Let’s talk about sex: Does language constitute a barrier to women reporting and receiving treatment for dyspareunia in the Spanish speaking community?

Abstract

Title: Let’s talk about sex: Does language constitute a barrier to women reporting and receiving treatment for dyspareunia in the Spanish speaking community? Purpose: To identify the prevalence of dyspareunia and sexual dysfunction within the population of English and Spanish speaking women visiting outpatient clinics and to compare the rates of patients discussing symptoms of painful sex with healthcare providers between language groups. Design: Cross-sectional survey, descriptive study Setting: The University of Kansas Obstetrics and Gynecology Clinic and affiliated Jay Doc Free Health Clinic Patients: Convenience sample of English and Spanish speaking women, ages 18-45 Methods: Subjects completed anonymous surveys in either English or Spanish. The surveys were administered through REDCap and included the validated questionnaires for the Visual Analog Scales (VAS) for pain, Female Sexual Function Index (FSFI) and Patient Global Impression of Improvement (PGI-I). Data on demographics and discussion of pain with healthcare providers was also collected. The prevalence of sexual dysfunction and dyspareunia was calculated for each cohort and the rate of discussion of dyspareunia was identified for each language. Prevalence, FSFI domain scores and discussion rates were compared between groups using t-test and chi-square analysis. Main Result: A total of 160 women were surveyed (107 English speaking and 53 Spanish speaking). The prevalence of dyspareunia was found to be 42.06% and 28.30% in the English and Spanish cohorts respectively (p=0.087) and the rates of discussion of dyspareunia was significantly higher in the English cohort compared to the Spanish (20.56% vs 5.66%, p=0.011).The prevalence of sexual dysfunction, based on an FSFI score <26.55, was found to be 46.73% and 62.26% in English and Spanish cohorts respectively (p=0.048). When comparing the individual FSFI domains, scores for desires, arousal, lubrication, orgasm and pain were significantly higher in the English cohort (p<0.05). Conclusion: Our main outcome measures show a significantly higher prevalence of dyspareunia and rate of discussion in the English cohort compared to the Spanish cohort. The FSFI score and 5 out of 6 of individual domain scores were significantly higher in the English cohort. A significantly larger portion of the Spanish speakers scored below 26.55, signifying sexual dysfunction. Our measurements for sexual dysfunction and dyspareunia prevalence are higher than estimates found in literature. We encourage continuing research to obtain a larger sample size for expanded analysis. The differences in Spanish speakers low FSFI scores compared to their lower prevalence of subjective dyspareunia requires more investigation. Future studies should investigate specific barriers in communication between Spanish speakers and clinicians when discussing sexual function and pain. Disclosures: The authors have nothing to disclose