Physicians are at higher risk of sexual dysfunction—here's why
Key Takeaways
Industry Buzz
"Specialties marked by elevated burnout rates are prone to experiencing such issues, [and] sexual dysfunction isn't solely psychological. It can also stem from mental stress, depression, substance abuse, hormonal imbalances, diabetes, hypertension, and hyperlipidemia. The key to management lies in identifying and addressing the specific causes.” — Sangeeta Hatila, MD, MBBS, board-certified psychiatrist
Physicians and other healthcare professionals dedicate their lives to caring for others—but often at the expense of their own well-being. Behind the long hours, high-stress environments, and relentless expectations lies a topic rarely discussed in medicine: sexual dysfunction.
Mounting research shows that healthcare providers are more likely to experience sexual dysfunction than the general population. These struggles aren't just physical—they reflect deeper emotional and psychological tolls of practicing medicine. And while trainees are especially vulnerable, this issue extends across the profession, affecting both men and women in all stages of their careers.
The extent of sexual dysfunction among HCPs
Several studies have pointed to a higher prevalence of sexual dysfunction among medical residents compared with the general population. At the same time, sexual health issues impact a higher proportion of female than male healthcare trainees.
“Emotional and intimate connections play a greater role in women's sexual desire compared to men,” Sangeeta Hatila, MD, MBBS, a board-certified psychiatrist, tells MDLinx. “And constraints on free time hinder female trainees in forming stable relationships.”
Let's take a closer look at the data.
International studies, as reported by Tunisian investigators, indicate that 30% to 80% of female doctors in training experience sexual dysfunction;[] a study done in Beirut found that 13% to 30% of male doctors in training experienced sexual dysfunction.[]
Among the Beirut male interns and residents, 21% reported low sexual desire.
A 2022 study by the Tunisian researchers identified 40% of female residents as experiencing sexual dysfunction. Cognitive distraction was a prominent underlying factor contributing to these symptoms.
In the US, a study from Washington University in St. Louis showed that the incidence of sexual dysfunction among trainee doctors surpasses that of the general population of similar age.[]
Sexual anxiety
Sexual anxiety refers to feelings of unease, fear, or apprehension related to sexual activities. A classic study from 1967 found that nearly half of medical trainees were experiencing significant sexual anxiety.[]
Their anxiety was related to various concerns, including difficulties with sexual performance and problems with intimate relationships, self-pleasure, sexual orientation, and managing patients with sexual issues.
Sexual anxiety may interfere with a person's ability to engage in and enjoy sexual activities, leading to avoidance or distress. It can be a standalone issue or coexist with other mental health conditions.
Who is most at risk?
The harsh reality is that the demanding nature of working in healthcare, both physically and mentally, affects HCP's overall quality of life. The increasing rates of burnout, stress, and anxiety among healthcare workers delivers a significant blow to HCP's sexual well-being.
Whether certain medical specialties have a higher prevalence of sexual dysfunction than others is unknown, as direct data on any such correlation is limited. However, according to Dr. Hatila, “Specialties marked by elevated burnout rates are prone to experiencing such issues.”
A survey by the American Medical Association identified six medical fields with the highest burnout rates: Emergency Medicine (62%), Hospital Medicine (59%), Family Medicine (58%), Pediatrics (55%), Obstetrics and Gynecology (54%), and Internal Medicine (52%).
Docs in these specialties contend with heightened stress, unpredictable schedules, emergencies, night shifts, and overtime.[]
The COVID-19 pandemic contributed its share to the problem, too. In a Brazilian study, almost 80% of female doctors met criteria for sexual dysfunction, attributed to depression, anxiety, and resultant burnout.[]
In women, the most common issues include low sexual desire, reduced arousal, trouble achieving orgasm, and painful intercourse (dyspareunia). In men, prevalent concerns are problems with getting or maintaining an erection, difficulties reaching orgasm, and premature ejaculation.[]
Impact on personal and professional life
Long hours, relentless stress, and the perpetual pursuit of excellence don't exactly create a conducive environment for a flourishing sex life. Physicians may find themselves battling feelings of isolation and the fear of being stigmatized. In a field where confidence is key, this can have a cascading effect on a doctor's mental well-being.
Unresolved sexual health issues can strain relationships, leaving both partners grappling with the lack of intimacy. A decline in sexual desire and erectile dysfunction has also been linked to infertility.[]
Therapeutic interventions
“Sexual dysfunction isn't solely psychological,” Dr. Hatila says. “It can also stem from mental stress, depression, substance abuse, hormonal imbalances, diabetes, hypertension, and hyperlipidemia. The key to management lies in identifying and addressing the specific causes.”
Once all other physical and psychiatric illnesses have been ruled out, the psychological aspects can be dealt with through therapies intended to overcome emotional barriers to intimacy, like cognitive-behavioral therapy and sex therapy.
Medications, such as phosphodiesterase type-5 inhibitors, could be considered for erectile dysfunction. Other integral parts of the treatment plan include lifestyle adjustments, stress management, and promoting open communication between partners.
A proactive approach would involve training at the residency level relating to managing sexual anxiety. Training institutes and program supervisors must make sure the training emphasizes not just taking care of patients but also prioritizes residents' mental health.
Medical teaching centers should designate a dedicated counselor, ensuring strict confidentiality through established protocols. This initiative could equip residents with the necessary knowledge and support to handle the challenges of sexual health within the demanding healthcare environment.
Related: 6 sexual health myths busted