Sexual difficulties. A general practice speciality.

Sexual problems afflict many patients, and most general practitioners will have to deal with these diagnostic challenges. Between 25 and 50 per cent of difficulties have an organic cause, the remainder are emotional or psychogenic in origin. The PLISSIT counselling model is looked at, and the areas covered by the psychosexual history are discussed. A brief description of sexual physiology in men and women explains the impact of psychological factors. The effect of disease on sexuality, and its role in dysfunction, is explored and some principles of the methods of treatment are looked at. Sexual therapy and counselling provide an opportunity for the general practitioner to practise holistic medicine, and to deal with issues of great concern to patients.