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Womens Sexual Health: Provider Survey Created for: The Association of Reproductive Health Professionals and HealthyWomen Presented by: Harris Interactive.

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Presentation on theme: "Womens Sexual Health: Provider Survey Created for: The Association of Reproductive Health Professionals and HealthyWomen Presented by: Harris Interactive."— Presentation transcript:

1 Womens Sexual Health: Provider Survey Created for: The Association of Reproductive Health Professionals and HealthyWomen Presented by: Harris Interactive © Harris Interactive 10/26/09

2 Table of Contents Background and Objectives Methodology Executive Summary Discussion of Female Sexual Health Sexual Dysfunction Knowledge Attitudes About Female Sexual Dysfunction Addressing and Diagnosing Female Sexual Dysfunction Provider and Consumer Comparison Implications and Recommendations Demographics © Harris Interactive 2

3 Background and Objectives © Harris Interactive 3 HealthyWomen in partnership with the Association of Reproductive Health Professionals (ARHP), commissioned Harris Interactive to conduct an online survey to explore health care providers attitudes, behaviors and perceptions regarding female sexuality and sexual dysfunction. An additional focus of this research is to augment previous research conducted among female consumers concerning their attitudes, behaviors and perceptions regarding their sexuality. The goal of this research is to deepen HealthyWomen and ARHPs existing knowledge to further enable these organizations to foster education, outreach and understanding to help women to feel comfortable with their sexuality and to empower them to communicate openly with their health care providers about sex and sexuality issues.

4 Methodology This survey was conducted online within the United States by Harris Interactive on behalf of HealthyWomen between September 15-28, 2009 among 304 health care providers who practice in the U.S. Of the 304 health care providers who participated in this survey, 200 were physicians and 104 were Nurse Practitioners/Physician Assistants/Nurse Midwives. Surveys were weighted as need to reflect the composition of the US population of physicians and Nurse Practitioners/Physician Assistants/Nurse Midwives. –Physicians were weighted by gender, years in practice, region, and specialty. –Nurse Practitioners/Physician Assistants/Nurse Midwives were weighted by education, gender, ethnicity, region, and income. The survey was 15 minutes in length. © Harris Interactive 4

5 Executive Summary 5

6 © Harris Interactive 6 Providers report relatively low levels of knowledge when it comes to female sexuality or sexual dysfunction, and few are comfortable diagnosing and treating patients experiencing symptoms of these conditions. –Fewer than half of heath care providers (44%) report they are extremely or very knowledgeable about female sexual function, and only 7%-32% of providers report they are extremely or very knowledgeable about various female sexual problems, including dyspareunia (32%), hypoactive sexual desire disorder (18%) and sexual arousal disorder (18%). – Additionally, over one-quarter (27%) are not aware of any of the female sexual response models Just 16% are aware of Rosemary Bassons model. – Further, just 12% of providers are very or extremely confident diagnosing female patients with female sexual dysfunction, and just 11% are very or extremely confident in their ability to provide appropriate care for their patients experiencing symptoms of sexual dysfunction.

7 Executive Summary (cont.) © Harris Interactive 7 There seems to be a lack of communication about female sexual health and sexual dysfunction between health care providers and their patients, potentially preventing many women from receiving appropriate care. –For half of providers (50%), sexual health is the topic they least commonly discuss with female patients. – On average, providers report that they have discussed issues related to sexual health with about four in ten (39%) of their female patients. –When female sexual health is discussed, the majority of providers (74%) report they rely on their patients to initiate the discussion. However, given that the consumer survey found that less than one-fifth (18%) of women who experienced a sexual health issue reported discussing it with their health care provider, this may indicate that some women who are experiencing symptoms may be going without treatment. Significant differences exist between male and female health care providers when it comes to communicating with female patients about sexual health. – More female providers than male providers discuss sexual health as part of their routine exam, and female providers report have discussed issues related to sexual health with an average of 45% of their female patients whereas male providers, on average, have discussed sexual health with 34% of their female patients. Female providers also report a higher level of comfort discussing sexual health compared to their male colleagues.

