Taking a sexual history

Significant social changes have resulted in increased exposure to sexual issues and greater tolerance of sexual behaviours such as premarital sex and homosexuality. These changes are not universal, however. We live in a multicultural society with widely varying sexual mores and frequent clashes of culture across generations. The media has contributed to unrealistic expectations about body image and sexual performance while at the same time increasing awareness of sexually transmitted diseases. Consequently, patients seek help with these issues and will discuss them freely if the general practitioner is comfortable in the area of sexual health.

This article outlines an approach to sexual assessment and ways of addressing the barriers faced in taking a sexual history.

All sexual disorders involve biological, psychological and social factors. General practice can provide a safe, non-judgmental environment for the patient to divulge sexual difficulties and have these dealt with holistically. However, this takes time, a significant obstacle in current practice.