Translating Sexual Dysfunction: Does Language Impact Clinical Discussion of Painful Sex?

Dyspareunia and sexual dysfunction are estimated to affect up to 22% and 43% of women, respectively. There is concern that these statistics do not depict the true prevalence and that these conditions are frequently undiagnosed and untreated. By 2060, Latinos will make up 30% of the total population in the United States. Because our patient population becomes more diverse, we need to ensure that our healthcare practices accommodate the changes.

We surveyed a convenience sample of 107 English and 71 Spanish-speaking women, aged 18 to 45 years, at university-affiliated clinics to identify the prevalence of dyspareunia and sexual dysfunction within our community. In addition, we wanted to identify the rate that clinicians discuss painful sex with patients to identify whether language impacted communication. The surveys collected data on subjective reporting of pain with sex and objective identification of sexual dysfunction with the Female Sexual Function Index. Additional questions identified if subjects discussed pain with their clinician. These questions were analyzed between languages across all domains.

A greater prevalence of both dyspareunia and sexual dysfunction was measured in our study population compared with previous reports (37.79% and 54.71%, respectively). Spanish-speaking women had significantly lower self-reported dyspareunia (28.99%) but scored significantly lower on the Female Sexual Function Index, qualifying for sexual dysfunction (63.24%). Spanish speakers discussed painful sex significantly less compared with the English cohort, but the overall discussion rate was only 17.26%.

These pilot data demonstrate a need for further research on language as a barrier to communication about sexual function in clinic.