Resident education and training in female sexuality: results of a national survey

IntroductionConsidering the prevalence of female sexual dysfunction, the lack of education and training in female sexual function and dysfunction (FSF&;D) during and obstetrics and gynecology residency highlights a need for greater focus on this topic.AimTo assess understanding and confidence among third and fourth year Ob/Gyn residents with respect to FSF&;D.MethodsAn Internet‐based survey was constructed to evaluate third and fourth year residents in American Council for Graduate Medical Education‐approved Ob/Gyn programs. Residents were asked about familiarity, knowledge, and confidence in treating various aspects of FSF&;D, based on the Council on Resident Education in Obstetrics and Gynecology (CREOG) Educational Objectives for Ob/Gyn training. They were also queried regarding areas of improvement for their education.Main Outcome MeasureResponses to survey instrument.ResultsTwo hundred thirty‐four residents responded. The majority (91.5%) reported attending ≤5 didactic activities on FSF&;D. Only 19.6% reported often or always screening women for sexual function problems; most had very little or no knowledge in administering or interpreting screening questionnaires. While many (82.8%) felt confident about obtaining a complete sexual history, only 54.7% felt able to perform a targeted physical exam. Although most residents had cared for women with dyspareunia (55.1%), a minority had managed many women with low desire (18.4%), arousal problems (8.1%), anorgasmia (5.6%), or vaginismus (16.7%). In treating patients, 34–56% reported rarely or never suggesting ancillary therapy such as counseling and medications. However, the majority believed that their confidence would increase through FSF&;D lectures (97.9%), FSF&;D patient observations (97.4%), rotating with a urogynecologist (94.4%), and online modules (90.6%).ConclusionDespite CREOG requirements for Ob/Gyn training in female sexuality, most residents feel ill‐equipped to address these problems. Additional evidence‐based educational and didactic activities would enhance residents' knowledge and confidence in treating these common, quality‐of‐life issues. Pancholy AB, Goldenhar L, Fellner AN, Crisp C, Kleeman S, and Pauls R. Resident education and training in female sexuality: Results of a national survey.     

Brazilian Residents' Attitude and Practice Toward Sexual Health Issues in Pregnant Patients

IntroductionSexual difficulties and questions regarding sexual function are frequent in pregnancy, yet they are infrequently discussed in academic communities, medical schools, and residency programs. Embarrassment, lack of experience, inadequate communication skills and insufficient knowledge on how to deal with sexual complaints, and questions in pregnancy are common, especially among young health professionals.AimThe aim of this study was to assess and compare the attitude and behavior of Brazilian residents in three different medical programs (obstetrics gynecology, internal medicine, and psychiatry) toward sexual health issues of pregnant patients.MethodsSurvey conducted in a single Brazilian university using anonymous self responsive questionnaires on how residents deal with sexual health issues of obstetric patients. A total of 154 residents from the three different programs (47 obstetrics gynecology, 33 psychiatry, 74 internal medicine) participated.Main Outcome MeasuresAttitude and practice of medical residents regarding sexual health issues of pregnant patients.ResultsLess than 20% of the residents reported that they routinely asked obstetric patients about their sexual health, although almost 70% stated this should be part of every history. Psychiatry residents were significantly more likely to actively seek information about the sexual health of obstetric patients than others (57.6%, 17%, 4.1%, psychiatry, obstetrics gynecology, internal medicine, respectively, P < 0.001). Although over 80% answered that most obstetric patients react well or indifferently to questions about sexual function, less than 25% of the residents reported being completely confident answering these questions, and 71% of them admitted that they lacked specific knowledge in the area of sexual dysfunctions. The two main obstacles in evaluating patients' sexuality were lack of specific knowledge and not enough time to explore these aspects in medical consultations, reported by 71% and 20% of all participants, respectively.ConclusionsMost residents do not feel comfortable or confident and lack specific knowledge and skills to deal with questions related to sexual problems during pregnancy. Vieira TCSB, de Souza E, Abdo CHN, Torloni MR, Santana TGM, Leite APL, and Nakamura MU. Brazilian residents' attitude and practice toward sexual health issues in pregnant patients. J Sex Med **;**:**–**.     

