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Theme 1 - Being Proactive In Discussing Sexual Issues (It’s My Responsibility)
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| Initiate Discussions of Sexual Issues |
“We need to make sure to open up the conversation.” “give patients permission to talk about sexual health and side effects.” “Providers should initiate conversations about sexual health and let patients know these issues can be further addressed at any time.”
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Theme 2 – Normalize Discussions of Sexual Health
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| Assure Patients that Sexual Health Concerns are Common and Appropriate for Discussion |
“Sexual problems are common in patients with breast cancer and should be addressed proactively.” “Providers need to normalize conversations about sexual health by including it as part of the ROS as we do nausea, fatigue, etc. This invites patients to share, because they are unlikely to bring concerns up unprompted.” “allow the discussion of possible sexual health related toxicities to be as relevant and real as any other possible treatment related toxicities…”
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| Broaden the Accepted Topic of Conversation |
“Be open with talking about orgasm and masturbation, and not only sex.” “I should try to ask my patients about their sexual health, desire and vaginal dryness…” “Raising sexual side effects such as libido during the first discussion is important.”
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Theme 3 – Knowing the Patients to Target
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| Raise the Topic With All Patients |
“Important to ask all pts about sexual health issues” “Give patient permission to talk about anything that may impact QOL (sexuality, intimacy) as race, age and ethnicity is not a factor, and bring up the topic…” “Ask all patients if they are experiencing any changes in sexual function that are distressing to them.”
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| Give Special Care for Certain Groups |
“Recommend vaginal moisturizers from the beginning of AI or OS therapy (rather than wait for there to be a problem)” “Vaginal moisturizers may be needed daily in women on AIs” “The importance of vaginal moisturizers in helping patients on aromatase inhibitors”
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Theme 4 - Understanding How To Raise the Topic
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| Build the Relationship as the Foundation for Discussing Sensitive Topics |
“That is important to know about a patient's relationships - partners etc to develop trust and comfort to best address sexual concerns.” “Loved the tip on using the social history as a way to get to know patients and their partners and that this is an excellent segue to discussing sexual side effects of treatment” “Sexual issues in women with breast cancer need to be discussed openly, and there are resources out there for women and physicians”
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| Raise the Topic Early and Often |
“It is important to introduce the topic early and revisit as the patient seems receptive…” “that I need to include more information regarding sexual health at the outset of a woman's treatment plan to lay the foundation for an open discussion regarding her sexual concerns throughout treatment and continuing through survivorship.” “Talk about sexual health often and up front in the cancer journey.”
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| Inquire about Sexual Concerns and Discuss Sexual Side Effects |
“Simply asking a patient if she has any sexual concerns is an easy way to open up the conversation.” “Even acknowledging sexual side effects goes a long way.” “Discuss sexual side effects as part of routine tox evaluation and become more knowledgeable about management of sexual side effects to advise patient”
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Theme 5 - Understanding How to Respond to Concerns
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| Convey the Message that Help is Available |
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| Address Key Concerns: Vaginal Health Issues |
“The importance of vaginal moisturizers in helping patients on aromatase inhibitors” “Vaginal moisturizers should be used 3-5x/week” “Vaginal moisturizers may be needed daily in women on AI’s”
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