by jennbossio | Aug 2, 2024 | Medicine, Sexual Health
Lichen sclerosis is a chronic skin condition that affects the genital and anal areas, yet it remains largely under-recognized in both the medical community and the general population. This lack of awareness can lead to misdiagnosis, inadequate treatment, and significant emotional and physical distress for those affected. As healthcare providers and therapists specializing in sexual health, it’s crucial that we bridge this gap to better support our patients.
What is Lichen Sclerosis?
Lichen sclerosis is a skin condition that primarily affects the vulva, but it can also occur on the penis, around the anus, and on other parts of the body. It is characterized by white, patchy skin that is thinner than normal. This can lead to itching, discomfort, and painful sex. Over time, if not managed properly, it can cause the skin to tear easily and may lead to scarring which can further impact sexual function and quality of life.
The Role of Sex Therapy and Couple’s Therapy
For individuals and couples dealing with lichen sclerosis, sex therapy and couple’s therapy can be invaluable. These therapies provide a safe space to address the emotional and psychological impacts of living with a chronic genital condition. Therapy can help individuals and couples navigate their sexual relationship, exploring new ways to experience intimacy and pleasure without pain.
Sex therapists can also provide education on the condition and guidance on how to manage symptoms during intimate moments. This might include the use of lubricants, adjustments in sexual techniques, and exploring non-penetrative forms of sexual activity that are comfortable for both partners.
The Importance of Educating Healthcare Providers
There is a pressing need for healthcare providers to have a deep understanding of conditions like lichen sclerosis. Enhanced training in recognizing the early signs of this condition can lead to quicker diagnoses and prevent the progression of symptoms. Healthcare providers need to be equipped to offer or recommend appropriate treatments such as topical corticosteroids, which are commonly used to manage the symptoms effectively.
Furthermore, healthcare professionals must understand the emotional and relational impact of genital skin conditions. This awareness will enable them to provide holistic care that addresses both the physical and psychological needs of their patients.
You Are Not Alone
For those diagnosed with lichen sclerosis, it’s crucial to remember that you are not alone. Many people live with this condition and still lead fulfilling lives, both sexually and otherwise. Online forums, support groups, and resources can connect you with others who understand what you are going through. Sharing experiences and coping strategies can be incredibly empowering.
It’s Our Responsibility as Healthcare Providers
As healthcare providers specializing in sexual health, it’s our responsibility to ensure that conditions like lichen sclerosis are not shrouded in mystery and misinformation. By promoting education and understanding among medical professionals and offering specialized therapies like sex therapy and couple’s therapy, we can significantly improve the quality of life for those affected by this challenging condition.
At the Tri Health Clinic, we are committed to providing comprehensive care for all aspects of sexual health. If you or someone you know is struggling with symptoms of lichen sclerosis, please reach out. Our team is here to support you every step of the way. Visit us at http://trihealthclinic.com to learn more about how we can help you navigate this condition together.
by jennbossio | Dec 1, 2023 | Medicine, Sexual Health
In the field of psychiatry, patient well-being extends beyond just mental health symptoms. Sexual health is a vital aspect that often goes unaddressed, despite its significant impact on treatment outcomes and patient adherence to medications. As a psychiatrist, being aware of the impact of psychiatric medications on sexual functioning, addressing sexual side effects, and discussing sexual health with patients can lead to more comprehensive and effective care, as well as better medication adherence and improved patient outcomes. In this blog, we explore important sexual health considerations that psychiatrists need to be aware of, shedding light on the significance of addressing this crucial aspect of mental health treatment.
Impact of Psychiatric Medications on Sexual Functioning
Psychiatric medications, such as antidepressants and antipsychotics, can have varying effects on a patient’s sexual functioning. While these medications play a crucial role in managing mental health symptoms, they can also lead to sexual side effects, including decreased libido, difficulty achieving orgasm, and erectile dysfunction. These side effects can significantly impact a patient’s overall quality of life and may even result in non-adherence to prescribed medications.
