Sexual History: Importance, Process, and Tips for Patients and Clinicians

Sexual History – Sex may be something you don’t prefer to talk about. No matter how modern and developed we have become, this topic has still remained a taboo in our society. But opening up to your friends and family is far more difficult than to professionals who are intended to help you with your doubts, and there is a method to get this done through a process called sexual history. Let’s dig a little deeper into sexual history and how it is conducted.

What Does Sexual History Mean?

Sexual history is a process in which a set of questions and topics are discussed by a healthcare provider with the patient to detect the risk of acquiring sexually transmitted diseases and to get an understanding of their sexual health. In sexual history, the clinicians can help you to realize your high-risk sexual behaviours and practices. Moreover, sexual history is also taken by healthcare providers prior to your STD screening to get a better idea about the infection. Further, they can assist you with your questions and curiosity regarding your sex methods and practices, so you can nurture healthy sex relationships. Sexually active people should regularly get their sexual history done to lead a happy and healthy sex life.^[1]^[5]

Read Also: Orgasm gap: What you need to know

What Is Your Role As A Patient?

As a patient, you need to keep in mind the following points in your mind during your sexual history^[3] :

Giving the correct info: Talking about sex life could be overwhelming and awkward as everyone doesn’t feel comfortable. This could lead you to give false answers to avoid embarrassment, leading to complications in the further procedure. So being honest to your clinician is essential.
Trusting your healthcare provider: It’s necessary to build trust with your healthcare provider so that you can open up freely while giving correct information. It’s suggested that you go to your known and trusted specialist to make sure your information is confidential.
Open-up voluntarily: As sex has always been considered a taboo in our society, it could be equally tough for the professionals to feel awkward during the process. So you should try to open up by yourself to make it easier.
Getting a sexual history done regularly: To live a healthy and peaceful sex life, it’s mandatory to get sexual history done regularly and as needed. This can avoid the risk of STIs and provide you better clarity over your sex practices.

Learn more: Dyspareunia (painful intercourse): Causes, treatments and more

Things To Keep In Mind As A Clinician

There are lots of responsibilities of the clinician as well, during taking the sexual history of any patient. Here are a few things mentioned that clinicians keep in mind.^[1]^[5]^[6]^[8]

Comforting and assuring: It’s important to make a comforting environment for patients by mentioning that they are not the only people who are having complications regarding sex and STDs. Also, assuring them that their personal information will be confidential and convincing them to open up and answer.
Keep the info confidential: It should be morally compulsory to maintain the confidentiality of the patient’s personal information. Maintaining the trust of patients is mandatory.
Focusing on the patient’s concern: It’s needed to focus on the symptoms and issues the patient is facing and carrying the procedure accordingly. Along with this, the questions and doubts about which they are curious must be answered thoroughly.
Don’t make assumptions: The major mistake clinicians make is to make assumptions about patients’ sex life. Instead, all questions must be asked in detail to avoid any misconception. The five P’s of sexual history elaborate on which questions professionals must ask.
Explaining and taking permission: It is significant to explain the importance of the questions you are asking to the patients for their healthy sexual life and STD diagnosis. Also, if patients don’t exactly come up with the problems related to sex, ask them if they would be fine to discuss questions related to their sex life for better understanding and treatment.
Pay attention to your body language and gestures: If a doctor seems to be embarrassed, the patients feel more uncomfortable and embarrassed. So it is essential to keep your body language and gestures neutral even if you feel confused or embarrassed.

What type of words should be used?

Words are the basis of effective communication and when it comes to critical topics like sex, it’s necessary to be careful with the words you are using. While taking sexual history, it is important to use the words that are understandable and don’t make the patients feel awkward. Following are some points to keep in mind while choosing the words for taking a sexual history:^[7]

It is mandatory to use the sexual words which would be understood by the patient and equally acceptable.
If patients use any word which creates even the slightest of doubt in your mind, it’s better to clear the meaning to avoid any miscommunication.
Moreover, it’s better to ask them about the words they use in their day-to-day life and then use those words accordingly for better clarity.
Also, ensure if the patient is comfortable with the words you are using or not.
If the patient seems to be confused, use the alternative words for those terms for better clarity. For example, sexual intercourse – sex – while getting physical – while doing it.

