More than 40% of women will experience a sexual health problem at some point in their lives. Fewer than 10% will bring it up with a physician. That gap isn't a patient failure. It's a clinical opportunity, and one that general practitioners are uniquely positioned to close.

Routine gynecologic care keeps women healthy. But sexual wellness and hormone management occupy a distinct clinical space. Novant Health is excited to now offer specialty services offering dedicated time and a framework that most primary care appointments aren't structured to support. Knowing when to refer, and to whom, can meaningfully change outcomes for patients who would otherwise go unheard.

What annual visits reveal about your patients' sexual health

Many of the symptoms your patients bring to annual visits are signals of a deeper concern they haven't yet named. Vaginal dryness, pain with intercourse, low libido, difficulty with arousal or orgasm, pelvic floor dysfunction and menopausal symptoms like hot flashes, night sweats, brain fog and sleep disruption are all referral-worthy presentations when they're affecting a patient's quality of life.

These symptoms don't resolve on their own, and patients would benefit from a referral to a physician with the subspecialty expertise to evaluate the full biopsychosocial picture: the brain, the pelvic floor and the genital organs together, not in isolation.

What subspecialty care brings to your patients

Dr. Maggie Evans, ob-gyn, practices at the Novant Health Menopause Care & Sexual Wellness Center on Daniel Island on Daniel Island. Board-certified in obstetrics and gynecology with more than 20 years of experience, she has built her subspecialty around the conditions that most often go unaddressed in routine care.

Her clinical tool kit includes hormone replacement therapy, FDA-approved medications for low sexual desire (Addyi and Vyleesi), off-label testosterone for libido, vaginal tissue treatments, nonhormonal options for women who cannot or choose not to use hormones and referrals to pelvic floor physical therapy and sexual health therapists when appropriate. That breadth matters: Sexual health concerns rarely have a single-system cause, and effective treatment usually requires a coordinated approach.

"Sexual health and hormone management are issues that affect every woman during her lifetime, but many women aren't comfortable talking about them. As a gynecologist specializing in this area, I want to give every one of my patients a chance to share their concerns and ask their questions so they can get the care they deserve."

A practical referral guide for general practitioners

Consider referring when your patient presents with one or more of the following:

• Vaginal dryness or atrophy causing discomfort or interference with daily life
• Dyspareunia (painful intercourse) that hasn't resolved with initial management
• Low libido or loss of desire that's distressing to the patient
• Difficulty with arousal or orgasm
• Pelvic floor dysfunction, whether hypertonic or hypotonic in presentation
• Menopausal symptoms that are disrupting sexual health or overall well-being

Your role in creating space for these conversations is irreplaceable. Even a brief, direct question during an annual visit, "Are you experiencing any changes in sexual comfort or desire?" can be enough to open the door. From there, a referral can carry the conversation forward with the time and expertise it requires.

Refer with confidence

Novant Health ob-gyn physicians specializing in sexual health and hormone replacement are available across North and South Carolina, so your patients can access expert care close to home. Our board-certified specialists bring focused training in menopause management, hormone replacement therapy and sexual wellness to clinics throughout the region. For patients who prefer a flexible option, Novant Health also offers virtual menopause clinics, giving them access to specialized care without the need to travel.

Your patients don't have to manage these symptoms alone, and you don't have to navigate these conversations without a subspecialty partner.