Attitudes and knowledge of pain specialists in Israel regarding sexual health in chronic pain patients

Sexual health is a critical component of quality of life. Chronic pain can significantly impair sexual functioning through complex and multimodal effects spanning physical, psychological, and social domains. Nevertheless, when properly managed, many people with chronic pain can still enjoy fulfilling sexual relationships. Therefore, addressing sexual health concerns is an important aspect of holistic modern chronic pain management. This study is the first to investigate attitudes and perspectives of pain specialists regarding sexual health issues, including barriers to diagnosis and management. A Nationwide web-based survey of all registered and active board-certified pain specialists in Israel held in August-September 2024. Out of 133 physician members of the Israeli Pain Association, 75 (56.4%) completed the survey, 62.7% of them males, and most (73.3%) worked in public facilities, and the primary specialty of 41.3% was anesthesiology. While 81.3% of physicians acknowledged the high prevalence of sexual dysfunction in chronic pain patients, only 14.7% proactively discuss it with patients. Similarly, 89.3% reported little to no training on sexual health, and 60% felt underprepared to address these issues. Most felt more comfortable discussing sexual health with same-gender patients, time constraints, low priority, and lack of knowledge were noted as key barriers. This study reveals a gap between physicians' awareness of sexual health issues and their translation of this into clinical practice. Time constraints, discomfort, and insufficient training hinder discussions. Improving referral pathways and fostering system-level support are essential to integrating sexual health into routine pain management. In particular, the results underscore an urgent need to integrate sexual health training into pain medicine, which could improve patient outcomes and quality of life among chronic pain patients.