Objectives: Dyspareunia and sexual dysfunction are estimated to affect up to 22% and 43% of women respectively. There is concern that these statistics do not depict the true prevalence and that these conditions are frequently undiagnosed and untreated. By 2060, Latinos will make up 30% of the total population in the United States. As our patient population becomes more diverse, we need to ensure that our healthcare practices accommodate the changes. Methods:We surveyed a convenience sample of 107 English and 71 Spanish-speaking women, aged 18-45, at university affiliated clinics to identify the prevalence of dyspareunia and sexual dysfunction within our community. Additionally, we wanted to identify the rate that clinicians discuss painful sex with patients to identify if language impacted communication. The surveys collected data on subjective reporting of pain with sex and objective identification of sexual dysfunction with the Female Sexual Function Index (FSFI). Additional questions identified if subjects discussed pain with their clinician. These questions were analyzed between languages across all domains.Results: A greater prevalence of both dyspareunia and sexual dysfunction were measured in our study population compared to prior reports (37.79% and 54.71% respectively). Spanish-speaking women had significantly lower self-reported dyspareunia (28.99%), but scored significantly lower on the FSFI, qualifying for sexual dysfunction (63.24%). Spanish-speakers discussed painful sex significantly less compared to the English cohort, but the overall discussion rate was only 17.26%. Conclusions:This pilot data demonstrates a need for further research on language as a barrier to communication about sexual function in clinic.
Introduction. Contraception is a critical component of addressing the health needs of women in the postpartum period. We assessed contraception initiation by 90 days postpartum at a large, academic medical center in the Midwest. Methods. In this retrospective cohort study, 299 charts were randomly sampled and 231 were analyzed from deliveries between May 1 to July 5, 2018. Contraceptive method, maternal demographics, and obstetric characteristics at hospital discharge were collected, as well as contraceptive method at the postpartum follow-up appointment. Methods and strata of contraception were categorized as follows: 1) highly effective methods (HEM) defined as sterilization, intrauterine device, or implant, 2) moderately effective methods (MEM) defined as injectable contraception, progestin-only pills, and combined estrogen/progestin pills, patches, and rings, and 3) less effective methods (LEM) defined as condoms, natural family planning, and lactational amenorrhea. Women lost to follow-up who had initiated a HEM or injectable contraception were coded as still using the method at 90 days. We used logistic regression to identity factors associated with HEM use. Results. Of the 231 included patients, 118 (51%) received contraception before hospital discharge and 166 (83%) by 90 days postpartum. Postpartum visits were attended by 74% (171/231) of patients. Before hospital discharge, 28% (65/231) obtained a HEM and 41% (82/200) were using a HEM by 90 days postpartum. Patients obtaining HEM or injectable contraception before hospital discharge attended a follow-up visit less often than those who did not receive HEM before discharge (RR = 0.68, 95% CI: 0.54 - 0.86, p ≤ 0.01). Conclusion. When readily available, many women will initiate contraception in the postpartum period. Health systems should work to ensure comprehensive access to contraception for women in the postpartum period.
OBJECTIVES/SPECIFIC AIMS: Dyspareunia is a type of female sexual dysfunction estimated to affect 8%–22% of women of all ages. There is concern that these statistics do not depict the true prevalence, because it frequently goes undiagnosed and untreated. By 2050, Latinos will make up 30% of the total population in the United States. As our patient population becomes more diverse, we need to ensure that our healthcare practices accommodate the changes. Our goals are to determine the prevalence of dyspareunia within our patient population and to identify if language impacts patients reporting symptoms of sexual dysfunction to their healthcare provider. METHODS/STUDY POPULATION: Our study is a convenience sample, cross-sectional survey of English and Spanish-speaking women, ages 18–45, who present to university-affiliated clinics. In total, 100 women from each language group will be studied. The survey will be completed in REDCap and will include the validated questionnaires for the Female Sexual Function Index (FSFI), Visual Analog Scales for pain, and Patient Global Impression of Severity and Improvement. Additional data on demographics and patient discussion of pain with their healthcare provider will be collected. RESULTS/ANTICIPATED RESULTS: The demographic and pain discussion questions will identify reporting rates. The FSFI score will be used to identify patients with sexual dysfunction and dyspareunia and calculate the prevalence in each language group. The domains will be analyzed to assess variations between populations. DISCUSSION/SIGNIFICANCE OF IMPACT: Dyspareunia has a great impact on patients’ quality of life when untreated. This study will allow us to identify barriers to diagnosing and treating cases of dyspareunia. If we detect differences in reporting rates between the language groups, future research could be tailored and conducted to identify the specific problems in communication. With this knowledge, we can improve how we discuss sexual health in clinic and ultimately improve quality of care for all patients.
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