Sexual and Reproductive Health in Young Women with CF: Is It Being Discussed?
Dr Lewis First, MD, MS, Editor-in-Chief, Pediatrics
Care of cystic fibrosis has come a long way over the past several decades with patients with this genetic disorder now living way into adulthood—prompting the need for seamless transitions of care from pediatrician to adult clinician and from pediatric multidisciplinary CF program to an adult one. In the midst of these transitions, there is a role for discussion of sexual and reproductive health counseling with teenagers and young adults—and yet while this is an essential conversation to have with these patients, just how often does it occur and if it does, is it done in a way that is comfortable for the patient?
Kazmerski et al. (peds.2015-4452) decided to look into questions like these by performing qualitative interviews with CF patients ages 18 to 30 and their corresponding CF program directors. Key themes from these discussions emerged including the importance of having such conversations but also the relative discomfort of both patient and CF specialist to talk about sexual health as well as be familiar with resources to improve sexual and reproductive health care in these patients. It was also noted that earlier discussions were preferred by patients especially if they were initiated by the CF provider.
Yet while one might want to assign this important conversation to CF providers, there is also the CF patient’s general pediatrician who can and should be bringing up issues of sexual and reproductive health during health maintenance visits. The authors of this study did not focus on the role of the primary care pediatrician to work in collaboration with the CF specialist, but that is why we chose to publish this article—so that all pediatricians can be made aware of the need to sexually counsel a teen or young adult patient with CF just as we would patients at the same age without CF.
This article calls for better sexual and reproductive health education and services for CF patients as well as other chronic disease patients, and there is no reason that education and services cannot be offered by the primary care medical home in conjunction with the CF program in your area. Are you doing that? If so, let us know by sharing your practice tips with our readers by responding to this blog, leaving a comment on our online website where the article is posted, or by sharing a post on our Facebook or Twitter links.