Approaches to taking a sexual history.

Advances in modern medicine have extended the lives of many people, in both quantity and quality. One of the emerging quality of life factors for many women as they approach and pass the menopause is sexuality. Sexuality is a very important part of physical and emotional health, underscoring the importance of incorporating the sexual history as part of the overall patient history. Although health professionals may experience a degree of anxiety and discomfort in discussing sexual issues, it is nonetheless essential to learn to be comfortable in asking questions about sexuality and in responding to issues that arise from such questioning. Most patients also show some discomfort when discussing their sexual problems. A sensitive, nonjudgmental approach on the part of the physician is essential and may create an atmosphere of security for both patient and physician. It is sometimes helpful to begin the sexual history with basic, open-ended questions, thereby allowing for expansion according to the responses received. Dispelling the myth that all older people should have a declining interest in sex may help patients feel less reticent about talking to physicians about sexual matters.