis showed that urogynecology complaints were significantly associated with sexual complaints.

As most women only volunteer symptoms when asked directly, clinicians should be vigilant in identifying sexual problems but always establish the question of bother to avoid over-diagnosis.