Medical school curricula fail to teach female sexual medicine

Medical school curricula fail to teach female sexual medicine | Image Credit: © master1305 - © master1305 - stock.adobe.com.

According to a recent article published in Sexual Medicine, there is a need for medical school curriculums in the United States to include improved female sexual medicine (FSM) information.

While research has associated sexual health with many health conditions, physicians often have a lack of training in sexual health, preventing them from discussing the topic with their patients. Since 1997, the number of medical schools requiring some sexual health education has continuously decreased from 95%.

Female sexual dysfunction (FSD), described as a problem in sexual response inhibiting satisfaction during sexual activity or causing distress, is particularly lacking in medical health education. However, data has indicated up to 41% of women experience FSD, and that women experiencing chronic vulvar pain are unlikely to seek physician aid because of a fear of stigma and distrust of physicians.

Investigators evaluated the preclinical and clinical curricula of medical schools in Chicago to evaluate which aspects of female sexual anatomy, pathology, physiology, physical exam, history taking, and treatment options are taught to medical students.

There were 6 allopathic institutions and 1 osteopathic institution included in the analysis. Data was obtained from students or faculty responsible for the preclinical sex and reproduction course or the third year OBGYN clerkship. Institutional level data was evaluated, while personal data was not included in the study.

Preclinical content included syllabi, lecture materials, and supplemental resources on the anatomy, physiology, and pathology of the genitourinary tract. Concepts were categorized based on physiology, anatomy, epidemiology, pathophysiology, treatment, and physical exam.

Clinical content included OBGYN clerkship syllabi, lecture materials, and supplemental resources. Investigators evaluated the learning objectives discussed in the syllabus and the necessary learning content.

Specific aspects of clitoral anatomy were reviewed in the preclinical assessment. Glans were discussed by 6 of the 7 institutions, corona by 1, clitoral hood by 2, corpus cavernosa by 6, corpus spongiosa by 4, crus by 6, bulb by 6, and clitoral neurovasculature by 5.

The physiology of the female orgasm was discussed by 4 of the 7 institutions, the prevalence and epidemiology of FSD by 3, treatment for FSD by 3, and a genitourinary physical exam to assess FSD by 1. Training on sexual history often only included partners, practices, protections from sexually transmitted infections (STIs), STI history, and pregnancy plans.

Six weeks dedicated to the core OBGYN clerkship were seen in 5 of the 7 institutions, while one dedicated 5 weeks and another dedicated 4 weeks. Topics related to FSM in the clerkship syllabi were seen in 5 institutions, and only one of these had a synchronous clerkship time dedicated to these topics.

These results indicated a need to standardize preclinical and clinical materials to teach medical students about FSM. Investigators believed this would prepare future physicians to deal with topics related to sexual health.

“Sexual health affects general health and general health affects sexual health,” said Michael Krychman, MDCM, executive director of the Southern California Center for Sexual Health and Survivorship Medicine. “It remains an important and integral topic for medical and residency training.”

Reference

Codispoti N, Negris O, Myers MC, et al. Female sexual medicine: an assessment of medical school curricula in a major United States city. Sex Med. 2023;11(4). doi:10.1093/sexmed/qfad051