mHealth technologies for pregnancy prevention: A challenge for patient-centred contraceptive counselling in Dutch general practice.

Background: A general practitioner (GP) standardly provides contraceptive counselling and care in the Netherlands. Recent years have seen the rise of mobile health technologies that aim to prevent pregnancy based on fertility awareness-based methods (FABMs). We lack high-quality evidence of these methods' effectiveness and clarity on how healthcare professionals include them in contraceptive counselling.

Depressive feelings as mediator in the relation between adverse childhood events and lower urinary tract symptoms in males and females.

Background: Adverse childhood events (ACEs) are prevalent and lead to well-established adverse health sequelae in adulthood. Recent literature has claimed that exposure to trauma in early life may worsen lower urinary tract symptoms (LUTS) because emotion can alter the perception of bodily distress in the brain. Specifically, depressive symptoms might influence the association between ACEs and LUTS.

[Testis cancer screening? Don't do it].

At the end of 2022, the Erasmus Medical Centre (Rotterdam) drew attention to testicular cancer with the 'Balls alarm' campaign. Testicular cancer is the most common cancer in young men. They were called upon to do a monthly self-examination.

[Medical termination of pregnancy by general practitioners].

A medical termination of pregnancy can be carried out effectively and safely up to 9 weeks' amenorrhea by general practitioners. In the case of an early pregnancy, reliable anamnesis and absence of risk factors for an EUG, ultrasound diagnostics are not strictly necessary before a medical termination of pregnancy. Anamnesis and/or b-HCG monitoring are a sound alternative.

Exploring concomitant pelvic floor symptoms in community-dwelling females and males.

Objectives: Researchers and clinicians tend to focus on one pelvic floor symptom (PFS) at the time. However, the pelvic floor acts as one functional unit, increasing the likelihood of concurrent PFS in patients with pelvic floor dysfunction. There is also a paucity of literature on the prevalence of concomitant PFS, especially in males.

Dutch GPs' views on prescribing mifepristone and misoprostol: a mixed-methods study.

Background: The World Health Organization has indicated that GPs can safely and effectively provide mifepristone and misoprostol for medical termination of pregnancy (TOP). Dutch GPs are allowed to treat miscarriages with mifepristone and misoprostol, but few do so. Current Dutch abortion law prohibits GPs from prescribing these medications for medical TOP.

[Elimination of HPV-related cancer: a call for screening and HPV vaccination in The Netherlands].

The World Health Organization launched a campaign on elimination of cervical cancer on November 17th 2020. In this article the authors give an overview of HPV-related cancer in The Netherlands and stress that HPV-vaccinations for boys and girls and screening for women is of utmost importance to eliminated cervical cancer in The Netherlands and the benefit for boys to avoid HPV related cancer themselves. They state that HPV vaccinations are efficient and safe.

[Mifepristone in primary care: no impediments against its use in management of missed miscarriage].

In the Netherlands, medical treatment to women with a non-vital pregnancy is provided in secondary care. In a Dutch pilot study, it has been shown that treatment of a missed miscarriage with misoprostol in primary care is an acceptable alternative. However, there are clear indications that medical treatment in women with a non-vital pregnancy is greatly improved when mifepristone is prescribed in addition to misoprostol.

Women's appraisal of the management of vulvodynia by their general practitioner: a qualitative study.

Background: Provoked Vulvodynia (PVD) is the most common cause of vulvar pain. General practitioners (GPs) are insufficiently familiar with it, causing a delay in many women receiving correct diagnosis and treatment. Besides patients factors, this delay can partly be explained by the reluctance of GPs to explore the sexual context of PVD and by their negative emotional reactions such as helplessness and frustration when consulted by patients with medically unexplained symptoms like PVD.

The Relationship Between Vulvovaginal Candidiasis and Provoked Vulvodynia: A Systematic Review.

Background: Provoked vulvodynia (PVD) is a chronic vulvar pain condition affecting up to 8.3% of the female population. Despite many years of research, no clear cause for PVD has been identified.

[#DoctorsToo].

At the end of 2017, the worldwide spread of the #MeToo symbol clearly showed the extent of sexual harassment in both the public domain and the workplace. In healthcare too, it is known that some doctors have unwanted sexual contact with their patients and with young doctors in training. In the opinion of the authors, measures taken against sexual harassment in healthcare so far do not seem to be very effective.

Facilitators and barriers in the diagnostic process of vulvovaginal complaints (vulvodynia) in general practice: a qualitative study.

Background: The gap between the relatively high prevalence of provoked vulvodynia (PVD) in the general population and the low incidence in primary care can partly be explained by physicians' lack of knowledge about the assessment and management of PVD.

