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HCPs are more likely to experience sexual dysfunction—especially during residency

MDlinx Jan 30, 2024

Medical residency is an arduous journey filled with long hours, intense pressure, and the unyielding pursuit of knowledge and skill. However, beneath the facade of dedication and determination, there's a silent struggle that many medical residents face: sexual dysfunction. 


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.


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.

Woods SM, Natterson J. Sexual attitudes of medical students: some implications for medical education. Am J Psychiatry. 1967 Sep;124(3):323-332.

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?


Young, healthy residents might not expect frequent sexual issues, in theory, unless there's an underlying physical problem. Yet, the harsh reality is that the demanding nature of residency, both physically and mentally, affects residents’ overall quality of life, including sexual well-being. As the Tunisian researchers discovered, residents' sexual well-being has a significant connection to burnout, stress, and anxiety.

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%). Residents in these specialties contend with heightened stress, unpredictable schedules, emergencies, night shifts, and overtime.

Berg S. These 6 physician specialties have the most burnout. American Medical Association. August 29, 2023.


The COVID-19 pandemic contributed its share to the problem, too. In one Brazilian study conducted in 2020, almost 80% of female doctors met criteria for sexual dysfunction, attributed to depression, anxiety, and resultant burnout.

De Souza Ziegler N, Muller GC, Grossi FS, et al. Impact of the covid-19 pandemic on mental health and sexuality of female doctors. PLoS One. 2023;18(7):e0281321



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.

Li W, Li S, Lu P, et al. Sexual dysfunction and health condition in Chinese doctor: prevalence and risk factors. Sci Rep. 2020;10(1):15180.




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. Residents 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.

Leeners B, Tschudin S, Wischmann T, et al. Sexual dysfunction and disorders as a consequence of infertility: a systematic review and meta-analysis. Hum Reprod Update. 2023;29(1):95-125.




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 a teaching plan where residents receive training on addressing and 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.

What this means for you

As a healthcare professional, it's important to be attuned to your mental well-being while being proactive in managing stress. If you notice persistent changes in sexual desire, arousal, or satisfaction, don't hesitate to seek help. Familiarize yourself with available resources, including counselors, and prioritize open communication about your sexual health.


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