Sexual health discussions between health care professionals and midlife-older women living with Type 2 diabetes: an interpretative phenomenological study

Aim: To explore the barriers and facilitators to sexual discussions in primary care according to a sample of women aged 50 and older living with Type 2 diabetes.

Design: A qualitative, interpretative phenomenological analysis study.

Methods: Ten women aged 50-83 years living with Type 2 diabetes were interviewed between August 2016-March 2017. Data were analysed using interpretative phenomenological analysis.

Results: The participants reported changes to their sexual health and well-being, which they attributed to diabetes, menopause, ageing and changes within intimate relationships. Not all changes were considered problematic, but those that were, tended not to be discussed with healthcare professionals. The women assumed that the topic of sex was not broached by professionals due to embarrassment (both their own and that of the healthcare professional), ageism and social taboos around older women’s sexual pleasure. The place that sexual health and well-being held in the women’s lives also influenced primary care discussions.

Conclusion: These findings demonstrate that social taboos around gender, ageing and sex influenced the barriers to sexual health and well-being discussions in primary care. Facilitators to overcoming these barriers were professional-patient rapport, consulting with a female healthcare professional and instigation of the conversation by healthcare professionals.

Impact: Type 2 diabetes can have a negative impact on women’s sexual health and well-being. Prior to this study, little evidence existed of the barriers that older women with Type 2 diabetes faced with regard to sexual health care. This study shows that midlife-older women with Type 2 diabetes can experience sexual health and well-being problems which are neglected within primary care. It also shows that women want their healthcare professionals to explore these problems. Raising awareness and providing training for healthcare professionals may lead to better provision of sexual health support for midlife-older women with Type 2 diabetes.