Sexual History Flashcards
How do you open the consultation?
Introduce/identify/consent
‘this is going to involve me asking some personal questions which you might find uncomfortable. Everything you tell me is confidential within the boundaries of the team looking after your care. If you would like to stop at any time please let me know’
What questions should you ask about vaginal symptoms?
Have you noticed any discharge? is it different to normal? does it smell? what does it look like?
Do you have any pain when passing urine? do you feel you are going more often?
Do you have any itching/soreness down below? whereabouts exactly?
Have you noticed any skin changes around your vagina? have you noticed any blisters/spots/ulcers around your vagina or anus?
Have you had any pain in your tummy? where? does it move? etc
Do you ever experience any pain around the time of sex? does it feel within your vagina or your stomach? when and how long does it last? (dyspareunia)
Have you noticed any rashes anywhere else? do you have any pain in your joints? pain in your eyes? do you have a fever/fatigue/myalgia?
What do you ask about a menstrual history?
When was your last period?
Do you have regular periods? are they monthly?
How long is your cycle? how long do you bleed for?
Any pain with pain or heavy bleeding during periods? is this new or longstanding?
Do you have episodes of bleeding between periods? do any occur after sexual intercourse? is this new or longstanding?
What do you ask about in a gynae history?
When was your last cervical screening/smear test? what were the results? have you ever had an abnormal result?
Have you ever had any previous treatments to your cervix?
What do you ask about in an obstetric history?
What contraception do you use at the moment? how long have you used it? any issues/ any previous contraception?
Do you think you might be pregnant at the moment?
What questions should you ask about penile symptoms?
Have you noticed any pain in your groin/testicles/penis?
Have you noticed any swellings or change in size of your testicles?
Have you noticed any genital itching? is the skin around your testicles/penis sore?
Have you noticed any redness around your genitals? have you noticed any lumps/bumps/ulcers around your penis/testicles/anus?
Have you noticed any discharge from your penis?
Do you have any pain/burning in your genitals/stomach when passing urine? do you feel you are passing more frequently than normal? is there any blood?
Have you noticed any rashes anywhere else? do you have any pain in your joints? or eyes? do you have a fever/fatigue/myalgia?
How do you ask about previous/recent sexual contacts?
Preface by saying - some of these are quite sensitive questions but are important to know the answers to to assess your risk of being in contact with an STI and the risks to other contacts
When did you last have a sexual encounter? was it consensual? how old are they? (if appropriate)
What sex was the partner in question?
What was involved in the encounter? - specify if patient gave/received or both digital/oral/vaginal/anal
Was there more than one person involved?
What contraception was used if any? at what points? ie throughout or only at a certain point, were there any issues with contraception used?
Have you had any other partners within the last 3 months? repeat above if so
What questions do you ask about PHM/PSH?
Have you had any sexually transmitted infections in the past?
Is there anything you see the doctor regularly for?
Have you been to hospital for anything in the past?
What questions should you ask about drug history?
Current medications - esp oral contraceptives, how good at taking them they are; OTC medications
Recent antibiotics
Allergies
What social history questions are important?
Smoking - how many/day? how long?
Alcohol - units/wk? specify type/vol/strength and where they drink
Have you ever taken any other drugs? IV especially significant
How do you assess HIV risk?
Have you ever had sex with a partner you know to be HIV positive?
Have you ever had sex with a bisexual man/engaged in male homosexual activity?
Have you ever had sex with someone abroad or who was born in a different country?
Have you ever injected drug?
Are you aware of any of your previous partners who have injected drugs?
Have you ever pain someone for sex/been paid for sex?
How do you close the consultation?
Summarise if appropriate
Re-affirm confidentiality or discuss if any breaches are felt to be appropriate
Thank patient