Addressing Sexual Side Effects and Medication Adherence
As a psychiatrist, it is essential to have open and honest discussions with patients about potential sexual side effects of prescribed medications. By addressing these concerns proactively, patients are more likely to be compliant with their treatment plans, which in turn means they are more likely to experience meaningful improvements. Psychiatrists can explore alternative medications or adjust dosages to minimize sexual side effects while maintaining optimal symptom management.
Balancing Sexual Side Effects with Treatment Benefits
It can be challenging for patients to navigate the trade-off between managing their mental health symptoms and experiencing sexual side effects from medications. As a psychiatrist, providing informed guidance is crucial. Engage in an empathetic conversation, acknowledging the significance of sexual health while weighing the potential benefits of treatment. Clarify that there are options available to address sexual side effects, and work collaboratively with patients to find the best approach.
Sex Therapy Can Help Even The Toughest Sexual Side Effects
One of the options to address sexual side effects with psychiatric medications is sex therapy. Sex therapy addresses many of the underlying contributing factors behind sexual difficulties. It also equips patients with the knowledge and skills to continue experiencing a meaningful and enjoyable sexual life, even with unavoidable physiological impacts to their sexual function. For example, sex therapy teaches individuals and couples how to make sex fun again, even without a reliable erection, or with low to non-existent sexual desire (yes! It is possible!),
Importance of Inquiring about Sexual Function
Inquiring about sexual function should be a routine part of psychiatric evaluations. Mental health conditions themselves can impact a patient’s sexual health, often leading to sexual dysfunction and decreased desire. However, these concerns often go unaddressed due to stigma or discomfort during discussions. Often, psychiatrists are worried to ask out of fear of “opening Pandora’s Box”. They think “I’m not a gynecologist or a urologist. They didn’t teach me this stuff in med school. What if I ask about sexual health and I don’t know how to address what my patient tells me?”. Fear not. You do not have to have all the answers — that is what partnerships with sex therapists can afford you. Instead, by actively asking patients about their sexual health, psychiatrists can identify underlying issues and offer appropriate interventions or referrals.
Sexual Health Facts for Psychiatrists to Consider
- Studies indicate that sexual side effects are a significant factor contributing to medication non-adherence among psychiatric patients, with discontinuation rates as high as 40%.
- Approximately 30% to 70% of patients experience sexual dysfunction related to psychiatric medications, with antidepressants being one of the primary culprits.
- Patients are more likely to discuss sexual health concerns when the topic is initiated by their healthcare provider, highlighting the importance of psychiatrists proactively addressing this aspect.
Sexual Health: It’s Okay to Ask
Addressing sexual health is a critical aspect of comprehensive psychiatric care. As a psychiatrist, being aware of the impact of psychiatric medications on sexual functioning and openly discussing potential side effects with patients can enhance medication adherence and overall treatment outcomes. Engaging in conversations about sexual health helps patients feel more comfortable discussing their concerns, allowing for better assessment and intervention. By prioritizing sexual health in psychiatric practice, we can improve patient well-being and ensure more holistic and patient-centered care.
by jennbossio | Oct 31, 2023 | Medicine, Sexual Health
Dear Readers,
Over the past few weeks, I find myself reflecting on a significant juncture in my professional journey. September was a month of stark contrasts, where personal accolades mingled with professional challenges, leaving me with a renewed commitment to a cause dear to my heart.
In the same month that I was honored to be recognized among Kingston’s Top 40 Under 40 young professionals, I also had to make the painful decision to leave my position at the Chronic Pain Clinic at Hotel Dieu Hospital. This decision did not come lightly (far from it!), but it was one that echoed the values I hold dear: a commitment to patient care and a belief in the power of passionate healthcare professionals.
Five years ago, I embarked on a mission to establish a pelvic pain program within the Chronic Pain Clinic. It was a labor of love, one that took three years to materialize due to countless administrative roadblocks. When the program finally took flight, it was nothing short of amazing. We were finally able to offer evidence-based care to a critically under-served population of individuals with chronic pelvic pain. However, my joy was soon tempered by the realization that the vital support needed to sustain it was lacking.
