Background Sexuality has received little scholarly attention and professional training in sexual health is limited. Although the available literature demonstrates the importance of sexuality to patients, physicians often do not introduce the subject during clinical encounters or address sexual concerns in patients who have chronic diseases. Because of the embarrassment of patients in talking about their sexuality, as well as time constraints and without physician prompting, patients are reluctant to bring up sexual concerns and inquiry about sexual functioning may be neglected.
Objectives We aimed to collect the point of view of patients suffering from chronic low back pain (CLBP) about barriers of their communication with their rheumatologist on sexual problems due to their chronic rheumatism. We collected also expectations of patients to ameliorate the level of this communication.
Methods In this cross sectional study, One hundred patients suffering from CLBP were consecutively included (50 females and 50 males, mean age: 43.28±7.5 years). CLBP and sexual life characteristics were collected. Patients were asked to give their point of view about barriers for sexual communication with the rheumatologist and also to express their eventual expectations.
Results Eighty one percent of our patients complain about sexual problems related to their chronic rheumatic disorder. 66% have already broached the subject with their rheumatologist (49% have been informed, 21% have been advised). No sexually suffered patient had been addressed to a sexologist. Satisfaction in talking with doctor about sexuality assessed by visual analogical scale was 50±10.8. Barriers for sexual communication between patient and their rheumatologist in order of importance were: sexuality is a subject taboo (63%), visit conditions are not optimal to broach such a delicate subject (27%) and sexuality is not broached at all (10%) (Sexuality is an insignificant subject, the management of CLBP is more important). 93% indicated that sexual consulting must be included in CLBP management, 74% expressed their need to be advised about adaptation of intercourse position, 45% proposed to integrate educational brochure about sexual problems in CLBP consulting and how to deal with them, 33% reported the necessity of partner advising and 30% of patients preferred sexual audiovisual information. Presence of partner was solicited by 25 patients. Approaching sexuality problems was preferred with a doctor of the same gender in 81%.
Conclusions This study demonstrates a lack of communication between CLBP patients and their rheumatologist about sexual problems caused by the rheumatic disorder. According to patients, the most evoked problems are the nature taboo of the subject and the inadequacy of the visit conditions. Patients expect that rheumatologist should be more interested in this topic and that they should be more informed and advised on their sexual live. Further studies on large samples are needed to confirm those results.
Disclosure of Interest None Declared