Attitudes and practices of family doctors on sexual dysfunction in women with hypertension

Abstract Background Sexual dysfunction in women treated for arterial hypertension is underreported and often overlooked in primary care, despite its impact on quality of life. Family doctors play a crucial role in recognizing and addressing these issues. Methods In 2023, a cross-sectional survey was conducted among 302 family medicine doctors (FMDs) in Croatia (83.8% women; median age 46 years). The questionnaire collected data on demographics, practice characteristics, and attitudes and practices regarding sexual dysfunction in female patients with hypertension. Statistical analyses explored associations between physician characteristics and reported behaviours and attitudes. Results Only 10% of FMDs regularly ask about sexual function in women with hypertension. The majority (59%) discuss sexual health only if the patient initiates the topic. Main barriers to addressing sexual dysfunction include perceived patient reluctance (45.8%) and lack of time (29.7%). Only 4.3% frequently record a diagnosis of sexual dysfunction (F52) when identified. Doctors in specialist training more often recognize the link between antihypertensive therapy and sexual dysfunction (p = 0.02). FMDs in private practice more frequently report an increase in sexual dysfunction since the COVID-19 pandemic (p = 0.04). Older doctors (≥56 years) are more likely to assess sexual function (p = 0.04). Doctors with predominantly older patient populations and those who rate their patients’ health literacy as excellent more frequently observe sexual dysfunction (p < 0.001). Conclusions Sexual dysfunction in hypertensive women is insufficiently addressed by family doctors in Croatia, mainly due to patient reluctance and time constraints. Although most doctors agree that improving health literacy could enhance outcomes, routine inquiry about sexual health remains uncommon. Targeted education and integration of sexual health into routine hypertension care are needed to improve patient quality of life. Key messages • Sexual dysfunction is rarely addressed by family doctors in hypertensive women, mainly due to patient reluctance and lack of time. • Targeted education and integration of sexual health into routine hypertension care are needed to improve patient quality of life.