8 Executive Summary (cont.) © Harris Interactive 8 There seems to be a disconnect between health care providers and consumers when it comes to female sexual health. –When comparing consumers and providers responses about what it means to be sexually healthy, they agree in many areas. However, while providers are more likely to mention good physical health (67% vs. 47% of women) and mental health (67% vs. 42% of women) as part of the definition, women are more likely than providers to mention having sex frequently (27% vs. 13% of providers). –Additionally, consumers report health care providers are taking far fewer steps in response patients symptoms of sexual dysfunction, than what health care providers report they are doing. –There are significant differences between the groups on the frequency with which health care providers are performing tests and providing information and/or advice.

9 © Harris Interactive Implications and Recommendations 9

10 © Harris Interactive 10 Health care providers need more information about female sexuality and sexual dysfunction to ensure they are addressing and diagnosing cases of sexual dysfunction in their female patients. – Many providers report they are not very knowledgeable when it comes to the topic of female sexual dysfunction and many do not view addressing female sexual dysfunction with their patients as very or extremely important. –Improving education about female sexuality and sexual dysfunction will enable health care providers to start a dialog with their female patients and help them feel more comfortable and confident in addressing their patients concerns. Health care providers should be encouraged to make discussing sexual health part of their routine with their female patients. – Currently, the majority of health care providers are relying on their patients to initiate the conversation and it was learned from the consumer survey, even when women experience symptoms of sexual dysfunction, few women are likely to discuss their issues with their health care providers. – If more providers initiated discussions of female sexual health and sexual dysfunction with patients, its likely that more women experiencing symptoms could obtain appropriate care and treatment for their symptoms.

11 Implications and Recommendations © Harris Interactive 11 There is a need for increased awareness of available therapies to treat female sexual dysfunction as well as the development of new treatments that effectively treat the symptoms of FSD. – Providers are more likely to cite their lack of knowledge about the treatments available than any other factor as a reason for their confidence in their ability to provide appropriate care to their patients. – Additionally, in the few cases of female sexual dysfunction that providers diagnose and treat, there is a low level of satisfaction with the treatments available and according to providers, there is a relatively low rate of improvement in symptoms experienced by the patients.

12 © Harris Interactive Discussion of Female Sexual Health 12

13 Key Findings - Discussion of Female Sexual Health For half of providers, sexual health is the least commonly discussed topic with their female patients. – On average, providers have discussed issues related to sexual health with 39% of their female patients. – When the topic of sexual health is discussed during a visit, nearly three-quarters (74%) of providers report their patients are initiating the conversation. Although it is not discussed very frequently, many providers report they are comfortable speaking about sexual health issues. – Most providers (87%) say they are comfortable discussing sexual health with female patients, and over two-fifths (42%) of providers report they are very/extremely comfortable discussing these issues. Female providers (54%) are more likely to say they are very or extremely comfortable than male providers (31%) discussing sexual health with female patients. – When it comes to comfort levels with discussing sexual health with different types of patients, approximately one-third (32%) of health care providers say they would be most comfortable discussing sexual health with patients who are in committed relationships or are married, more than any other group of women. © Harris Interactive 13

14 Topics Discussed With Female Patients For half of providers (50%), sexual health is the least commonly discussed topic with female patients. © Harris Interactive 14 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q700 Which of the following topics do you discuss with your female patients most commonly, and which do you discuss least commonly? Male: 59% Female: 40% Male: 59% Female: 40%

15 © Harris Interactive 15 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q703 Next, we have some questions about womens sexual health. What do you think it means for women to be sexually healthy? Please select all that apply. Meaning of Sexual Health Health care providers report sexual health means for women to be satisfied with their sex lives, having a good relationship with their partners, and enjoying sex. Providers are less inclined to believe being sexually healthy means having sex frequently or being able to have children.

