Bringing Women’s Sexual Health to the Forefront

UH multidisciplinary approach provides in-house expertise, training, clinical research

Innovations in Obstetrics & Gynecology | Winter 2020

Sheryl Kingsberg, PhD

Sexual health is critically important to the overall health and quality of life for women regardless of age, says Sheryl Kingsberg, PhD, Division Chief, OB/GYN Behavioral Medicine, University Hospitals Cleveland Medical Center, and Professor, Reproductive Biology and Psychiatry departments, Case Western Reserve University School of Medicine. “However, Cleveland’s University Hospitals is one of the few medical centers that offers sexual medicine as an integrated part of women’s health,” she says.

Sex Matters to Women

Surveys support that sexuality and sexual health does matter to most women. One study found roughly 60 percent of women in their 60s are sexually active,¹  and another found nearly one-quarter of married women in their 70s are as well.²  Furthermore, the AARP Survey of Midlife and Older Adults found that 60 percent of women say sex is a critical component to a good relationship.³

Despite how important sexual health is to women and to their overall health, 43 percent of women report having a sexual problem, such as low desire, problems with arousal or orgasm, or pain with sexual activity, says Kingsberg. Often, these problems overlap. One in 10 of these women report they are distressed by the problem, the hallmark criteria for a diagnosis.

Sexual dysfunction also affects women who survive cancer — an ever-increasing number. More than half of women with breast cancer, and 65 to 90 percent of women with gynecological cancers, report long-term sexual dysfunction as a result of their cancer or cancer treatment,4  creating additional psychological distress and reduced quality of life for these survivors, says Kingsberg. The growing number of cancer survivors receiving care at University Hospitals Seidman Cancer Center now have an integrated referral for sexual concerns to help restore excellent quality of life.

Opportunity For Healthcare Providers

More than one-third of women who sought medical help for their sexual health issues felt their concerns were not adequately addressed or taken seriously enough, according to Kingsberg. Fostering better dialogue between women and healthcare providers, and lessening the perceived stigma, are important first steps.

“Most healthcare providers are not trained or not comfortable screening for — much less diagnosing or treating — sexual dysfunction,” Kingsberg says. “And many clinicians don’t realize there are approved pharmacologic treatment options for these problems.”

As Kingsberg and others have found, no one medical specialty “owns” sexual health, so women often are not sure where to go for help.

Multidisciplinary Approach

Women’s sexual health is complex, so UH is stepping up with a comprehensive approach to patient care:

In-house expertise. “Our multidisciplinary program reflects the biopsychosocial nature of women’s sexual health,” Kingsberg says. “We have psychologists, gynecologists, advanced nurse practitioners, and pelvic floor physical therapists all with expertise in treating female sexual dysfunctions.”

Kingsberg, who leads the women’s sexual medicine program at UH, is an international expert in the field, with both clinical and research expertise. She’s also a leader in professional organizations, including the North American Menopause Society and the International Society for the Study of Women’s Sexual Health.

Training. In addition to providing much-needed clinical expertise, UH trains clinicians to screen and assess women’s sexual health issues and offers sexual health education for OB/GYN residents.

Clinical research. UH is also leading the way in clinical research. “Our MacDonald Clinical Trials [Unit] has been a leading research site for the development of the first and only two Food and Drug Administration-approved pharmacological treatments for hypoactive sexual desire disorder, flibanserin (Addyi) and bremelanotide (Vyleesi),” says Kingsberg. “We are also involved in helping to design clinical trials for treatments for sexual arousal disorders and orgasmic disorders as well as therapies for genitourinary syndrome of menopause [GSM].”

GSM is highly prevalent and often chronic. Symptoms include sexual pain, genital dryness, vaginal irritation or itching, and bleeding after sex.

Kingsberg says she hopes this program serves as a model for other academic institutions and private healthcare systems.

“Every woman deserves to have her sexual concerns addressed,” Kingsberg says. “Our sexual medicine program provides a multidisciplinary approach to address women’s sexual health concerns across their lifespan.”

Any clinician can refer patients to the program. For more information, or to refer a patient, call 216-553-1537, or select “sexual medicine referral” in AEMR, and a registered nurse at University Hospitals Ahuja Medical Center will schedule your patient with the appropriate provider.

¹Thomas HN, Hess R, Thurston RC. Correlates of sexual activity and satisfaction in midlife and older women. Ann
Fam Med 2015;13:336–342.
²Schneidewind-Skibbe A, Hayes RD, Koochaki PE, Meyer J, Dennerstein L. The frequency of sexual intercourse reported
by women: a review of community-based studies and factors limiting their conclusions. J Sex Med 2008;5:301–335.
³Fisher L, Anderson O, Chapagain M, Montenegro X, Smoot J, Takalkar A. Sex, romance, and relationships: 2009
AARP survey of midlife and older adults. 2010.
⁴Krychman ML, Pereira L, Carter J, Amsterdam A. Sexual oncology: sexual health issues in women with cancer. Oncology 2006;71:
18–25.

Additional References:

Sheryl A. Kingsberg, Jonathan Schaffir, Brooke M. Faught, JoAnn V. Pinkerton, Sharon J. Parish, Cheryl B. Iglesia, Jennifer Gudeman, Julie Krop, and James A. Simon. Optimal Outcomes and a Roadmap for Improved Patient–Clinician. Journal of Women's Health.Apr 2019.432-443.http://doi.org/10.1089/jwh.2018.7352

10 Strategies for Coping With Loss of Libido and Other Menopause Symptoms | Patient Advice | US News. May 10, 2018.