Does the North American Society for Pediatric and Adolescent Gynecology Short Curriculum Increase Resident Knowledge in Pediatric and Adolescent Gynecology?

Study ObjectiveTo determine if the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum improves self-reported knowledge in pediatric and adolescent gynecology (PAG) among obstetrics and gynecology (Ob/Gyn) residents, at programs without PAG-trained faculty.DesignProspective, cross-sectional exposure to the NASPAG short curriculum with a follow-up questionnaire.SettingOb/Gyn residency training programs without PAG faculty.ParticipantsOb/Gyn residents in training from February 2015 to June 2015.InterventionsExposure to the NASPAG Short Curriculum.Main Outcome MeasuresImprovement in self-perceived knowledge after completion of curriculum.ResultsTwo hundred twenty-seven residents met inclusion criteria; 34 completed the study (15% response). Less than 50% of residents reported adequate knowledge in the areas of prepubertal vaginal bleeding, vulvovaginitis, precocious and delayed puberty, Home environment, Education and Employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide/depression, Safety from injury and violence (HEEADSSS) interview, pelvic pain, and bleeding management in teens with developmental delay. After completion of the curriculum, self-reported knowledge improved in 8 of 10 learning objectives, with no significant improvement in bleeding disorders or Müllerian anomalies. There was no association between pretest knowledge and level of residency training, type of residency program, previous exposure to PAG lectures, and previous exposure to patients with PAG complaints.ConclusionSignificant deficiencies exist regarding self-reported knowledge of core PAG topics among Ob/Gyn residents at programs without PAG-trained faculty. Use of the NASPAG Short Curriculum by residents without access to PAG-trained faculty resulted in improved self-reported knowledge in PAG.     

Barriers Preventing Medical Students From Performing Pelvic Examinations During Obstetrics and Gynaecology Clinical Clerkship Rotations

ObjectiveThis study sought to identify barriers that prevent medical students from performing pelvic examinations in their obstetrics and gynaecology (Ob/Gyn) clinical clerkship rotations and to compare the perspectives of faculty, residents, nurses, and students regarding perceived barriers.MethodsAn electronic survey was distributed to third-year Dalhousie University (Halifax, NS) medical students on completion of their Ob/Gyn clerkship rotations in the 2015-2016 academic year and to Ob/Gyn nursing staff, faculty, and residents (Canadian Task Force Classification III).ResultsThere were 82 responses, giving an overall response rate of 28%. Students reported performing an average of 9.2 speculum examinations, 3.8 cervical checks, and 2.8 bimanual examinations during their 6-week rotations. They reported being declined the opportunity to perform an examination an average of 7.1 times. Students perceived themselves to be more competent performing these examinations compared with staff perception of student competency. Students perceived resident interest in teaching, resident and staff time constraints, and patient willingness to have a medical student involved in their examination as frequent barriers. Faculty, residents, and nurses perceived student gender, patient willingness, difficulty of examination, and resident time constraints to be significant barriers.ConclusionThis study is the first to examine multidisciplinary perspectives on perceived barriers to medical students performing pelvic examinations. Staff and students have different perceptions of a student's competence performing these examinations. Existing barriers are likely multifactorial.     

What We Don't Talk about When We Don't Talk about Sex1: Results of a National Survey of U.S. Obstetrician/Gynecologists