As the program’s demands increased, the administrative burden grew proportionally, and we simply didn’t have the administrative support we needed for the success of the program. Spending a significant portion of my time on paperwork meant less time for what truly mattered – the patients. Expressing these concerns to our superiors unfortunately yielded no meaningful change. It was clear that the system was struggling, and the passion that fueled our team was at risk.
In an effort to secure better resources for patient care, we sought external funding and created an application for a $50,000 grant. This grant was designed to enhance the quality of care we could provide, as well as the number of patients we could service. However, when it came to garnering support from the clinic’s leadership, we faced a disheartening setback. Concerns were expressed — some of which were misinformed — and a meeting to address those concerns was declined. The grant, a potential lifeline for our program, was dismissed without the dialogue it deserved.
It became evident that despite our best efforts, the core focus on patient care was being compromised. This realization weighed heavily on my conscience. Thus, with a heavy heart, I tendered my resignation, knowing that without a concrete plan for the program’s continuation, the patients we served would face a gap in their care.
This experience has underscored the critical importance of institutions prioritizing both their employees and, by extension, the patients they serve. It is a reminder that the burnout of passionate healthcare providers, when ignored, can lead to significant consequences for patient care. Administrators, burdened by burnout themselves, may inadvertently make decisions that compromise the very essence of healthcare provision.
This reflection is not a lament but a call to action. It is a plea for a reevaluation of our healthcare systems, with a focus on fostering environments that allow passionate professionals to thrive. Let us remember that it is the dedication of these professionals that truly drives quality patient care.
Thank you for allowing me to share this deeply personal reflection with you. May it serve as a catalyst for positive change within our healthcare institutions.
Sincerely,
Dr. Jenn Bossio, C.Psych
by jennbossio | Aug 25, 2023 | Medicine, Sexual Health
As a General Practitioner (GP), you play a crucial role in your patients’ overall well-being, and this includes their sexual health. Addressing sexual health concerns in your practice may feel daunting, but it’s an essential aspect of providing comprehensive care. The truth is, it can be considered negligent not to ask about sex. In this blog post, we’ll guide you through key considerations and strategies for effectively assessing sexual health concerns in your practice.
Be the First One to Bring it Up:
Because of the lack of sexual health training physicians often receive, many are — understandably — hesitant to ask about sexual health. They fear opening Pandora’s Box. “What if I don’t have all the answers?”. So physicians assume “if it’s important, my patient will bring it up”, while patients are often embarrassed and waiting for physicians to ask about sexual health. This creates a stalemate. Then what happens is patients either the patient never asks or the very moment the physician touches the door handle to leave the room, the patient starts “Well, doc, there is this one thing…”; and there is never enough time to go into a full, comprehensive sexual health assessment, never mind explore useful treatment options.
This can all be avoided by being the first one to ask, as the physician.
Normalize the Conversation:
Initiating a conversation about sexual health can be uncomfortable for both you and your patients. However, normalizing the topic can break down barriers. Incorporate sexual health into routine discussions about overall well-being, just like you would address diet, exercise, and mental health. The good news is that the more you practice talking about sexual health in your practice, the less uncomfortable it will be!
Create a Safe and Judgement-Free Environment:
Patients may feel embarrassed or anxious when discussing sexual health. Ensure that your practice offers a safe, non-judgmental space where patients can openly share their concerns. Reassure them that you are there to provide support and guidance. Consider having safe space symbols, or LGBT+ prints around the office. Use inclusive language with patients. Don’t assume the gender of a patient’s partner. These small acts that you can incorporate into even the smallest of interactions all work to build a safe space to discuss sex.
Use Open-Ended Questions:
Employ open-ended questions to encourage patients to share their experiences. For example, ask, “How has your sexual functioning been?” rather than “Do you have any sexual health problems?” This approach encourages patients to express their concerns in their own words. It also takes some of the pressure off of you to come up with all the exact right questions; when you leave a question open-ended, it allows the patient to tell you the important stuff you need to know.
