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Women suffer poor sexual and reproductive health

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Almost half of British women experience poor sexual and reproductive health, a much higher number than men, with many also experiencing a larger range of issues, according to new research.

This is one of the findings from a major new study published by BMC Public Health using interview data from more than 7,000 women and 5,000 men from Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal).

Cuts to budgets and a fragmented commissioning system have created barriers that prevent women from accessing holistic care.

Public health budgets have witnessed substantial cuts since 2015.

Councils’ public health grant has been reduced by £331 million from 2016/17 to 2020/21. This followed a £200 million in-year reduction in 2015/16. By 2019/20, public health budgets will have been cut by a total of £700 million.

So currently more than 8 million women of reproductive age now live in areas where the local councils have reduced their Sexual and Reproductive Health budgets.

The Faculty of Sexual and Reproductive Healthcare (FSRH), the Royal College of Obstetricians and Gynaecologists (RCOG), the Royal College of General Practitioners (RCGP) and the Academy of Medical Royal Colleges (AoMRC) have now called for an end to the fragmentation of sexual and reproductive healthcare services.

They would like to see holistic integrated commissioning of sexual and reproductive healthcare, because of the negative impact of the current situation for women.

Women, who make up half of the population, are being failed by a fragmented system.

The UK’s population behaviour continues to change, with a widening of the gap between when people start having sex and the age when they have their first child.

Women are, therefore, spending a longer time preventing unplanned pregnancies and a lifetime of managing their reproductive and post-reproductive health. The current system does little to support this reality.

The National Survey of Sexual Attitudes and Lifestyles’ analysis considered 18 different issues in three sexual and reproductive health domains: risk of unplanned pregnancy and sexually transmitted infections (STIs); sexual function problems – for example, lack of interest in sex, painful sex and erectile dysfunction; and sexual coercion, including nonvolitional sex since the age of 13.

And in addition to finding that almost half of British women experience poor sexual and reproductive health in these areas, the study found that women experience a wider variety of issues than men, and that many report a low interest in sex.

Many of the women reporting sexual function problems were not necessarily at high risk of unplanned pregnancies and/or STIs.

The study also identified a smaller group of “highly vulnerable” women who reported adverse experiences in all sexual and reproductive health areas above, from risk of unplanned pregnancies to sexual coercion.

The researchers conclude groups such as women with low interest in sex and “highly vulnerable” women risk being overlooked by intervention efforts because their profiles differ from those traditionally considered at risk of adverse outcomes, underscoring the need for tailored approaches.

They call for interventions with the “most widespread benefits” at a time of budget constraints.

Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare, said: “This study confirms what we have been warning for years: that women are falling through the cracks of an underfunded and fragmented sexual and reproductive healthcare system.

“There are surely multiple factors at play, including personal reasons, leading to almost half of British women experiencing poor sexual and reproductive health, but we cannot continue to ignore that a large part of the population is not accessing the help and care they need.

“Women’s health has stood to suffer the most from the reorganisation of NHS services in 2013,” Dr Kasliwal continued.

“Where once women could have all their sexual and reproductive health needs met in one place and one go, women are now often subject to non-holistic, disintegrated care.

“However, as this study shows, seemingly different sexual and reproductive health issues have common underlying factors, and these results show why we need holistic, integrated commissioning of sexual and reproductive healthcare.

“FSRH calls for strategic prioritisation of women’s health in national policy to tackle this large unmet healthcare need.

“Women must be placed at the heart of the recently announced sexual and reproductive health strategy, which has the potential to significantly improve the lives of 51 per cent of the population.”

To read the report, click here.

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