IntroductionSexuality is a key aspect of women's physical and psychological health. Research shows both patients and physicians face barriers to communication about sexuality. Given their expertise and training in addressing conditions of the female genital tract across the female life course, obstetrician/gynecologists (ob/gyns) are well positioned among all physicians to address sexuality issues with female patients. New practice guidelines for management of female sexual dysfunction and the importance of female sexual behavior and function to virtually all aspects of ob/gyn care, and to women's health more broadly, warrant up‐to‐date information regarding ob/gyns' sexual‐history‐taking routine.AimsTo determine ob/gyns' practices of communication with patients about sexuality, and to examine the individual and practice‐level correlates of such communication.MethodA population‐based sample of 1,154 practicing U.S. ob/gyns (53% male; mean age 48 years) was surveyed regarding their practices of communication with patients about sex.Main Outcome MeasuresSelf‐reported frequency measures of ob/gyns' communication practices with patients including whether or not ob/gyns discuss patients' sexual activities, sexual orientation, satisfaction with sexual life, pleasure with sexual activity, and sexual problems or dysfunction, as well as whether or not one ever expresses disapproval of or disagreement with patients' sexual practices. Multivariable analysis was used to correlate physicians' personal and practice characteristics with these communication practices.ResultsSurvey response rate was 65.6%. Sixty‐three percent of ob/gyns reported routinely assessing patients' sexual activities; 40% routinely asked about sexual problems. Fewer asked about sexual satisfaction (28.5%), sexual orientation/identity (27.7%), or pleasure with sexual activity (13.8%). A quarter of ob/gyns reported they had expressed disapproval of patients' sexual practices. Ob/gyns practicing predominately gynecology were significantly more likely than other ob/gyns to routinely ask about each of the five outcomes investigated.ConclusionThe majority of U.S. ob/gyns report routinely asking patients about their sexual activities, but most other areas of patients' sexuality are not routinely discussed. Sobecki JN, Curlin FA, Rasinski KA, and Lindau ST. What we don't talk about when we don't talk about sex: Results of a national survey of U.S. obstetrician/gynecologists. J Sex Med 2012;9:1285–1294.     

Endoscopy teaching in Canada: a survey of obstetrics and gynecology program directors and graduating residents

OBJECTIVE: To examine the current state of basic and advanced gynecologic endoscopy teaching in Canadian Obstetrics and Gynecology (Ob/Gyn) residency programs. METHODS: On Institutional Research Board approval, 2 pretested anonymous questionnaires were developed: one distributed to all Canadian Ob/Gyn program directors and a second to graduating residents (Canadian Task Force classification III). Two mailings were sent to maximize response, and some department chairs received personal telephone calls by the senior author to encourage participation. Residents on maternity leave were excluded from the study. RESULTS: Fifteen of 16 (94%) program directors, and 47 of 62 (76%) residents participated. Directors expect all residents to be knowledgeable and competent performing basic endoscopic procedures on graduation. However, considerable variation exists among programs that teach advanced endoscopy. Some of the more important factors limiting integration of advanced endoscopic teaching include paucity of trained faculty, lack of attending interest, scarcity of operating time, and financial constraints. Most graduating residents consider undertaking additional gynecologic endoscopy fellowships. CONCLUSION: Most Ob/Gyn program directors and graduating residents consider endoscopic surgery essential to contemporary practice. There is consensus to improve resident teaching in gynecologic endoscopy and commitment to better prepare future practitioners to ensure patient safety. Paucity of trained faculty and fiscal constraints appear to be important limiting factors.     

Video Playback as an Educational Tool for Improving Resident Laparoscopic Performance: A Randomized Controlled Trial