Understand the Patient’s Perspective:
Listening actively is key. Allow patients to share their worries, fears, and expectations. Remember that sexual health concerns can impact various aspects of their lives, including relationships, self-esteem, and overall happiness. Also remember that few people get really good sexual health education, so many concerns that patients bring to you may actually be quite normative, and not indication of sexual dysfunction at all. For example, many men worry that they are ejaculating too soon — since porn will have many believe that it is typical to go upwards of 30 minutes before ejaculating. However, we only raise a red flag if ejacualation is consistenyl happening in less than 60 seconds; this is much less than the average person thinks is normal. Approach your patients with an empathetic ear while discussing sexual health.
Take a Bio-Psycho-Social Approach:
Sexual health is interconnected with physical, emotional, and psychological well-being. Addressing sexual health concerns often involves considering a patient’s medical history, current medications, mental health, and relationship dynamics. Sexual health concerns can indicate a whole range of issues beyond the purely urological or gynecological. Most mental health diagnoses are comorbid with sexual dysfunction (e..g, depression, anxiety, trauma). Many medications lead to changes in sexual function. Relationship discord is a significant contributing factor for many — but certainly not all — people experiencing sexual concerns. Know that is and what isn’t contributing to sexual health concerns will help you avoid unnecessary interventions, and also provide a more full picture of your patient’s health.
Assess for Underlying Medical Conditions:
Many medical conditions, such as diabetes, cardiovascular diseases, and hormonal imbalances, can affect sexual health. Inquire about any recent changes in health, medications, or symptoms that might be impacting sexual function. Remember that sexual dysfunction could be the “canary in the coalmine” for many common health concerns.
Encourage Open Communication:
Encourage patients to communicate openly with their partners about sexual concerns. Healthy communication is a foundation for addressing sexual health issues together, and yet many people fail to discuss their sexual troubles with partners. Oftentimes, assumptions that partners are disappointed and judging for one’s sexual challenges make the problem worse. And, often, these assumptions are completely wrong!
Offer Information and Resources:
Provide patients with accurate information about sexual health, available treatments, and lifestyle modifications. Share reputable resources or direct them to specialized clinics if needed. For example, the Tri Health Clinic is a phenomenal resource for sexual health. It contains a curated library of books, podcasts, videos, and handouts for a range of sexual concerns, including erectile dysfunction, early ejaculation, genital pain, low desire, sex and illness, etc. Check out the library HERE.
Consider Referrals:
In cases where sexual health concerns are complex or require specialized expertise, consider referring patients to sexual health specialists or therapists. Collaborate with these experts to ensure comprehensive care. Ontario is fortunate to have a number of excellent sex therapists. The Tri Health Clinic is one of these options. As a GP, it is important to know that most sex therapists are, unfortunately, not OHIP covered, so having a conversation with your patients about this is important. Further, these clinics do accept physician referrals, but patients are also welcome to self-refer.
Regular Follow-Ups:
For ongoing sexual health concerns, schedule follow-up appointments to monitor progress, adjust treatment plans, and provide continuous support.
You Can Integrate Sexual Health Into Your Medical Practice:
By integrating sexual health assessments into your practice, you can contribute to your patients’ overall well-being and enhance the quality of care you provide. Remember, addressing sexual health concerns requires sensitivity, empathy, and an open mind. And it gets easier to do with practice. Your efforts to create a safe and supportive environment will empower your patients to discuss their concerns openly, leading to improved sexual health and a better quality of life.
For more information and resources on sexual health, click through my website at http://www.drjennbossio.com.
by jennbossio | May 24, 2023 | Medicine, Sexual Health
Urology and gynecology specialties increasingly recognize the impact of psychological factors on patient well-being and treatment outcomes. Hiring a psychologist with training in sexual health on these medical teams can address this need effectively. In this post, we explore the key reasons for bringing a sexual health psychologist on board.
