In many situations, patients have questions that need answers, but lack the confidence or comfort to bring these topics up for themselves at their medical appointments. This is why it is vital to ensure that questions about sexual health, wellness, and any issues with sexual dysfunction are addressed by the medical professional or staff upon initial health history or review, and again at each appointment. By frankly addressing these vital aspects of human existence, this helps the patient to feel secure and empowered in bringing up intimacy and sexual related issues.
The most basic question that can start the conversation about sexual health is simply, “Have you been sexually active in the last year?”
This question is an easy opening to approach all topics and subjects underneath the sexual activity umbrella. Never assume that any of your patients are not sexually active, especially if they are over 18 years of age. Once your patient has responded to the question, you can then branch out into whichever direction you need to go. Consider a broad, open statement with question to follow up and help guide the conversation.
“I am going to ask you a few questions about your sexual health. Since sexual health is very important to overall health, I ask all my adult patients these questions. Before I begin, do you have any questions or sexual concerns you would like to discuss?”
If the patient does not object or halt the conversation, continue on with gentle questions. Depending on where you need the conversation to go with the patient and what information you seek, consider these subsequent follow ups and questions:
- “In the past twelve months, how many sexual partners have you had?”
- “Are you sexually active with men, women, or both?”
- “Do you practice safe sex and safe sex acts?”
- “What is your gender identity?”
- Gender identity is a person’s internal sense of being male, female, both, neither, or another gender.
- “What is your sexual orientation?”
- Sexual orientation is a person’s characterization of their emotional and sexual attraction to others. Examples include lesbian, gay, heterosexual, and bisexual.
- “When you are sexually active, do you have pain anywhere over your body?”
- “If so, please describe it for me.”
- “How long has this been going on?”
- “Are there things that exacerbate the pain?”
- “When you are sexually active, are you able to reach and enjoy orgasm?”
- “When you are sexually active, do you have pain with penetration or insertion?”
- “Are you dealing with any level of vaginal dryness?”
- “If so, has your skin torn or become irritated?”
- “Have you noticed or felt that your vagina feels very tight or constricted?”
- “Are you having any issues with incontinence– bladder or bowel?”
- “When you are attempting to be sexually active, are you able to achieve and maintain your erection?”
- “If you cannot, can you achieve a partial erection?”
- “Are you unable to achieve or maintain an erection?”
- “When having gynecologic or vaginal exams, do you experience pain or discomfort?”
- “Are you experiencing any breast or chest pain?”
- “If so, can you please show me where?”
These starter questions can be utilized to open broader conversations about specifics in sexual health, wellness, and sexual dysfunction issues that might be present. After getting some insight in to the patients’ issues, you can then elect to prescribe a specific therapy or treatment plan to help them get back on track. Sexual health is an important part of being a human and neglecting this aspect of care provides sub-par patient care.