Study ObjectiveIn this single-masked randomized controlled study, we evaluate whether watching video recordings of oneself performing Fundamentals of Laparoscopic Skills (FLS) exercises results in an improvement on the 30-point Global Operative Assessment of Laparoscopic Skills (GOALS) assessment among Obstetrics and Gynecology (Ob/Gyn) residents.DesignTwenty-three Ob/Gyn residents in the 2020–2021 academic year completed the FLS exercises while being timed, video recorded, and receiving real-time feedback from an Ob/Gyn faculty member. Baseline GOALS assessment was completed by participants and faculty. After the intervention, all participants then repeated the FLS exercises while being timed and were again scored using the GOALS assessment. Each participant completed the study in a single session. In addition, all participants completed a pre- and post-test survey.SettingUniversity of Louisville Laparoscopic Skills Labortaory.ParticipantsUniversity of Louisville Ob/Gyn residents in the 2020–2021 academic year.InterventionTwelve participants were randomized to the intervention and were allowed to watch their video recording in addition to receiving verbal feedback whereas the remaining 11 received verbal feedback only.Measurements and Main ResultsThere were significant improvements in faculty (p <.01) and self-reported GOALS scores (p <.01) when comparing both the intervention and control group with baseline scores. The intervention group improved by 3.2 points more than that of the control group based on masked faculty evaluation (95% confidence interval, 1.4–5.0 points; p <.01). The difference was not significant in resident self-scores. Overall time improved for all participants (15:54 ± 0.21 minutes before and 13:13 ± 0.14 minutes after), but this difference was not significant between the 2 groups. Higher postgraduate year (PGY) residents reported significantly more comfort performing laparoscopic tasks, earned higher GOALS score (faculty and self-scores), and completed the first set of exercises in less time. A significant interaction between PGY and intervention was detected with improvement in GOALS score most strongly associated with PGY4 residents (p <.01).ConclusionAlthough all learners objectively benefit from watching recordings of themselves performing surgical tasks, advanced learners may benefit the most when video recordings are used as an educational tool.     

The Effect of Mindfulness-Based Sexual Counseling on Sexual Distress,Attitude Toward Sexuality,and Body Image Concerns in Pregnant Women: A Randomized Controlled Trial

Introduction

Sexual distress during pregnancy can cause a negative attitude toward sexuality during pregnancy, and this can be seen especially in conjunction with body image concerns. This study was conducted to determine the effects of mindfulness-based sexual counseling (MBSC) on sexual distress, attitudes toward sexuality, and body image concerns in pregnant women.

Methods

A randomized controlled trial was conducted in a sample of women who experienced sexual distress presenting to a Healthy Living Center in eastern Turkey. Women (N = 134) were randomly assigned to receive a 4-week, 8-session counseling program based on mindfulness (experimental group; n = 67) or treatment as usual (control group; n = 67). The primary outcome of the study, sexual distress, was assessed using the Female Sexual Distress Scale-Revised. Secondary outcomes included attitude toward sexuality, assessed using the Attitude Scale toward Sexuality during Pregnancy, and body image concerns, using the Body Image Concerns during Pregnancy Scale. Outcomes were compared postintervention, correcting for baseline using analysis of covariance. The study was registered with ClinicalTrials.gov (NCT04900194).

Results

Mean scores for sexual distress (7.69 vs 17.36; P < .001) and body image concerns (57.76 vs 73.88; P < .001) decreased significantly in the mindfulness group compared with the control group. Similarly, mean scores for attitudes toward sexuality significantly improved in the mindfulness group compared with the control group (133.52 vs 105.78; P < .05).

Discussion

MBSC is a promising strategy to help women experiencing sexual distress during pregnancy to reduce their levels of sexual distress, raise their positive attitudes toward sexuality, and lower their body image concerns. Larger clinical trials of MBSC are recommended to support introduction of MBSC into clinical practice.     

Gender and sexual health in clinical practice in Lebanon.

This study examines the readiness of obstetricians/gynecologists (Ob/Gyns) in Lebanon to provide sexual consultation, their degree of comfort when discussing issues of sexual health, and their attitudes regarding assessment, treatment, and referral. Data on these concepts were collected through face-to-face interviews with 286 randomly selected Ob/Gyns. Most Ob/Gyns reported feeling comfortable discussing sexuality during consultations, which they attributed much more to professional experience than to training. Most Ob/Gyns reported giving proper time for management of sexual health issues and follow-up, as these issues are brought up frequently by their women clients. However, results suggest that only one-third (31%) of Lebanese Ob/Gyns nearly always take the initiative in asking patients about their sexual health. Moreover, almost 45% of participating Ob/Gyns did not recognize a strong relationship between reproductive health and sexual functioning. Gender was not found to be an important predictor for any of the indicators measured in the present study. Ob/Gyns in Lebanon are significant consultants on various sexual issues, and they need better postgraduate training, continuing medical education, and access to medical congress resources on the topic of sexuality and its relationship to reproductive health.     

