Rheumatologists need to understand how sexual health issues affect their patients


An ARHP session on Tuesday will explore the difficulties patients can face with respect to the impact of rheumatic disease, chronic illness, and medications on their sexual health, as well as the challenges clinicians face when talking to patients about this sometimes sensitive subject. The session, Sexual Health, Intimacy & the Effects of Rheumatic Disease, will be held from 11:00 am – 12:00 pm in RoomW181c.


“Rheumatic diseases can cause both physical and mental limitations, or stressors, that can affect patients’ intimacy and sexual health, and it’s often difficult for them to talk about,” said Julie Schwartzman-Morris, MD, Associate Professor, Division of Rheumatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in Great Neck, NY. “It can also be a difficult topic for providers to talk about—even making the time to ask about it and then knowing how to respond to patients’ complaints can be a challenge.”

Dr. Schwartzman-Morris will serve as co-moderator of the session alongside Monica C. Richey, MSN, ANP-BC/GNP, Nurse Practitioner in the Division of Rheumatology at Northwell Health.


“It’s important for us, as rheumatology health professionals, to understand the particular disease processes and the ramifications they can have in leading to sexual dysfunction, as well as the medications that we use, many of which can have side effects in that arena,” Dr. Schwartzman-Morris said. “We need to be able to help our patients understand that the issues they are having represent a real physiologic disorder as a part of their disease or, potentially, as part of the emotional impact of their disease.”


Because these issues are fairly common and can be complicated, Dr. Schwartzman-Morris believes medical school and training programs should place more emphasis on teaching providers how to address and manage patients’ disease-related sexual and intimacy issues.


“We teach our trainees to take a sexual history, which mostly involves simply asking if they are sexually active and if they use contraception, but we don’t always teach how to ask patients if they have issues with their sexuality or intimacy or physicality,” she said. “It’s a prominent and often sensitive issue in people’s lives, but it’s something that is just not on our radar in many instances.”


Dr. Schwartzman-Morris will discuss the “wheel of total health” concept—the idea that effective evaluation of a patient requires assessing physical, spiritual, emotional, and sexual health. The discussion will include practical suggestions for assessing the physical and emotional difficulties patients are having and methods for helping patients and their partners rediscover their sexual lives, including resources for patient education.


“There are a lot of different diseases we treat that can impact the sexual health of our patients. Sometimes the treatments themselves can cause sexual problems. So even if they are getting better from their disease, their sexual health may still be impacted and we need to be able address that,” Dr. Schwartzman-Morris said. “Just learning the language of how to inquire and how to help patients deal with it is an important part of treating the whole person and not just their disease.”