UH Training the Next Generation of Female Sexual Health Providers

Growing field demands qualified clinicians

Innovations in Urology | Spring 2024

Studies have shown that more than 40 percent of women experience problems related to sexual health at some point in their lifetimes. However, the care of women with sexual health issues has traditionally been piecemeal and incomplete. Women may seek care from gynecologists, urologists, or plastic surgeons, often with little follow-up or long-term management and without addressing the psychosocial effects these problems may cause.

Rachel Pope, MD

“The need for focused female sexual health programs with specially trained clinicians is significant,” says Rachel Pope, MD, MPH, Division Chief, Female Sexual Health, University Hospitals Urology Institute. “Now that we have established a Female Sexual Health program at UH, we are preparing to train the next generation of clinicians by offering a one-year fellowship in Female Reconstruction & Sexual Health (FRESH) for physicians who have completed their residency in gynecology or urology.”

UH designed FRESH with specific objectives to help clinicians in training master the complete range of diagnostic, etiology, management and treatment of female sexual dysfunction, including surgery when necessary. Qualified candidates must have completed an ACGME accredited gynecologic or urology residency program and have an interest in female sexual health.

UH’s Female Sexual Health division is staffed with clinicians in a range of specialties, so fellows will receive a strong foundation in all areas, including surgery for hysterectomy and gender-affirming vaginoplasty; reconstructive surgery for those with physical changes from cancer treatment; dermatological conditions, such as lichen sclerosus, hidradenitis suppurativa, and more. Fellows will also complete the requirements for a Menopause Society Practitioner Certification.

“Our division includes gynecologists, urologists, pelvic floor specialists, nurse practitioners and psychologists. We work together to provide patients with comprehensive, long-term care, and now, we’re collaborating to prepare future clinicians,” says Dr. Pope.

UH Division of Female Sexual Health (L to R) Jean Marino, MSN, APRN-CNP, NCMP, IF; Rachel Pope, MD, MPH; Sheryl Kingsberg, PhD, IF; Erika Kelley, PhD; Karen Connor, DPT, PT, DPT, PRPC; Anna Myers, MSN, APRN-CNP, CUNP, IF, CSC

Lifespan Care for Women

When Dr. Pope was a resident at UH, there were a few clinicians in the gynecology division who were early champions of specialized care for female sexual health. When she returned to UH after her training, she was committed to creating a division focused on patients’ needs, a place where clinicians could spend the necessary time to address women’s pressing sexual health concerns. Lee Ponsky, MD, FACS, Chair of the Urology Institute, wholeheartedly encouraged and supported this endeavor.

“This is something you don’t typically see in medicine,” Dr. Pope says. “A lot of patients with these (often complicated) issues see physicians in private practice who may not have access to the interdisciplinary care the patient needs. However, in academic settings, we typically focus and train in a specific subspecialty, so institutions such as UH can treat complex patients and conditions with in-depth expertise, a multidisciplinary approach and a thorough understanding of the nuances involved.”

The Division of Female Sexual Health treats conditions including:

• Menopause-related conditions, as low libido and vaginal dryness
• Vulvar dermatoses, such as lichen sclerosus
• Pelvic floor dysfunction and vaginismus
• Arousal and orgasm disorders, including persistent genital arousal disorder
• Sexual dysfunction following cancer treatment for patients who often have significant discomfort or dysfunction and may require complex reconstructive surgery
• Sexual function after childbirth for women who have unresolved pain or injuries after delivery
• Vulvodynia

“Sexual health issues affect women at all stages of their lives,” says Dr. Pope, “so I encourage all clinicians to ask patients during routine appointments if they have concerns and then to feel comfortable referring patients with complex issues to us, knowing our team can care for them. Many women are not aware that help is even available and won’t bring up their concerns unless specifically asked.”

UH Leading the Way in This Subspecialty

“Female sexual health is a relatively new field in medicine, but these are not new problems,” says Dr. Pope. “Women have always had issues related to sexual health. However, due to lingering stigmas and the fact that they are largely nonvisible conditions, they haven’t always been addressed. Furthermore, the lack of widely accessible providers can be a barrier to women who are seeking help.”

“Currently, there are only two similar training programs in the U.S., and only one is associated with a university,” Dr. Pope says. “UH is really on the forefront of this developing field, and I imagine as it grows, we will more fully realize the scope of need. In the meantime, UH is doing its part to ensure there will be clinicians well trained to care for these women.”

The Female Reconstruction and Sexual Health Fellowship program will begin in August 2024. UH is currently accepting applications.

For more information about the Fellowship or the Female Sexual Health Division, call Dr. Pope at 216-844-3009.

Contributing Expert:
Rachel Pope, MD, MPH
Division Chief, Female Sexual Health
University Hospitals Urology Institute
Associate Professor of Urology and Obstetrics and Gynecology
Case Western Reserve University School of Medicine