AFJOG

Sexual health is a multifaceted aspect of well-being that encompasses not only reproductive function but also emotional, psychological, and relational dimensions. The provision of comprehensive healthcare in Obstetrics and Gynaecology necessitates the inclusion of sexual health services and it is time that we recognize the profound impact these aspects can have on her overall quality of life. Several studies have emphasised the importance of addressing sexual health in Obstetrics and Gynaecology, albeit various challenges associated in addressing this condition. Conversations surrounding sexual health within this realm have been approached with hesitation or even silence. Cultural taboos, societal norms, and professional discomfort have contributed to a lack of open dialogue about intimate matters. Research has shown that general practitioners may face barriers in discussing sexual health issues proactively with patients, indicating the need for further attention in this area. 1,2 Moreover, the attitudes and perceptions of healthcare providers towards obtaining sexual histories from patients may influence the extent to which sexual health is addressed in clinical practice. 3,4 Medical students’ self-reported confidence in Obstetrics and Gynaecology is influenced by their exposure to clinical experiences and discussions around sexual health. 5 This highlights the need for appropriate training in the field of sexual health. There are several reasons why Obstetricians and Gynaecologists should initiate conversations about sexual health. First, sexual dysfunction is prevalent, affecting up to 43% of women. 6 By taking a sexual history and screening for issues, doctors can identify and treat conditions that impact sexual function. Secondly, patients expressed desire for their doctors to initiate discussions about sexual health. 7 As women become more aware of the biological and medical aspects of female sexual dysfunction, they are likely to increase their demand for medical counseling regarding sexuality. Studies have shown that patients are willing to discuss sexuality- related issues with their physicians but are often reluctant due to fear that the physician might be embarrassed and/or will dismiss their concern. However, doctors often cite lack of time, comfort level, and perceived importance as barriers to discussing sexual health. 8 Third, sexual health encompasses more than just function. It includes orientation, identity, and relationships. 9 By addressing sexual health holistically, doctors can better support the mental health and wellbeing of their patients. Finally, issues such as infertility, menopause, gynaecological cancers and childbirth, may directly impact sexual function and relationships. 10 Comprehensive care requires addressing the sexual health needs that arise from these conditions. In the era of patient-centered care, it is essential that we recognize and address the comprehensive needs of our patients. By actively involving sexual health practitioners in Obstetrics and Gynaecology, we demonstrate a commitment to the holistic well-being of the women we serve. This approach not only enhances patient satisfaction but also contributes to better health outcomes and the establishment of a trusting and enduring patient-provider relationship. In conclusion, the integration of sexual health practitioners into Obstetrics and Gynaecology is a step towards a more comprehensive and patient-centric model of care. As we strive to break down the barriers surrounding intimate conversations, we must embrace the expertise of sexual health practitioners to ensure that every woman's journey through reproductive health is met with compassion, understanding, and excellence. Dr Jireh Serfontein Clinical Head, MySexualHealth, Pretoria The role of the sexual health practitioner in Obstetrics and Gynaecology Female sexual dysfunction remains a multifaceted medical problem which is difficult to evaluate in a clinical setting. Historically the evaluation has been limited to psychological assessment in conjunction with the use of subjective tools. A thorough physical, pelvic examination with relevant biochemical evaluation and collaborative efforts between sexual health practitioner/s and physicians is vital when commencing the journey to restoration of female sexual health as highlighted in the editorial and review. For the readers who are not aware of this, World Sexual Health Day is observed on 4th September each year, and the theme for 2023 is ‘consent’. Is too much of a good thing bad? It has been 41 years since Liggins and Howie first reported the maturational benefit of the use of antenatal corticosteroids in preterm infants. While there has been a significant reduction in respiratory morbidity and widespread recommendation of its use in women at risk of preterm delivery, scientific validity of its use at different gestational ages, need for repeat administration and associated long-term sequelae is discussed in the review. The review article on caesarean scar pregnancy, reiterates the overall low incidence but serious maternal implications if not diagnosed early and managed appropriately. Clinical and ultrasound features and predictors are discussed. A prospective case-controlled study to determine the prevalence of COVID-19 infection in asymptomatic women presenting with preterm labour or preterm prelabour rupture of membranes concludes that other infective causes remain significant contributors as opposed to COVID-19 infection. Lastly, the guideline on screening for chromosomal and structural fetal anomalies aims to assist decision making that is both ethically sound and medicolegally safe, for South African OBGYN’s. We are grateful to the writing group for their joint effort and collaboration. “Isn’t it amazing how much stuff we get done the day before vacation?”- Zig Ziglar ZeelhaAbdool Deputy Editor Journal article summary: In this edition EDITORIAL African Journal of Obstetrics and Gynaecology | Volume 1 | Issue 2 | 2023 | 01