This study reveals a gap between physicians' awareness of sexual health issues in chronic pain patients and their translation of this awareness into clinical practice, with time constraints, discomfort, and insufficient training serving as key barriers.
Key Findings
Results
A majority of pain specialists acknowledged high prevalence of sexual dysfunction in chronic pain patients, but very few proactively discuss it with patients.
81.3% of physicians acknowledged the high prevalence of sexual dysfunction in chronic pain patients
Only 14.7% proactively discuss sexual health with patients
This represents a substantial gap between awareness and clinical practice
Survey conducted nationwide in August-September 2024 among Israeli board-certified pain specialists
Results
The vast majority of pain specialists reported little to no training on sexual health, and a majority felt underprepared to address these issues.
89.3% reported little to no training on sexual health
60% felt underprepared to address sexual health issues in chronic pain patients
Lack of knowledge was noted as a key barrier to discussing sexual health with patients
Results
Most pain specialists reported greater comfort discussing sexual health with same-gender patients.
Gender concordance between physician and patient was identified as a factor affecting comfort level in discussing sexual health
This was noted alongside time constraints and low priority as key barriers
62.7% of survey respondents were male physicians
Results
Time constraints, low priority assigned to sexual health, and lack of knowledge were identified as the key barriers to addressing sexual health in chronic pain patients.
These three barriers were specifically noted by survey respondents
The barriers explain the disconnect between high awareness (81.3%) and low proactive discussion rates (14.7%)
The findings underscore the need for system-level support and improved referral pathways
Methods
The survey achieved a 56.4% response rate among all registered and active board-certified pain specialists in Israel.
75 out of 133 physician members of the Israeli Pain Association completed the survey
Response rate was 56.4%
41.3% had anesthesiology as their primary specialty
73.3% worked in public facilities
Survey was web-based and conducted in August-September 2024
Background
This study is described as the first to investigate attitudes and perspectives of pain specialists regarding sexual health issues in chronic pain patients.
The authors explicitly state it is 'the first to investigate attitudes and perspectives of pain specialists regarding sexual health issues, including barriers to diagnosis and management'
The study was nationwide in scope, covering all registered and active board-certified pain specialists in Israel
The study examined both attitudes and knowledge, as well as barriers to clinical practice
What This Means
This research surveyed pain specialists in Israel to understand how they approach sexual health concerns in patients with chronic pain. The study found a striking disconnect: while more than 80% of doctors recognized that sexual dysfunction is common among chronic pain patients, fewer than 15% actually bring up the topic proactively with their patients. Additionally, nearly 90% of these specialists said they had received little to no training on sexual health, and 60% did not feel adequately prepared to address these issues when they arose.
The main obstacles doctors cited were lack of time during appointments, not viewing sexual health as a high priority compared to other pain management concerns, insufficient knowledge on the subject, and discomfort — particularly when the patient was of a different gender. These findings suggest that even when medical professionals understand that sexual health matters for their patients' overall quality of life, practical and educational barriers prevent them from consistently addressing it in clinical care.
This research suggests that integrating sexual health training into pain medicine education and creating better referral pathways could help close this gap. Chronic pain can affect sexual functioning through physical, psychological, and social channels, and addressing sexual health as part of comprehensive pain management could meaningfully improve patients' quality of life. The authors call for system-level changes to support physicians in making sexual health a routine part of chronic pain care.
Sharon H, Cohen R, Brill S, Khashan M, Hochberg U. (2025). Attitudes and knowledge of pain specialists in Israel regarding sexual health in chronic pain patients.. Scientific reports. https://doi.org/10.1038/s41598-025-15148-9