K Bajzak, D Gustafson, G Logan, W Badaiki, W Graham, N Duggan

(049) Why isn’t Women’s Sexual Health Part of the Conversation? The Case of Vulvodynia

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Introduction Vulvodynia is a complex pelvic pain condition that affects up to one in four women at some time in their lives. Patients report that primary care providers lack knowledge essential to diagnosis and management of this condition. Objectives The aim of this three-phase study was to identify ways of addressing the barriers to diagnosis and management of vulvodynia for women living in rural, northern and remote communities in XX. This paper reports on the second phase and asked: 1) How do family physicians and nurse practitioners describe their awareness and experience with diagnosing and managing vulvodynia? and 2) How would they like to receive information that addresses this knowledge gap? Methods Phase two of this qualitative case study collected data using an intake survey and individual and group interviews with a purposive sample of family physicians and nurse practitioners practicing in Newfoundland and Labrador. Surveys were completed prior to interviews and gathered data about demographics and vulvodynia awareness. Interviews were conducted in person or via teleconference between October 2018 and April 2019 and using standardized open-ended prompts. Audio-taped interviews were transcribed, de-identified and coded thematically. Two researchers independently analyzed all data. Results Two major themes emerged: a) lack of awareness about the condition and b) four barriers to having a sexual health conversation (the dynamics of discomfort, making the time, generational differences between patient and provider, and the gendering of practitioner responsibilities). Primary care providers also identified their preferred methods for addressing gaps in their knowledge. Conclusions Diagnosis and management of vulvodynia requires skilled communication and specific knowledge of this pelvic pain condition. Providing primary care providers with a simple toolkit has the potential to address reported lack of awareness about vulvodynia and the identified barriers to initiating a sexual health conversation. Disclosure No.

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