16 © Harris Interactive 16 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q720 With approximately what percentage of your female patients have you discussed issues related to sexual health? Discussion of Sexual Health with Patients On average, providers have discussed issues related to sexual health with 39% of their female patients. Female providers discuss these issues with a greater percentage of patients than male providers, on average. Male: 34% Female: 45% Male: 34% Female: 45% Mean39%30%41%

17 © Harris Interactive 17 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q1000 Which of the following forms of communication do you use to talk with patients about their sexual health? Please select all that apply. Nearly all providers (96%) report they used in-person office visits to talk with patients about their sexual health, and just 3% report communicating with patients via email. Forms of Communication Used to Discuss Sexual Health

18 © Harris Interactive 18 BASE: Have discussed female sexual health (total n=300; MD n=199; NP/PA/NM n=101) Q735 When you have discussed issues related to sexual health with your female patients, how does the topic usually come up? Please select all that apply. Initiation of Sexual Health Discussion About three-quarters (74%) of providers rely on patients to bring up the issue of sexual health either by bringing sexual health up during a visit or by making an appointment to specifically discuss the issue. More female providers than male providers discuss sexual health as part of their routine exam. Male: 48% Female: 64% Male: 48% Female: 64% Male: 30% Female: 45% Male: 30% Female: 45% Patient brings it up (NET): 74%

19 © Harris Interactive 19 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q745 How comfortable are you discussing sexual health topics, including sexual desire and sexual function, with your female patients? Top 2: 37% Top 2: 53% Top 2: 42% Comfort Discussing Sexual Health Issues The majority of health care providers (87%) report they are comfortable discussing sexual health issues with their patients although NP/PA/NM report a higher degree of comfort when compared to MDs. Female providers report a higher level of comfort discussing sexual health with their female patients compared to their male colleagues. Male: 31% Female: 54% Male: 31% Female: 54%

20 © Harris Interactive 20 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q747 Thinking about women with each of the following characteristics, with whom would you be most comfortable discussing sexual health topics, including sexual desire and sexual function, and with whom would you be least comfortable discussing these topics? Comfort Discussing Sexual Health with Different Types of Patients Approximately one-third (32%) of health care providers say they would be most comfortable discussing sexual health with patients who are in committed relationships or are married. Nearly four in ten (39%) report they would be least comfortable discussing sexual health with patients with conservative values. *Note: Only patient types with a response >1% are listed.

21 © Harris Interactive 21 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q750 In general, are you more comfortable discussing sexual health with female or male patients? Comfort Discussing Sexual Health with Different Sexes Nearly half (49%) of health care providers report they are comfortable discussing sexual health with both female and male patients; however, nearly half (47%) of female health care providers indicate they are more comfortable talking to their female patients than male patients. Male: 9% Female: 47% Male: 9% Female: 47%

22 © Harris Interactive Sexual Dysfunction Knowledge 22

23 Key Findings - Sexual Dysfunction Knowledge © Harris Interactive 23 Health care providers report a lack of knowledge about female sexual function and dysfunction. –Fewer than half of providers report they are very or extremely knowledgeable about female sexual function (44%). –Over one-quarter (27%) of providers are not aware of Masters and Johnsons, Helen Singer Kaplans, or Rosemary Bassons model of sexual response. Less than one-fifth (16%) of health care providers are aware of Rosemary Bassons model. When looking specifically at different types of female sexual dysfunction, few providers are very or extremely knowledgeable about any condition. –Less than one-fifth (18%) of providers indicate they are very or extremely knowledgeable about Hypoactive Sexual Disorder. – Providers are most likely to report being very or extremely knowledgeable about Dyspareunia (32%) and least likely to be very or extremely knowledgeable about Persistent Genital Arousal Disorder (7%).

24 © Harris Interactive 24 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q800 Next we have some questions about female sexual function. How knowledgeable would you say you are about female sexual function? Top 2: 37% Top 2: 44% Top 2: 60% Knowledge of Female Sexual Function Fewer than half of heath care providers (44%) report they are extremely/very knowledgeable about female sexual function.

25 © Harris Interactive BASE: All respondents (total n=304) Q805 Do you agree or disagree with the following statements? Female Sexual Desire and Sexual Norms Almost all health care providers interviewed (98%) agree that a womans level of sexual desire may change based on circumstances. Many also agree that the nature of female sexual desire may change over time (88%) and that the female sexual response is different than male sexual response (85%).

26 © Harris Interactive 26 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q805 Do you agree or disagree with the following statements? Female Sexual Desire and Sexual Norms By Specialty There are not many differences between MDs and NP/PA/NMs when it comes to attitudes about female sexual desire. However, NP/PA/NMs are more likely than MDs to agree that only 30% of women are orgasmic during vaginal intercourse (68% and 60%, respectively).