Patient Care from a Bio-Psycho-Social Lens:
Urological and gynecological conditions involve physical, psychological, and emotional aspects. A psychologist with training in sexual health offers a unique perspective, considering patients’ mental health, intimate relationships, and physical well-being. This holistic approach ensures comprehensive care.
Addressing Sexual Dysfunction Matters:
Sexual dysfunction is common among these patient populations, significantly impacting quality of life. Psychologists can have specialized training in assessing and treating sexual difficulties, improving sexual functioning and satisfaction. They provide essential interventions within the medical team.
Psychological Support and Coping:
Patients with urological or gynecological conditions often face emotional challenges. A psychologist offers valuable emotional support, helping patients cope with their conditions effectively. This support alleviates distress and enhances overall well-being.
Enhancing Treatment Adherence:
Psychological factors affect treatment adherence. Psychologists collaborate with medical professionals to address barriers hindering compliance. By promoting education, addressing fears, and providing coping strategies, they improve treatment adherence.
Improving Patient Satisfaction and Retention:
Incorporating a psychologist on a medical team boosts patient satisfaction. Addressing psychological aspects helps patients feel supported and understood. This enhances patient retention and leads to positive referrals, benefiting the medical practice.
Collaborative Care Approach:
Psychologists foster collaboration within the medical team. Working closely with medical professionals, they ensure a comprehensive and coordinated approach to patient care. This collaboration improves treatment planning and outcomes.
In conclusion, hiring a psychologist for urology and gynecology teams is an investment in comprehensive patient care. Their expertise in addressing psychological aspects, including sexual dysfunction and emotional well-being, offers invaluable benefits to patients and the medical practice. By integrating sexual health psychology, these teams provide holistic care that meets the diverse needs of patients effectively.
by jennbossio | Jan 14, 2023 | Medicine, Sexual Health
Improved patient outcomes & reduced healthcare utilization:
Psychological interventions have been shown to improve patient outcomes by addressing the psychological factors that impact physical health. By providing support for mental health concerns, psychologists can contribute to better treatment adherence, reduced symptom severity, and improved overall well-being. This can lead to fewer hospital readmissions, emergency room visits, and other costly medical interventions.
Lower healthcare costs:
Addressing the psychological aspects of medical conditions can result in cost savings by reducing the need for unnecessary medical tests, procedures, or interventions. For example, psychological interventions can help patients manage pain, anxiety, and stress, potentially reducing the need for pain medications or additional diagnostic tests. By focusing on patients’ psychological well-being, psychologists can help optimize healthcare resources and minimize unnecessary healthcare expenses.
Increased patient satisfaction and retention:
Integrating psychological support into medical care can enhance patient satisfaction and increase patient retention rates. Satisfied patients are more likely to remain loyal to the healthcare provider or institution, reducing the cost associated with patient turnover and attracting new patients through positive word-of-mouth.
Prevention & early intervention:
By identifying and addressing psychological concerns at an early stage, psychologists can help prevent the development or escalation of chronic health conditions. Preventative care and early intervention can reduce the need for more intensive and costly treatments in the future.
Research funding opportunities:
Psychologists often have access to grants and funding sources specifically aimed at mental health research or interdisciplinary projects. By securing research grants, psychologists can generate additional revenue for the medical team, offsetting the cost of their position.
Team synergy and collaboration:
A psychologist’s presence within a medical team can promote interdisciplinary collaboration and knowledge sharing, leading to more efficient and effective patient care, as healthcare professionals work together to address both physical and psychological aspects of health. Improved communication and collaboration can enhance the overall efficiency and effectiveness of the team, potentially resulting in cost savings.
Consider the many benefits of hiring a psychologist on your medical team
By considering the potential benefits in terms of improved patient outcomes, reduced healthcare utilization, increased patient satisfaction, research funding opportunities, and collaborative synergy, hiring a psychologist can often be a worthwhile investment that yields long-term cost savings.
