Welcome to The Sex Issue: A Guide to Patient Sexual Health Topics. The World Health Organization defines sexual health as "a state of physical, emotional, mental and social well-being in relation to sexuality...not merely the absence of disease, dysfunction, or infirmity." Many factors can influence patients' positive feelings about their sexuality, including age, culture, and relationships. Explore more about cultural impact by reading "The Influence of Mother-Daughter Connectedness on Sexual Activity" (page 36).
For many of us, it can be uncomfortable to broach the subject of a patient's sexual history. However, assessing our patients' sexual health is vital to maintaining and optimizing their physiologic and psychosocial health. In "How to Take a Sexual Health History," we discuss key points you need to know (page 6).
Opening the dialogue about a patient's sexual health requires a confidential, respectful, accepting, and positive approach to sexuality and sexual relationships. Sexuality is diverse and unique to each individual patient. It's a way to convey love, affection, and intimacy that can positively impact the patient's physical, emotional, and social well-being. Learn about best practices for our lesbian, gay, bisexual, and transgender patients and families in "A Center of Excellence Model for LGBT Patient Care" (page 15).
A sexual health history includes the patient's past and current sexual practices, identifying at-risk behaviors, exposure to sexually transmitted infections, and any sexual dysfunction. Get the facts about a common vaginal infection in "Danger! Bacterial Vaginosis During Pregnancy" (page 28) and how hormonal imbalance can be a common cause of sexual dysfunction for men in "Get to Know 'Low T'" (page 30).
When taking a sexual health history, we provide a safe space for patients and their partners to ask questions about their sexual health. Our post-op patients may require sexual activity recommendations at discharge to reduce the risk of complications. We can offer proactive evidence-based practice recommendations to support the patient's sexual health. Read more about this in "Talking with Your Post-op Patients about Sex" (page 12).
The sexual health history also allows us to identify patients who may be victims of sexual assault. We must be prepared to meet the physiologic and psychological needs of these patients as discussed in "Understanding Sexual Assault" (page 42). Our patients can experience varying degrees of sexual harassment in their school, work, and home environments. See how to respond in this issue's Ask an Expert: "Sexual Harassment in the Workplace" (page 55).
Sexuality can be expressed throughout a patient's lifespan. "Sex and the Older Adult" (page 20) provides tips for helping older patients achieve optimal sexual health and intimacy. As patients age, they may experience dementia, which can cause them to exhibit sexual disinhibition. In "Sexually Inappropriate Behavior in Patients with Dementia" (page 51), you'll find intervention strategies.
Providing our patients with an open forum to convey an accurate sexual health history throughout their lifespan helps us encourage physiologic, psychosocial, and sexual wellness. And that's what this special issue is all about!