27 © Harris Interactive 27 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q810 Of which of the following models of female sexual response are you aware? Please select all that apply. Familiarity with Models of Female Sexual Response Less than one-fifth (16%) of health care providers are aware of Rosemary Bassons model of female sexual response and over one-quarter (27%) are not aware of any of the female sexual response models.

28 © Harris Interactive 28 Definitions of Female Sexual Problems For the subsequent slide, respondents were asked to rate their knowledge of female sexual problems. Respondents were given the descriptions of each problem, outlined below, for reference. Hypoactive Sexual Desire Disorder: Persistent or recurrent deficiency or absence of sexual desire or sexual fantasies, which causes distress and is not better accounted for by another medical condition or medication. Sexual Arousal Disorder : The inability to achieve or maintain adequate lubrication/swelling response of sexual excitement, which causes distress and is not better accounted for by another medical condition or medication. Orgasmic Disorder : Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase, which causes distress and is not better accounted for by another medical condition or medication. Vaginismus : Persistent or recurrent involuntary spasm of the vaginal muscles that interferes with sexual intercourse, which causes distress and is not better accounted for by another medical condition or medication. Dyspareunia : Persistent or recurrent genital pain associated with sexual intercourse, which causes distress and is not better accounted for by another medical condition or medication. Sexual Aversion Disorder : Persistent or recurrent extreme aversion to and avoidance of sexual genital contact with a sexual partner, which causes distress and is not better accounted for by another medical condition or medication. Persistent Genital Arousal Disorder: Persistent and spontaneous genital arousal, with or without orgasm or genital engorgement that is unrelated to feelings of sexual desire.

29 © Harris Interactive 29 BASE: All respondents (total n=304) Q815 How knowledgeable would you say you are about each of the following types of female sexual problems or concerns? Level of Knowledge About Female Sexual Problems – by Total Providers report being most knowledgeable about Dyspareunia and Vaginismus. Less than one-fifth (18%) of providers indicate they are extremely/very knowledgeable about Hypoactive Sexual Disorder.

30 © Harris Interactive 30 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q815 How knowledgeable would you say you are about each of the following types of female sexual problems or concerns? Please click the on the name of each disorder for a brief description. Level of Knowledge About Female Sexual Problems – by Specialty MDs and NP/PA/NMs do not differ much in their knowledge about female sexual problems although NP/PA/NMs report having more knowledge of Sexual Arousal Disorder, Sexual Aversion Disorder, and Persistent Genital Arousal Disorder compared to MDs.

31 © Harris Interactive Attitudes About Female Sexual Dysfunction 31

32 Key Findings - Attitudes About Female Sexual Dysfunction © Harris Interactive 32 While providers indicate they believe sexual dysfunction has a negative impact in many areas of womens lives, relatively few indicate they think these conditions are very or extremely important to address. –About two-fifths (39%) of providers believe that it is very or extremely important to address sexual dysfunction in their female patients. – Even fewer providers (28%) view addressing low sexual desire with their female patients as very or extremely important. –However, the majority of providers believe that sexual dysfunction negatively impacts their patients sex lives, romantic relationships, self esteem, emotional/mental health, and physical health. –When female dysfunction is present, providers report they think FSD is the primary disorder in an average of 35% of the cases.

33 © Harris Interactive 33 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q825 In what percentage of female sexual dysfunction cases do you believe it is a primary disorder that is not caused by any other medical condition? Female Sexual Dysfunction as a Primary Disorder Health care providers think female sexual dysfunction is the primary disorder in 35% of FSD cases, on average. Only 3% of providers believe female sexual dysfunction is the primary disorder 75%-100% of the cases. Mean35%39%26%

34 © Harris Interactive 34 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q840 How important do you think it is to address female sexual dysfunction in female patients? Top 2: 37% Top 2: 39% Top 2: 45% Nearly all of health care providers (95%) view some importance in addressing sexual function with their female patients but only one in four (39%) believe it is extremely/very important. Importance of Addressing Female Sexual Dysfunction

