Sexual Health Assessment in the Primary Care of Older Women

Sexual health assessment is often neglected in primary care settings for various reasons including limited time with patients. Discussing sexual health with patients is particularly neglected in the older population despite the fact that people continue to be sexually active as they age. Older patients are at risk for sexually transmitted infections and without proper sexual assessment there is risk of misdiagnosis, ultimately leading to ineffective and inefficient treatment. Within the aging population, men are more likely to be asked about their sexual activity or concerns, leaving a gap in the assessment of sexual health of post-menopausal and geriatric women.

Sexual health assessment is a priority for older women despite the fact that the topic is often overlooked in primary care settings. A literature review was conducted with the objective of exploring the literature on sexual health assessment of older women, identifying barriers to communication and sexual health assessment for this population, and identifying interventions to improve clinical assessment and inform providers of these interventions. The literature review using PubMed, CINAHL, and Ovid Medline yielded various studies that explored barriers to conversations as well as interventions to improve these conversations. The studies found that some providers were being influenced by old stereotypes suggesting women were uncomfortable with sexual health related discussions. They also found that women wanted to have these discussions and would even return for follow up if provider time constraints were an issue. While women wanted to have the conversations, they may be reluctant to start the discussion.

It is important that providers initiate the conversations and include sexual health as a part of routine primary care assessment. There are efficient sexual health assessment tools that have been used for decades that can be integrated into primary care environments that do not already have such practices in place. These interventions include questionnaires, assessment tools, and communication skills training for providers. Primary care providers and their patients will benefit from open and regular conversations about sexual health.