To treat or not to treat: perceptions of the initial American Society for Reproductive Medicine COVID-19 recommendations among women’s health providers

PurposeThe objective of this study was to evaluate the perception of the initial ASRM COVID-19 recommendations for infertility treatment held by women’s health providers within varying subspecialties, as well as their attitudes toward pregnancy and fertility during this time.MethodsAn electronic survey was sent to all women’s healthcare providers, including physicians, mid-level providers and nurses, in all subspecialties of obstetrics and gynaecology (Ob/Gyn) at a large tertiary care university-affiliated hospital.ResultsOf the 278 eligible providers, the survey response rate was 45% (n = 127). Participants represented 8 Ob/Gyn subspecialties and all professional levels. Participants age 18–30 years were significantly more likely to feel that women should have access to infertility treatment despite the burden level of COVID-19 in respective community/states (p = 0.0058). Participants within the subspecialties of general Ob/Gyn, maternal foetal medicine and gynecologic oncology were significantly more likely to disagree that all women should refrain from planned conception during the COVID-19 pandemic, in comparison to those in urogynecology and reproductive endocrinology and infertility (p = 0.0003).ConclusionsConsidering the immediate and unknown long-term impact of the COVID-19 pandemic on fertility care delivery, a better understanding of perceptions regarding infertility management during this time is important. Our study shows overall support for the initial ASRM recommendations, representing a wide spectrum of women’s health providers.     

Attitudes,beliefs and comfort levels of midwifery students regarding sexual counselling in Turkey

Objectivethis aim of this study was to determine midwifery students’ attitudes and beliefs regarding sexual counselling, the factors preventing effective sexual counselling and comfort levels towards sexual counselling.Participantsthe study was conducted with 650 students studying in the midwifery departments of eight universities in Turkey (response rate 59.1%).Designthe data were obtained through a self-administered questionnaire in early 2016, which collected sociodemographic characteristics and comfort levels, and used the Sexuality Attitudes and Beliefs Survey.Findingsjust over half (52.4%) of the students had been confronted in clinical practice with caring for a woman who reported having sexual problems and 74.9% reported that the women they were caring for requested sexual counselling from them. Just under a half (48.8%), stated that midwives talk about these issues during care and a similar proportion (48.3%) reported that issues about sexual counselling were part of their midwifery education. Just over half (53.5%) of the midwifery students stated that sexuality is a very special subject to discuss with women but that insufficient time created a barrier to being able to discuss sexual problems. The students did not feel comfortable counselling all women, including homosexual women or sex workers who may be potentially carrying HIV.Conclusionseven though the attitudes of midwifery students toward sexual counselling were good, students were not always comfortable to provide counselling, especially to particular groups of women.Implications for practiceattitudes, beliefs and comfort levels of midwifery students about sexuality and sexual counselling can be improved. Students are an important group to target as they are specialised in women's health, Different groups should be supported through training concerning sexual counselling.     

Vacuum and forceps training in residency: experience and self-reported competency.

OBJECTIVE: Determine chief residents' experience with vacuum and forceps deliveries and self-perceived competencies with the procedures. STUDY DESIGN: Study 1: A written questionnaire was mailed to all fourth year residents in US RRC approved Ob/Gyn programs. Study 2: The study was replicated using a web-based survey the following year. Data were analyzed with chi (2) and Wilcoxon Signed Rank tests using SPSS. RESULTS: Surveys were received from 238 residents (20%) in Study 1 and 269 residents in Study 2 (23%, representing 50% of all residency programs). In both studies, residents reported performing significantly less forceps than vacuum deliveries. Virtually all residents wanted to learn to perform both deliveries, indicated attendings were willing to teach both, and felt competent to perform vacuum deliveries (Study 1, 94.5%; Study 2, 98.5%); only half felt competent to perform forceps deliveries (Study 1, 57.6%; Study 2, 55.0%). The majority of residents who felt competent to perform forceps deliveries reported that they would predominately use forceps or both methods of deliveries in their practice (Study 1, 75.8%; Study 2, 64.6%). The majority of residents who reported that they did not feel competent to perform forceps deliveries reported that they would predominately use vacuum deliveries in their practice (Study 1, 86.1%; Study 2, 84.2%). CONCLUSION: Current training results in a substantial portion of residents graduating who do not feel competent to perform forceps deliveries. Perceived competency affected future operative delivery plans.     

