Obtaining the Sexual History

Question 1

How to begin asking about sexual history

Answer 1

Taking a sexual history is an important part of a regular medical exam. I would like to ask you some questions about this if that’s alright

Question 2

What are the 5 P’s of sexual history?

Answer 2

partners
practices
STI protection
Past STIs
Pregnancy Planning or prevention

Question 3

What age group is most affected biennia STIs each year?`

Answer 3

15-24 (~50%)

Question 4

What is the average age of menarche?

Answer 4

10-16 (age of first menstruation)- the first few cycles are anovulatory

Question 5

What does the age of menarche depend on?

Answer 5

1) hormones

2) more adipose tissue= earlier age of menarche

Question 6

What is the average age of menopause?

Answer 6

range: 40-55

average is 51

Question 7

What is the menstrual cycle defined as?

Answer 7

the time between the 1st day or a period and the 1st day of the next period (normal 21-35 days)

Question 8

What is the duration of the menstrual cycles defined as?

Answer 8

number of days of bleeding (average 2-7 days)

Question 9

What is withdrawal bleeding?

Answer 9

bleeding that occurs following cessation of exogenous estrogen or progesterone products

Question 10

What is dysmenorrhea?

Answer 10

painful menstruation

Question 11

What is menorrhagia?

Answer 11

excess menstrual flow (bleeding)

Question 12

What is metorrhagia?

Answer 12

uterine bleeding at irregular intervals, particular BETWEEN expected menstrual cycles

Question 13

Menometrorrhagia is what?

Answer 13

uterine bleeding at irregular intervals, particular BETWEEN expected menstrual cycles that involves excessive blood flow

Question 14

What is amenorrhea?

Answer 14

Basically means a woman is not having menstrual cycles

Question 15

What is primary amenorrhea?

Answer 15

absence of menarche in the expected window (i.e. if a young woman hasn’t begun her menstrual cycles by age 16)

Question 16

What is secondary amenorrhea?

Answer 16

no menstruation for 6+ months

Question 17

What is oligomenorrhea?

Answer 17

condition characterized by “too few (oligo)” cycles with 6 weeks to 6 months between cycles

Question 18

What is dyschezia?

Answer 18

pain with defection

Question 19

What is dispareunia?

Answer 19

pain with or following sexual intercourse

Question 20

What is Mittleschmertz?

Answer 20

abdominal pain associated with ovulatory pain (seen often in adolescents and seen during mid-cycle)

Question 21

What is postcoital bleeding?

Answer 21

bleeding after sex ( think of STIs or tissue atrophy in post-menopausal women)

Question 22

What is breakthrough bleeding (BTB)?

Answer 22

bleeding that occurs while a patient is taking hormone therapy (continuous oral contraceptives or hormone therapy)

Question 23

What is menopause?

Answer 23

cessation of menstrual cycle due to depletion of primordial follicle depletion

Question 24

What does the term “climacteric” mean?

Answer 24

it indicates the stage where a women is still having menstrual cycles but is transitioning to menopause (mood changes seen, hot flashes)

Question 25

What is post-menopausal bleeding?

Answer 25

bleeding that occurs 1+ years after menopause (not related to exogenous hormone use)

Question 26

T or F. ~50% of pregnancies are unintended

Answer 26

Approximately true. (~51% in 2008). Women with incomes

Question 27

What is the most important question regarding menstrual history?

Answer 27

When was your last normal cycle?

Question 28

What is the range for a full-term pregnancy?

Answer 28

37-42 weeks