35 © Harris Interactive 35 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q845 How important do you think it is to address low sexual desire in female patients? Top 2: 27% Top 2: 28% Top 2: 33% Again, nearly all of health care providers interviewed (97%) agree addressing sexual desire with their female patients is important but just over one-quarter (28%) view it as extremely/very important. Importance of Addressing Low Sexual Desire in Female Patients

36 © Harris Interactive 36 BASE: All respondents (total n=304) Q850 What type of impact do you feel female sexual dysfunction has on your female patients in each of the following areas? The majority of providers believe female sexual dysfunction has a negative impact on their patients sex lives, relationships with romantic partners, self esteem, physical health and emotional/mental health. Impact of Female Sexual Dysfunction on the Patient

37 © Harris Interactive 37 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q850 What type of impact do you feel female sexual dysfunction has on your female patients in each of the following areas? Health care providers, regardless of their job title, agree that female sexual dysfunction has a negative impact on various aspects of their female patients lives. Impact of Female Sexual Dysfunction – by Specialty

38 © Harris Interactive Addressing and Diagnosing Female Sexual Dysfunction 38

39 Key Findings - Addressing and Diagnosing Female Sexual Dysfunction © Harris Interactive 39 Very few providers report discussing sexual dysfunction or low sexual desire with the majority of their patients. –On average, providers report discussing female sexual dysfunction with 27% of patients. –Providers view their patients discomfort with the topic (53%), not having enough time with their patients (51%), and relying on their patients to bring up the topic (49%) as the most common barriers to discussing sexual dysfunction. Over half of providers show a lack of confidence in their ability to provide appropriate care for the condition. –Just 12% of providers say they are confident in their ability to properly diagnose a patient with female sexual dysfunction, and 11% are confident in their ability to treat the condition. –Major barriers to confidence are related to lack of knowledge: of the treatments available (68%) and of the conditions in general (57%). Of providers who have treated patients for sexual dysfunction, over three-quarters are not satisfied with the treatments available. –Just 21% of providers say they are very or extremely satisfied with the treatments available. –When treatments are prescribed, the most common medications prescribed are lubricants (75%)and antidepressants (73%).

40 © Harris Interactive 40 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q900 With approximately what percentage of your female patients have you discussed female sexual dysfunction? On average, providers report discussing female sexual dysfunction with just over one-quarter (27%) of their patients. Percentage of Patients with Whom Providers Discussed FSD Mean27%29%23%

41 © Harris Interactive 41 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q905 With approximately what percentage of your female patients have you discussed low sexual desire? Providers also report, on average, they discuss low sexual desire with just over one-quarter (26%) of their patients. Amount of Patients with Whom Providers Discussed Low Desire Mean26%27%25%

42 © Harris Interactive 42 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q910 What prevents you from discussing issues related to female sexual dysfunction with female patients more often? Please rank the top three reasons why you might not discuss these issues with female patients more often. When providers were asked to rank the top three factors preventing them from discussing sexual dysfunction with their patients, physicians reported their patients discomfort as a barrier more often than any other reason. In the consumer study, 38% of women said they did not visit a health care provider about sexual health issues because they did not think it was important enough to discuss. Barriers to Discussing Sexual Dysfunction With Female Patients Note: Only statements with >5% response are displayed.

43 © Harris Interactive 43 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q818 How likely would you be to diagnose a patient with a female sexual dysfunction if she experiences physical symptoms of a disorder, such as persistent lack of desire or lack of arousal, but does not seem to be personally distressed by her symptoms? Bottom 2: 51% Bottom 2: 53% Bottom 2: 58% Likelihood of Sexual Disorder Diagnosis Absent of Distress Over half of providers (53%) report they would be unlikely to diagnose a patient with female sexual dysfunction if she experiences physical symptoms but does not seem to be distressed by her symptoms. More NP/PA/NMs (58%) than MDs (51%) report they would be unlikely to diagnose sexual disorder if the patient was not distressed.

