Contradictions in the medical encounter: female sexual dysfunction in primary care contacts

Background. Over the past two decades, primary care physicians have been en couraged to participate in the management of sexual disturbances. Women wit h type 2 diabetes, often treated by GPs, are at high risk of experiencing s exual dysfunction. Objective. Very few qualitative studies have described the impact of sexual dysfunction on the diabetic women experiencing it. Our aim was, therefore, to explore the effects, if any, of type 2 diabetes on 'womanhood and intim acy' and investigate whether women wish to receive medical attention for th eir sexual disturbances. Methods. We used a purposeful sample of middle-aged and older women (44-80 years) diagnosed with type 2 diabetes (n = 33). Methods triangulation was e mployed: focus group interviews were combined with observer data and a stru ctured, anonymous questionnaire. We performed content analysis, with co-res earcher control for systematic bias during the coding process. Results. Personal characteristics, such as age, sex, experience and attitud e of the doctor, the speciality considered to be appropriate (GP versus gyn aecologist) and circumstances (time and privacy) in the primary care settin g appeared to significantly influence women's willingness to discuss-if at all-sexual matters with physicians. Conclusion. GPs should aim to create an open atmosphere to encourage discus sion of female sexual dysfunction in the consultation room. However, women with sexual problems might benefit more from peer help through patient or w omen's organizations, The role of GPs might therefore consist of supporting these services and identifying female sexual dysfunction in type 2 diabete s, a problem that middle-aged and older women have difficulty communicating .