Uncontrolled retrospective study links structured sexual healthcare with improved sexual activity among women with gynaecological conditions

A structured sexual healthcare pathway implemented in a tertiary public gynaecological service in Barcelona was associated with documented improvements in sexual activity and sexual well-being among 184 women with gynaecological conditions and suspected sexual dysfunction, according to the study abstract. The retrospective, uncontrolled, single-centre design does not establish that the pathway caused the observed changes, and the researchers state that conclusions about scalability and resource efficiency are not supported.

The study included women aged 18 years or older who were referred for a specialised sexual health consultation at the hospital between January 2016 and December 2023. The intervention was a structured, stepwise approach delivered by gynaecologists with postgraduate training in clinical sexology. Outcomes included continuity within the planned follow-up pathway, treatment delivery, sexual activity and overall sexual well-being. Clinical outcomes were derived from assessments documented at each participant’s last recorded consultation, and no validated patient-reported outcome measures were used. Participants had a mean age of 41.6 years, with a standard deviation of 13.1 years.

The proportion of participants documented as sexually active rose from 58.7% at baseline, representing 108 of 184 women with a 95% confidence interval of 51.2% to 65.9%, to 84.8% at the last documented assessment, representing 156 of 184 women with a 95% confidence interval of 78.8% to 89.6%. Among the 76 women who were sexually inactive at baseline, 48, or 63.2% with a 95% confidence interval of 51.3% to 73.9%, had resumed sexual activity by the final documented assessment. This difference was reported as statistically significant in an exact McNemar test, with p less than 0.001. Overall, 101 participants, or 54.9% with a 95% confidence interval of 47.4% to 62.2%, experienced improvement in sexual health, defined as resolution of symptoms or adaptation to a satisfactory sexual life despite persistent symptoms. Another 33 participants, or 17.9% with a 95% confidence interval of 12.7% to 24.3%, reported a neutral or non-prioritised sexual life. Continuity within the planned follow-up pathway was documented for 118 of 184 participants, or 64.1%, with a 95% confidence interval of 56.7% to 71.1%.

These findings describe the real-world implementation and recorded outcomes of one pathway in one hospital over an eight-year referral period. The investigators identified the retrospective, uncontrolled design as a limitation on causal inference. The absence of validated patient-reported outcome measures also means that improvement was based on documented clinical assessments rather than a standardised instrument for measuring patient-reported sexual health outcomes. Because the study was confined to a single tertiary public hospital, the abstract does not support claims about effectiveness in other settings, scalability or resource efficiency.

Subject of Research: Real-world implementation and documented outcomes of a structured sexual healthcare pathway for women with gynaecological conditions

Article Title: Integrating structured sexual healthcare into a public gynaecological service: a single-centre retrospective implementation study

Article References: Anglès-Acedo, S., Barfull, A., Ribera-Torres, L., López-Frías, L., Sánchez, E., & Castelo-Branco, C. (2026). Integrating structured sexual healthcare into a public gynaecological service: a single-centre retrospective implementation study. BMC Public Health. https://doi.org/10.1186/s12889-026-29633-x

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29633-x

Keywords: sexual health, gynaecological care, structured care pathway, sexual activity, sexual well-being, retrospective study, clinical sexology, Barcelona, women’s health, Integrating, structured, sexual