1. A report on 2010 consensus outcomes & guidance for women’s health professionals Michael L Krychman, MDCM Medical Director of Sexual Medicine Hoag Hospital Executive Director SoCal Center for Sexual Health & Survivorship Medicine Associate Clinical Attending Physician University of Southern California Sexual Health Fundamentals for Patient Care

2. Disclosures Speakers Bureau: Wyeth, Warner Chilcott, Boehringer Ingelheim Consultant: Wyeth, Boehringer Ingelheim, Pfizer Sexual Health Fundamentals for Patient Care is an initiative of the Association of Reproductive Health Professionals (ARHP) This initiative was made possible by a consortium of grants from Boehringer Ingelheim, Pfizer, and Wyeth

3. Steering Committee Michael Krychman, MD Medical Director of Sexual Medicine Hoag Memorial Hospital Presbyterian Newport Beach, CA Anita Clayton, MD Professor University of Virginia Health System Charlottesville, VA Susan Kellogg-Spadt, CRNP, PhD Co-Founder, The Pelvic and Sexual Health Institute of Philadelphia Philadelphia, PA Linda Dominguez, RN-C, NP Clinician/Consultant Southwest Women's Health Gynecology Group Albuquerque, NM

4. Aims 1.Develop expert guidance to fill practice gaps for frontline providers on female sexual function, health, and wellness 2.Develop open-access assessment and practice tools for professional societies and advocacy groups

5. ob/gynurogynecologypsychiatry internal medicine sexuality mental health primary care gynecologic oncology MD APC PhD health education clinical research RN behavioral research women’s health Methods Needs assessment Retrospective literature review Web-based survey & interviews Professionally-facilitated consensus process Development of guidance for frontline providers

6. Methods: Consensus Panel Demographics

7. Consensus Results: Panelists Affirmed Frontline HCP Needs HCPs require increased clinical skills & better understanding of psychosocial issues HCPs are appropriately positioned to provide female sexual healthcare HCPs can effectively screen, diagnose, initiate treatment, refer HCPs must have this practice gap addressed to improve patient care HCPS need evidence-based guidance, tools, educational resources, training

8. Outcomes Open access tools to be widely disseminated ▪ Sexual Health Fundamentals fact sheets for frontline healthcare providers 1.Sex Therapy For Non-Sex Therapists 2.Talking With Patients About Sexuality And Sexual Health 3.Top Ten Things You Need To Know About Female Sexuality 4.Clinician Competencies for Sexual Health 5.Common Myths about Female Sexual Health

9. Outcomes (continued) Open access tools to be widely disseminated ▪ Recommended algorithm and screening tools ▪ White Paper ▪ Commentary articles and editorials

10. Consensus Results: Panelists Developed HCP Guidance Key assumptions about sexual health

11. Consensus Results: Panelists Developed HCP Guidance Inventory of competencies for expert care

12. Consensus Results: Panelists Developed HCP Guidance (con’t) Evidence-based guidance for provider tools, resources, training Comprehensive roster of relevant professional societies/ advocacy groups

13. DESIRE 101 Developed by Michael Krychman, MD, and Susan Kellogg Spadt, PhD, CRNP (2010). Available at www.SexualHealthFundamentals.org.www.SexualHealthFundamentals.org

14. FSD Intermediate Developed by Susan Kellogg Spadt, PhD, CRNP and Michael Krychman, MD (2010). Available at www.SexualHealthFundamentals.org.www.SexualHealthFundamentals.org

15. A sk General: “annual exam” question “An Important aspect of your overall health is sexual health…” Specific: Lead-in Questions “Many of my patient with ---- experience alterations in their sexual response. Are you experiencing anything you’d like to talk about? Currently in a sexual relationship? Male/Female/Both Any concerns? C larify/Normalize/Validate Monitor self and other body language YesNo Elicit more info Assess Discuss overlap of FSD’s Open ended? “Tell me more…” Meds, etc.Illness Psych/Cultural/Context/ Relationship Sexual Factors Summarize Concerns Differential Diagnosis DSDS, etcPelvic exam if needed Diagnosis R/O Anxiety Depression E ducate ICD-9 Codes Define for patient Confirm distress and prioritization for care HandoutsVerbalWebsiteBasic CxRefer specialists Treatment Refer + Practice limitations “A” “C” “E”

16. Next Steps Phase II consensus process Community meetings Shared sexual health clearinghouse Additional tools w/society partners Partner collaborations to raise awareness about guidance for frontline providers

17. Thank You Sexual Health Fundamentals for Patient Care For more information: www.sexualhealthfundamentals.org