44 © Harris Interactive 44 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q920 How confident are you in your ability to properly diagnose female patients experiencing symptoms of female sexual dysfunction? Bottom 2: 37% Bottom 2: 39% Bottom 2: 43% About two-fifths (39%) of health care providers feel not at all/not very confident in their ability to diagnose female sexual dysfunction. Only 12% of providers report they are extremely/very confident in their ability to diagnose sexual dysfunction in their female patients. Confidence in Diagnosing Female Sexual Dysfunction

45 © Harris Interactive 45 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q925 How confident are you in your ability to provide appropriate care to female patients experiencing symptoms of female sexual dysfunction? Bottom 2: 53% Bottom 2: 55% Bottom 2: 60% Over half (55%) of providers are not at all/not very confident in their ability to provide appropriate care for their patients experiencing symptoms of sexual dysfunction. NP/PA/NMs are less likely than MDs to be confident in their ability to provide appropriate care. Confidence in Providing Appropriate Care for Sexual Dysfunction

46 © Harris Interactive 46 BASE: Not confident (total n=169; MD n=109; NP/PA/NM n=60) Q930 What factors impact your level of confidence in your ability to provide appropriate care to female patients experiencing symptoms of female sexual dysfunction? Please select all that apply. Over two-thirds (68%) of providers cite lack of knowledge about the treatments available for sexual dysfunction as a factor impacting their confidence in their ability to provide appropriate care to their patients and the majority (57%) mention a lack of knowledge about the conditions in general. Factors Impacting Providers Confidence in Providing Appropriate Care

47 © Harris Interactive 47 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q932 Approximately what percentage of your female patients have you treated for female sexual dysfunction? Providers report, on average, they have treated 16% of their female patient population for female sexual dysfunction. Number of Patients Treated for Female Sexual Dysfunction Mean16%18%12%

48 © Harris Interactive 48 BASE: Discussed FSD with patients (total n=286; MD n=194; NP/PA/NM n=92) Q935 When female patients have experienced symptoms of female sexual dysfunction, which of the following steps have you taken? Please select all that apply. The most common steps taken by providers when female patients have experienced symptoms of sexual dysfunction are asking questions about the issue and performing routine exams. Steps Taken in Response to Sexual Dysfunction Diagnosis

49 © Harris Interactive 49 BASE: Treated patients for FSD (total n=244; MD n=173; NP/PA/NM n=71) Q940 What types of medication have you prescribed or recommended to female patients experiencing symptoms of female sexual dysfunction? Lubricants and antidepressants are the most commonly prescribed or recommended treatments for symptoms of female sexual dysfunction. Medications Prescribed to Treat Female Sexual Dysfunction

50 © Harris Interactive 50 BASE: Treated patients for FSD (total n=244; MD n=173; NP/PA/NM n=71) Q945 How satisfied are you with the current treatments available to treat female sexual dysfunctions? Bottom 2: 80% Bottom 2: 78% Bottom 2: 69% Most providers (78%) who have treated patients for female sexual dysfunction, are not satisfied with current treatments. Satisfaction with Available Treatments for Sexual Dysfunction

51 © Harris Interactive 51 BASE: Treated patients for FSD (total n=244; MD n=173; NP/PA/NM n=71) Q955 Approximately what percentage of your patients with female sexual dysfunction has reported improvement after following the treatment methods you recommended? Providers report, on average, less than one-third (29%) of patients who were treated for FSD, experienced improvement after following the treatment methods they recommended. Percentage of Patients Reporting Improvement After Treatment Mean29%30%23%

52 © Harris Interactive 52 BASE: All respondents (total n=304) Q950 How much do you think each of the following medications contributes to female sexual dysfunctions? SSRIs and tricyclic antidepressants are seen by providers as contributing to female sexual dysfunction more than other medications. Perceived Contribution of Medications to FSD

53 © Harris Interactive 53 BASE: All respondents (total n=304; MD n=200; NP/PA/NM n=104) Q950 How much do you think each of the following medications contributes to female sexual dysfunctions? Regardless of specialty, SSRIs and tricyclic antidepressants are seen as contributing to female sexual dysfunction more than other medications. Perceived Contribution of Medications to FSD – by Specialty

54 © Harris Interactive Provider and Consumer Comparison 54

55 Key Findings – Provider and Consumer Comparison © Harris Interactive 55 Although consumers and providers think similarly about what female health means and report they are somewhat comfortable speaking with each other about the female sexuality and dysfunction, comparing the consumer and provider reports uncovers a disconnect between the two groups. – Providers view sexual dysfunction as having more of a negative impact on areas of life when compared to patients. – Even though providers view the effects of sexual dysfunction more negatively than patients, as it was mentioned previously, the majority of providers (74%) report they rely on their patients to bring up the issue of sexual health, and most women do not. –When comparing the consumers and provider reports, consumers report health care providers are taking far fewer steps in response to a patients sexual dysfunction compared to what the health care providers are reporting. –There are significant differences between the groups on a number of items, including how often health care providers are performing tests and providing information and/or advice.