Does Cost Influence the Choice of Disposable Versus Reusable Instruments? Mailed Survey of Obstetrician/Gynaecologists

ObjectiveA “cost-awareness” campaign was undertaken at a tertiary hospital from 2015 to 2016 to raise awareness about costs of disposable versus reusable instruments in laparoscopic procedures. We undertook a before and after survey of obstetrician/gynecologists (Ob/Gyns) to find out if the campaign had affected their attitudes about choosing disposable versus less expensive reusable instruments.MethodsIn 2015 (before the cost-awareness campaign) and 2017 (after the cost-awareness campaign), all full-time university-associated Ob/Gyns were mailed a cover letter, questionnaire, and coffee card ($5) with a postage-paid return envelope. Responses (with unique identification) from Ob/Gyns who perform laparoscopic procedures were entered into a password-protected REDCap database on a secure server. All statistical analyses were performed using SAS software version 9.4 (SAS Institute Inc, Cary, NC) (Canadian Task Force Classification II-3).ResultsA total of 35 of 42 eligible Ob/Gyns (85%) with a median 10 years in practice completed questionnaires before and after the intervention. The majority had undertaken minimally invasive surgery training, mainly during residency (80%) and conferences (71%). Before the intervention, the three most important qualities influencing their decision to use a particular instrument were safety (66%), effectiveness (57%), and personal experience (49%). After the intervention, the three most important qualities were effectiveness (57%), safety (57%), and ease of use (46%). Device cost was ranked sixth (26%) before and seventh (17%) after the intervention. The majority (57%) of participants did not change their choice of disposable or reusable instruments, or they would make the choice according to the specific procedure.ConclusionGiven the current economy, operative costs are constantly under review. Knowledge about Ob/Gyns’ attitudes provides information to design more effective awareness campaigns to encourage use of less costly instruments. To change practice, a campaign increasing Ob/Gyns’ exposure to less expensive but safe and effective instruments may help to increase uptake and potentially lead to cost reduction. Cost awareness alone is unlikely to change practice.     

Society of Obstetricians and Gynaecologists of Canada Junior Member Committee Survey: Future Career Plans of Canadian Obstetrics and Gynaecology Residents

ObjectiveAlthough the SOGC Strategic Directions 2006–2011 includes a commitment to the development of a human resource strategy for obstetrical and gynaecological care, little is known about the career plans of Canadian obstetrics and gynaecology residents. If we are to determine the needs of our profession, we must be aware of the expected practice patterns of future women’s health care providers. The primary objective of this study was to evaluate the future career plans of Canadian obstetrics and gynaecology residents.MethodsThe SOGC Junior Member Committee administered two career surveys to Canadian obstetrics and gynaecology residents. The first was directly distributed to all Canadian residents and collected by local representatives of the SOGC Junior Member Committee in November 2002. The second was electronically administered from November 2005 to January 2006. The data collected from the surveys were collated and analyzed using statistical analysis software.ResultsThe first survey, in 2002, was completed by 236 obstetrics and gynaecology residents (68% response rate) and the second, in 2006, by 246 (65% response rate). In both surveys, respondents were evenly distributed over all five years of residency training and all residency training programs. In 2002, 63 residents (30%) were considering additional postgraduate fellowship training following completion of residency compared with 130 residents (53%) in 2006 (P < 0.001). In both surveys, senior residents (postgraduate years IV and V) were significantly less likely to consider further postgraduate training than residents in their first three years (2002: 17% vs. 38%; 2006: 42% vs. 58%). Of total respondents to the 2002 and 2006 surveys, 87% planned to practice obstetrics upon graduation. The 2006 survey also found that the majority of residents desired to work in call groups of 6 to 10 physicians, work three to five on-call shifts per month, and work a 40- to 60-hour week; 44% of residents planned work as locums after graduation.ConclusionRecognition of the planned practice patterns of our current residents may assist in the development of an appropriate human resource strategy for future obstetrical and gynaecological care in Canada.     

