GPs failing patients with sex problems

MANY GPs are failing to diagnose sexual problems in their patients because they are too embarrassed to ask searching questions - and would not know how to treat such disorders in any case, a leading psychiatrist has claimed.

Hundreds of cases of problems such as impotence, lack of interest in sex and difficulty with penetration are therefore going unrecognised. Patients often suffer unnecessary depression and stress-related problems.

The picture of distress and inhibition is painted by Professor Michael King, head of academic psychiatry at the Royal Free Hospital and University College School of Medicine in London, who has just undertaken a preliminary inquiry into sexual problems. In January he begins a further pounds 100,000, two-and-a-half-year study into the nature and extent of sexual problems in England and Wales.

The study, backed by the Wellcome Trust, aims to identify how many people in Britain are experiencing sexual difficulties and where, if anywhere, they are turning for help.

The only previous study along these lines, "Sexual Behaviour in Britain", originally published in the 1980s in the wake of the arrival of Aids, is now out of date, said Professor King. "Many GPs are ill at ease and embarrassed when it comes to taking sexual histories because they do not have the training. A majority are awkward and do not feel right with it. And many do not know where to send patients who may be experiencing sexual difficulties."

Professor King is particularly concerned that the arrival of Viagra, the impotency drug, will lead to prescriptions being written without treatment of the underlying problem.

Dr Rena Sampson, a consultant in psycho-sexual medicine who has trained GPs to recognise sexual problems and deal with them, believes that GPs' own backgrounds affect how they deal with the problems.

"It is down to how comfortable they feel with talking about sex or how comfortable they make the patient feel," she said. "If you have got your pen in your hand and your prescription pad in the other, the patient is not going to start talking about sexual problems."

Professor King hopes his study will provide a broad understanding of sexual problems. "We want to know just how old or young people with problems can be, what kind of help they get and is the help of any use. Who would they seek help from if they were prepared to talk about it, and does the GP play a role in this?"

Professor King has already carried out a pilot study into sexual dysfunction. The results triggered the present study. Around 2,000 men and women, first in the London area and later in other parts of the country, will be asked about their sex lives on a questionnaire. Professor King believes the answers will be more honest and less prone to embellishment than if they were interviewed in person.

A spokesman for the Royal College of General Practitioners, the body which represents GPs' interests, said: "GPs can only go by what somebody is saying to them. There are also risks in going too far the other way. If somebody is finding it embarrassing and you start leading or guiding them towards what possibly might or might not be a sexual problem, there are lots of dangers there as well.

"We would welcome and be very interested in any study which reveals how prevalent sexual dysfunction is."