56 © Harris Interactive 56 BASE: All providers (n=304) Q745 How comfortable are you discussing sexual health topics, including sexual desire and sexual function, with your female patients? BASE: All consumers (n=1210) Q830 How comfortable are you talking to each of the following people about sexual health issues? Comfort Discussing Sexual Health Issues The majority of health care providers (87%) report they are comfortable discussing sexual health issues with their patients. Women report the most comfort discussing sexual health issues with a OB/GYN compared to other types of health care providers. Consumers About Providers

57 © Harris Interactive 57 BASE: All Providers (n=304) Q703 Next, we have some questions about womens sexual health. What do you think it means for women to be sexually healthy? Please select all that apply. BASE: All Consumers (n=1,210) Q711. What does it mean to you to be sexually healthy? Please select all that apply. Meaning of Sexual Health: Provider and Consumer Comparison More health care providers than consumers think being in good overall mental and physical health is part of being sexually healthy, while women are more likely than providers to include having sex frequently as part of their definition.

58 © Harris Interactive 58 BASE: All Providers (total n=304) Q850 What type of impact do you feel female sexual dysfunction has on your female patients in each of the following areas? BASE: Consumers Experienced a Sexual Health Issue (n=850) Q985 Now thinking in general about the sexual health issues you have experienced, such as …, what impact, if any, have they had on each of the following? Providers view sexual dysfunction as having more of a negative impact on each area of life listed below when compared to patients themselves. Many patients view sexual dysfunction as having no impact on the areas listed below. Impact of Female Sexual Dysfunction on the Patient: Providers vs. Consumers Sex life Relationship with romantic partner Self esteem Emotional/Mental Health Physical health

59 © Harris Interactive 59 BASE: Discussed FSD with patients (total n=286; MD n=194; NP/PA/NM n=92) Q935 When female patients have experienced symptoms of female sexual dysfunction, which of the following steps have you taken? Please select all that apply. Overall, consumers report health care providers are taking far fewer steps in response to patients sexual dysfunction compared to information gathered through providers. There are significant differences between the groups on a number of items, including performing tests and providing information and/or advice. Steps Taken in Response to Sexual Dysfunction Diagnosis: Providers and Consumers

60 © Harris Interactive Demographics 60

61 Demographics Gender TOTALMDNP/PA/NM Male -69%13% Female -31%87% Age Under 40 -16%34% 40-59 -64%54% 60+ -20%12% MEAN AGE -49.744.6 Region East 25% Midwest 22%21%25% South 29%28%31% West 23%25%20% © Harris Interactive 61 Number of Patients Seen Weekly TOTALMDNP/PA/NM 1-9941%35%57% 100-19953%57%41% 200-2994%5%1% 300-3991% - 400+1%2%- MEAN102.7113.376.3 Number of Prescriptions Written Weekly 01%-4% 1-9938%29%61% 100-19929%32%20% 200-29917%19%10% 300-3998%11%3% 400+7%9%1% MEAN162.8195.381.3

62 Demographics Primary medical specialty TOTALMDNP/PA/NM Family Practice/General Practice/Internal Medicine 64%90%- Nurse Practitioner14%-53% Physician Assistant10%-34% Psychiatrist7%10%- Registered Nurse3%-- Nurse Midwife2%-13% Primary discipline Family medicine 53%50%61% Internal medicine 28%34%13% OB/GYN 9%5%20% Mental Health 9%10%6% © Harris Interactive 62 Year Graduated Med School TOTALMDNP/PA/NM 1960s -2%- 1970s -30%- 1980s -29%- 1990s -31%- 2000s -8%- Year Completed Residency 1970s -21%- 1980s -22%- 1990s -36%- 2000s -20%-


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