Fertility and fertility preservation: knowledge,awareness and attitudes of female graduate students

Purpose: To evaluate the general knowledge of female graduate students on reproductive aging and fertility preservation options, as well as to investigate the perceptions, personal beliefs, and desires regarding fertility and preservation modalities.

Materials and methods: A cross-sectional online survey study of female graduate students and medical trainees from academic institutions in Ohio was performed. Women were excluded if the online survey was incomplete or if they were?>45 years.

Results: Analysis of 590 surveys was performed (response rate of 26.3%). Ninety-four percent (557/590) of subjects were between 20 and 35 years. Our respondents tended to be nulliparous (87%), married or in a relationship (51%) and interested in future fertility (77%). The reasons cited for delaying childbearing were multi-factorial, with career building noted most commonly (69%). Nearly 60% of women reported they would consider fertility preservation in the future; however, the majority (87%) cited two or more barriers. When asked about their desire for information on fertility preservation, 28% desired to receive education on their choices and 36% wanted their Ob/Gyn to discuss fertility preservation options. Women?>30 years were significantly more likely to desire future fertility, want more fertility preservation education and consider pursuing fertility preservation in the future.

Conclusions: Graduate-level women often delay childbearing for professional pursuits. This study demonstrates a need for increased fertility preservation awareness and education, especially by Ob/Gyn providers.     

African American and White women׳s perceptions of weight gain,physical activity,and nutrition during pregnancy

ObjectiveTo describe African American and White women’s perceptions of weight gain, physical activity, and nutrition during pregnancy and to explore differences in perceptions by race.DesignQualitative interview study.SettingTwo Ob/Gyn clinics in South Carolina, USA.ParticipantsThirty pregnant women (15 African American, 15 White) between 20 and 30 weeks gestation, equally represented across pre-pregnancy BMI categories (10 normal weight, 10 overweight, and 10 obese).FindingsWhite women more frequently described intentions to meet weight gain, physical activity, and dietary guidelines in pregnancy than African American women. African American women were more concerned with inadequate weight gain while White women more commonly expressed concerns about excessive weight gain. More White women discussed the importance of physical activity for weight management. Regardless of race, few women described risks of excessive weight gain or benefits of physical activity as it relates to the baby’s health. The primary cited barrier of healthy eating was the high cost of fresh produce.Key conclusions and implications for practiceSeveral knowledge gaps as well as race differences were identified in women’s perceptions and intentions toward weight gain, physical activity, and nutrition during pregnancy. Future interventions should seek to educate women about common misperceptions. It may be necessary to culturally tailor gestational weight gain interventions to optimise health outcomes.     

