Sexual health is essential to overall well-being, yet healthcare providers often do not discuss it with patients, even when it may be relevant. Patients may hesitate to bring up sexual concerns due to worries about privacy, fear of offending or overstepping, doubts about the provider’s ability to handle the topic, or hoping the provider will address it if necessary. For people with anxiety disorders, these issues can be even more pronounced. Anxiety disorders are common globally and often correlate with sexual issues like lower satisfaction and increased dysfunction, which can negatively impact relationships and quality of life.

A recent study in The Journal of Sexual Medicine examined how patients at Danish anxiety clinics experience conversations about sexuality with their healthcare providers and identified the barriers they face in initiating these discussions. By focusing on a large sample of anxiety patients, the study sought to provide deeper insights into the experiences and obstacles they encounter, highlighting the importance of integrating sexual health conversations into mental health care.

This study looked at 272 patients with anxiety disorders, mostly women (70.6%) and primarily Danish (94.9%), with an average age of 32. About 90% of participants identified as heterosexual. Most were on anxiety medication (84.2%), with over half on drugs known to have sexual side effects. Common diagnoses included social phobia, generalized anxiety disorder, and obsessive-compulsive disorder.

Participants were assessed on anxiety severity using the Generalized Anxiety Disorder (GAD-7) scale and depression severity with the Patient Health Questionnaire (PHQ-9). Sexual dysfunction, distress, and other sexual issues were measured separately for men and women with criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). All participants completed a digital survey for the purposes of this study.

According to the survey results, most of the participants reported anxiety and depressive symptoms, but gender differences weren’t significant. Over 70% of participants were sexually active, and about 55% experienced new sexual issues after starting medication.

About 60% of patients believed it was important to talk about sexuality during treatment and wished healthcare staff would bring it up. However, only 36% of men and 25% of women had ever done so, with about half of the patients initiating these discussions themselves. When they did, 83% found it beneficial, and 66% reported a positive impact on their sexuality.

Patients cited various reasons for avoiding these conversations, including the assumption that providers would bring it up if necessary (94%), personal discomfort (94%), embarrassment (92%), and fear of anxiety or judgment. A significant portion of men (27.6%) changed or ceased their medication due to sexual side effects without consulting healthcare staff, highlighting the need for proactive discussions about these issues.

The authors of this study suggest that training healthcare providers to discuss sexuality sensitively could help reduce barriers. However, limitations of this study include its focus on severe anxiety cases in Denmark and the lack of detailed staff training/education information. Nonetheless, these findings underline the importance of addressing sexuality as part of anxiety treatment, as many patients benefit from these discussions.

References:

• Hald, G. M., Arendt, M., Pavan, S., Heymann-Szlachcinska, A., Øllgaard, M., Winding, C., Dilling-Hansen, D., Kruse, S. L., Frøslev, M., & Larsen, H. (2024). Sex talks—experiences with and barriers to communication about sexuality with healthcare staff among patients with anxiety disorder in Denmark. The Journal of Sexual Medicine, 21(11), 994–1003. https://doi.org/10.1093/jsxmed/qdae098