Objectives: To recognize barriers and facilitators of GPs in the diagnostic process of women presenting with recurrent vulvovaginal complaints.

Methods: A qualitative focus group study in 17 Dutch GPs, five men and 12 women.

Screening for sexual dissatisfaction among people with type 2 diabetes in primary care.

Aims: The identification and discussion of sexual care needs in people with type 2 diabetes mellitus (T2DM) in primary care is currently insufficient. The objective of this study was to determine the prevalence of sexual dissatisfaction, sexual problems and need for help by using a screening instrument among people with T2DM in primary care.

Methods: Data were collected in 45 general practices in the Netherlands from January 2015 to February 2016.

Is uncertain vulvovaginal candidiasis a marker of vulvodynia? A study in a Dutch general practice research database.

Background: A recent Dutch study in general practice showed a clear relationship between the diagnosis of vulvovaginal candidiasis (VVC) and symptoms suggestive of provoked vulvodynia (PVD). PVD accounts for the largest group of vulvar pains, but is often not recognised by GPs.

Aim: To investigate whether diagnostic uncertainty about VVC in general practice could also point to the diagnosis of PVD, and whether and how this diagnostic uncertainty affects management.

[Sexual history-taking in medical practice: the elephant in the room?].

Recently, the Dutch College of General Practitioners released a Practice Guideline on Sexual Problems which provides clear directives for the diagnosis and management of various sexual disorders in men and women. Patients who are managed in general practice and in outpatient clinics might experience distress related to sexual problems due to their age, medical condition or treatment, or distress related to problems in establishing and maintaining intimate relationships. We present two clinical cases.

[The Dutch College of General Practitioners practice guideline on 'Sexual problems'].

The Dutch College of General Practitioners practice guideline on 'Sexual problems' describes the diagnostics and management of common sexual problems. An adequate sexual anamnesis is essential in order to obtain a good picture of the patient's symptoms and of any underlying causes. Additional physical or other medical examination is of limited value.

Efficacy and Safety of Flibanserin for the Treatment of Hypoactive Sexual Desire Disorder in Women: A Systematic Review and Meta-analysis.

Importance: In August 2015, the US Food and Drug Administration (FDA) approved flibanserin as a treatment for hypoactive sexual desire disorder (HSDD) in premenopausal women, despite concern about suboptimal risk-benefit trade-offs.

Objective: To conduct a systematic review and meta-analysis of randomized clinical trials assessing efficacy and safety of flibanserin for the treatment of HSDD in women.

Data Sources: Medical databases (among others, Embase, Medline, Psycinfo) and trial registries were searched from inception to June 17, 2015.

Comorbidities Among Women With Vulvovaginal Complaints in Family Practice.

Background: The lifetime prevalence of women suffering from provoked vestibulodynia (PVD) is estimated to be approximately 15%. The etiology of PVD is not yet clear. Recent studies approach PVD as a chronic multifactorial sexual pain disorder.

Effectiveness of a PLISSIT model intervention in patients with type 2 diabetes mellitus in primary care: design of a cluster-randomised controlled trial.

Background: Sexual dysfunction is prevalent in patients with type 2 diabetes mellitus, but remains one of the most frequently neglected complications in diabetes care. Both patients and care providers appear to have difficulty with discussing sexual problems in diabetes care. A sexual counselling model for care providers, such as the PLISSIT model, might be a useful tool to improve the discussion of sexual issues in patients with type 2 diabetes mellitus.

Outcome predictors of Internet-based brief sex therapy for sexual dysfunctions in heterosexual men.

The authors investigated whether baseline and therapy process characteristics of 82 heterosexual men participating in an Internet-based sex therapy study predict posttreatment sexual functioning. Problem severity, baseline sexual desire and baseline sexual satisfaction, but also partner problems and quality of the therapeutic relationship are predictive for sexual functioning and sexual satisfaction after finishing Internet-based sex therapy. The obtained outcome predictors could benefit men with sexual dysfunctions by tailoring online therapy programs to their individual characteristics.

[Practice guideline 'Premature ejaculation'].

In 2010 the International Society of Sexual Medicine published its practice guideline for the diagnosis and treatment of premature ejaculation. This guideline was translated and adapted on a number of points by a committee consisting of members of two Dutch sexological societies, the 'WVSD' and the 'NVVS'. The most important subjects in this guideline are: (a) the case history is the most important diagnostic tool; (b) a physical examination is usually not necessary; (c) determination of the subtype of premature ejaculation can guide treatment; (d) pharmacotherapy alone is only applicable for primary premature ejaculation; (e) combination therapy is preferable for the secondary form of premature ejaculation, and pharmacotherapy is contraindicated for the other 2 subtypes.