Sexual Functioning of Latino Women Seeking Outpatient Gynecologic Care

IntroductionA sample of Latino women from an ambulatory obstetrics and gynecology (Ob/Gyn) clinic were queried about their sexual functioning using the Changes in Sexual Functioning Questionnaire (CSFQ-14).AimTo assess the degree of self-reported sexual complaints in a sample of Latino women living in the United States; to assess if the prevalence of symptoms differs from one study of women living in Spain; and to determine if sexual complaints were associated with demographics, sexual/reproductive history, selected medications, or religious practices.Main Outcome MeasuresCSFQ-14 scores and demographic variables.MethodsCSFQ-14 questionnaire in an out-patient, bilingual Ob/Gyn clinic in Central Virginia.ResultsSeventy-one native Spanish-speaking patients (59% born in Mexico) completed the U.S. Spanish version of the CSFQ-14 and a short questionnaire for potential covariates. The mean age was 28.7 years (range 17–60). Birth place was outside of the United States for 95.8% (N = 67). Eighty percent of participants had children and 96% reported being currently sexually active. Low sexual functioning, as defined by a total CSFQ score of ≤41, was found in 26 (41.3%) participants. Taking medication for depression and/or anxiety was associated with lower sexual functioning (P = 0.03). Women who had children of any age living in the household were less likely to report low sexual functioning (P = 0.05; P = 0.01 when restricted to infants) than women without children living in the household. Thirteen of 68 women (19.1%) reported a history of physical and/or sexual abuse, but this was not associated with low sexual functioning. There was no association between self-reported religious affiliation or church attendance frequency and sexual complaints. Respondents in our sample had lower (i.e., worse sexual function) overall CSFQ scores compared with a sample of college students in Spain (P < 0.01), but higher (i.e., better sexual function) overall scores than workers in Spain (P < 0.04). On the subscales, our Latino population reported greater pleasure and less desire/interest than women who live in Spain.ConclusionsSelf-reported rates of low sexual functioning were common in this cross section of Latino women. Medical treatment of depression and/or anxiety was associated with lower functioning. Direct inquiry about the sexual health of U.S. Latino women presenting for routine health care may assist in the identification of sexual difficulties in this population. Hullfish KL, Pastore LM, Mormon AJA, Wernecke Y, Bovbjerg VE, and Clayton AH. Sexual functioning of Latino women seeking outpatient gynecologic care.     

Sexual Activity and Physical Tenderness in Older Adults: Prevalence and Associated Characteristics From a Belgian Study

BackgroundDespite the World Health Organization calling for sexuality to be recognized as an aspect of well-being, no studies have explored sexual activity and physical tenderness in older adults aged ≥ 75 years in Belgium or those aged ≥ 85 years worldwide.AimTo assess the prevalence and predictors of sexual activity and physical tenderness in a sample of older adults.MethodsUsing data from a Belgian cross-sectional study on sexual violence (UN-MENAMAIS), information on sexual activity, physical tenderness, and associated characteristics was collected during structured face-to-face interviews with older adults living in the community, assisted living facilities, or nursing homes. Cluster random probability sampling with a random route-finding approach was used to select the participants.OutcomesCurrent sexual activity and physical tenderness in the previous 12 months, sociodemographic characteristics, chronological age, subjective age, number of sexual partners, sexual satisfaction, attitudes toward sexuality in later life, quality of life, and lifetime sexual victimisation.ResultsAmong the 511 participants included, 50.3% were in a relationship, mainly living with their partner; 31.3% indicated they were sexually active; and 47.3% of sexually inactive participants reported having experienced forms of physical tenderness in the previous 12 months. Sexual activity was associated with the presence of a partner, satisfaction with sexual life, permissive attitudes regarding sexuality in later life, a younger age, and a lack of disability. Physical tenderness was associated with the presence of a partner, community residency, and permissive attitudes regarding sexuality in later life.Clinical ImplicationsRaising awareness among the general population, healthcare professionals, and older adults about sexuality in later life could contribute to ending this taboo and should therefore be a priority for society.Strengths and LimitationsOur study fills a gap in the literature regarding sexual activity and physical tenderness in older adults aged ≥ 70 years, including respondents aged up to 99 years. Additionally, we explored different forms of sexual expression beyond intercourse, and face-to-face interviews contributed to the quality of the collected data. The main limitation of this study was the sample size, although the findings were similar to recent statistical indicators in Belgium.ConclusionOne in 3 older adults aged ≥ 70 years living in Belgium are sexually active. These findings provide an opportunity to inform the general public and older adults about later life sexuality and to educate healthcare professionals about aging sexuality to increase discussions and avoid assumptions of asexuality in later life.Cismaru-Inescu A, Hahaut B, Adam S et al. Sexual Activity and Physical Tenderness in Older Adults: Prevalence and Associated Characteristics From a Belgian Study. J Sex Med 2022;19:569–580.