Pulmonary Fibrosis and Sexual Health: A Q&A With Na’ama Avitzur, MD
Patients with pulmonary fibrosis (PF) have reported their diagnosis interfering with their sex life and sexual function, both physically and psychologically, according to
Sex and sexual function may seem taboo, especially when discussing health factors such as PF, but the lead investigator of the study said she encourages patients to talk to their health care provider in an interview with The American Journal of Managed Care® (AJMC®). The study, led by Na’ama Avitzur, MD, a pulmonary physician and a fellow at the University of British Columbia researching interstitial lung disease, aimed to address an
In this Q&A, Avitzur breaks down the study’s findings and suggests how the information can be used to advance
This transcript has been lightly edited for clarity.
AJMC: What inspired you and your colleagues to pursue this study?
Avitzur: The goal of this international multicenter study was to evaluate whether sexual function is a concern for patients with pulmonary fibrosis. Through this work, we learned that sexual dysfunction is a major issue that affects patients’ quality of life yet is rarely addressed in routine care. We hope this study can serve as a point of reference for future studies focused on understanding, addressing, and ultimately improving sexual function in people with PF.
While we may think patients are 100% focused on their disease, there are many other things in their lives that are important to them, even when they’re very functionally limited in their exertion. I’m hopeful that there will be more future studies analyzing different parts of patient sexual health and pulmonary fibrosis, or looking for different interventions or multidisciplinary ways to improve our patients’ quality-of-life. And I think it is an additional little piece that can be added to that picture of pulmonary fibrosis and quality-of-life improvements.
AJMC: Given the high prevalence of dyspnea affecting sexual activity in patients with PF, what clinical tools or interventions could help clinicians assess and address sexual function more routinely in idiopathic pulmonary fibrosis (IPF) care?
Avitzur: Part of what we used in our study was one specific question, question number 21 from the University of California, San Diego Shortness of Breath Questionnaire (UCSD-SOBQ). That question is limited in the sense that it really just assesses dyspnea during sexual activity, which is really multifactorial, and it doesn’t give us the full picture.
We are not suggesting clinicians should routinely administer lengthy sexual function questionnaires like the CSFQ used in our study, as these can be burdensome to patients who already fill out many surveys, but further research is needed to validate tools that address sexual function in PF.
In our study, patients reported that they were interested in having conversations with trusted health care providers, whether that’s their physicians, nurses, or other allied health care professionals. Therefore, I think building a relationship with our patients is essential.
Additionally, pulmonary rehabilitation could also be a helpful intervention. Some of the patients, or one of the patients we talked to, mentioned that in their local pulmonary rehab, there was a session on sexual health, so adding sessions like that could be beneficial to patients with PF.
AJMC: How might future clinical trials incorporate quality-of-life measures such as sexual health or mental health into IPF therapeutic endpoints, and what validated instruments would you suggest?
Avitzur: I think this is a good question that highlights the general idea of using health-related quality-of-life patient-reported outcomes in clinical trials. These aren’t typically used because they’re viewed as more subjective than traditional endpoints, such as lung function and things that are very objective.
But even if we’re looking at, let’s say, a trial where patients are followed over time, some of these patient-reported-outcome questionnaires, which are health-related in quality-of-life, have been validated in interstitial lung disease (ILD), or at least modified to use an ILD, the UCSD being one of them.
Although [question 21 in the USCD-SOBQ] just assesses dyspnea, there are more extensive [questionnaires], but these could be considered as therapeutic endpoints and trials. The other thing is perhaps we want to also consider using qualitative methods or mixed methods in trials as well to really get the patient voice.
AJMC: Are there emerging pharmacologic or non-drug-management strategies (eg, pulmonary rehab, psychosocial support) that you believe could mitigate the physical and psychological impacts of PF documented in your study?
Avitzur: I think the main point, and part of what drove us to do the study, or what we were hoping [to do], was reduce stigma surrounding sexual health, right? Sex is a very taboo topic, but what we discovered was that patients not only experience sexual dysfunction, but they also want to talk about it, and they want to talk about it with health care providers they trust and have a good relationship with. I think that was really insightful for us to learn from a nonpharmacological standpoint.
Practical strategies patients could consider include things like having a more passive role during sex, or if patients are using oxygen, making sure to increase their oxygen before they’re having sex; obviously, there are limitations involved with that, as we noted in our study. I think this could be something that is added to pulmonary rehabilitation programs to help address sexual dysfunction and reduce stigma. Also, adding sexual health sessions and psychosocial support, for sure, either with professionals or therapists that the patients see.
I also think there’s a lot of value in patient support groups where they can discuss with other people who have the same disease that they do, to see that they’re not the only ones with these symptoms or having issues with their sex life, and that this is a common problem. There are ongoing clinical trials looking at things like cough, pulmonary rehab, oxygen use, and mental health, and patients who continue to participate in those trials are all steps toward a more holistic approach to patient care.
AJMC: Your study highlights multiple domains affecting patients’ sexual function; how should multidisciplinary care teams (including pulmonologists, physical therapists, and mental health providers) collaborate to address these complex needs?
Avitzur: These results are just a reminder that patients are complex, and there’s not one single intervention that we can do to magically improve their sexual dysfunction or other quality-of-life challenges that these patients experience. Coming together with these teams, in a multidisciplinary way, is exactly what we should be aiming for, and future research should explore how we can develop multidisciplinary care models to optimize the best support for patients with PF.
AJMC: Considering the gap in effective therapies for IPF, what novel therapeutic targets or clinical trials (eg, immune modulation, precision medicine approaches) do you find most promising for future research?
Avitzur: This is an exciting time in the world of interstitial lung disease research. There are lots of different therapies coming down the pipeline, whether that’s for IPF or non-IPF, or even for certain comorbidities like vascular disease or pulmonary hypertension. There are a lot of things, hopefully, coming that will help our patients and improve their quality-of-life.
The goal of our study was not designed to evaluate therapeutic targets but rather to assess whether sexual function is a problem requiring more focus for patients with pulmonary fibrosis. This work is really just the tip of the iceberg to inform that sexual function is a priority for patients, and more research is required for treatment targets in this area.
AJMC: What patient education resources or support networks do you recommend for patients with IPF to help them navigate both disease management and quality-of-life challenges identified in your work?
Avitzur: I really think patient support groups are important, and from my experience working with these patients, I know they can be very beneficial to a lot of people who are ready for it. While not all patients are ready to join a support group, there are many local support groups, as well as other support in online forums on social media for patients with interstitial lung disease, not just IPF, but all forms of pulmonary fibrosis.
I’m from Canada, so the Canadian Pulmonary Fibrosis Foundation is a good website that has a lot of good resources for patients, including different videos and sessions that they’ve run in the past that they have on their website for various issues that patients with pulmonary fibrosis may face throughout their whole kind of disease course.
This study, to me, illustrated the fact that patients care about this topic, about sexual function, and they want to discuss it with their physician, and I would encourage them to do that. Physicians—this is again a topic that might be awkward to some people, but physicians and health care providers are professionals and should be ready to have these conversations.
I encourage patients not to suffer in silence. If you experience sexual dysfunction, bring this up with your trusted health care provider, because, again, it might help improve your quality-of-life and your sex life. [Patients] should know that the door is open if they want to open it, and they’re not the only ones experiencing this.
Reference:
1. McCrear S. Navigating sexual dysfunction in patients with pulmonary fibrosis. AJMC. January 22, 2026. Accessed January 28, 2026.
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