Learn More: Penis Hygiene: How to clean your penis and Safety Tips

Five P’s Of Sexual History

During examination, the clinician asks lots of questions to the patient, so that they better understand their sexual history, and the questions revolve around the five p’s of sexual history, that is mentioned below.^[3]

Partner: Asking about a person’s number of partners with whom they are sexually active and how often he/she get physical with them is a part of sexual history. Also, the sexuality of the partner and patient should be clarified. The last time they had sexual intercourse with their partner is also asked.
Practices: The type of sexual practice and behaviours preferred by the patient should be asked. The high risk behaviours must be pointed out. Also, type of sex – vaginal, oral or anal, preferred regularly must be asked, along with the self-stimulation technique if any.
Protection From STDs: It is also asked whether the patient gets the regular STD screening or not. Also, contraceptives and protections used must be known to clinicians to continue the process smoothly.
Past History of STDs: Patients must disclose their past STI history, if any, and also of their partners. Moreover, opening up about your past infections is necessary, as chances of being infected increase if you are infected before.
Pregnancy intentions: It is equally important to know whether the patient has been planning for pregnancy or not. Also, if they are intended to do so in the future, and if yes, then how soon?

Some other P’s: pleasure, Performance, and Pride

Other than the five p’s, there are other p’s as well, that is pleasure, performance, and pride. Sometimes the questions revolved around these p’s too. So worry about it, let’s discuss these p’s in detail.^[4]

Pleasure: Having a pleasurable sex is a testimony of a person’s overall well-being. Asking the patient whether they and their partners feel good while having sex or orgasm is equally important. This can also expose problems like premature ejaculation, dyspareunia, vaginismus, anorgasmia, or ejaculatory incompetence.
Performance: Physicians should also ask patients about what they feel about their own and their partner’s performance during sexual intercourse. Do they face problems while satisfying their partners, or are they satisfied with their partner? These questions may ultimately lead to the exact problems they are facing.
Pride: Also, it is needed to ask if they are aware and confident about their sexuality or sexual orientation. Are their family and friends supportive regarding their gender identity and sexuality? Also, questions regarding current harassment or violence are part of sexual history.

Learn More: Unlocking the Power of Foreplay: Why It’s Important and Surprising Benefits

Talking About Trauma and Sexual Violence

Patients who have arrived can be the victims of sexual assault and need to be handled with care and caution. Clinicians should warn patients about the questions that could be triggering for the patient before starting the conversation. Past trauma could affect a person’s current sex life. So, the clinicians should be empathetic and comforting towards them. Also, convincing them how opening up about this is important for their health is essential. Moreover, providing help to those who are right now in need should be ensured.^[3]

Importance Of Getting a Sexual History Done

There are a lot of benefits of getting sexual history or communicating with a doctor openly. Here are some benefits.^[2]

Future serious health issues regarding STIs could be avoided if detected and discussed through sexual history. The diagnosis and treatment are recommended earliest.
Your sex life and relationships could get healthy and better if you get regular professional assistance. Your mental, physical, sexual, and emotional health improved.
To get your doubts cleared about your sex practices and methods, having a sexual history is needed. Professional assistance provides you with a better understanding.

A note from kamarth

Sexual history is an important discussion between a patient and a professional, which includes significant aspects of the patient’s sex life. It is required to get a sexual history done as soon as you get any symptoms of STDs, and also even if you need clarity regarding your sex practices and behaviours. During the process, both clinician and patient got certain roles to perform to make it a success.

Also, the five P’s model of sexual history is well known and commonly used as it provides an easier approach to clinicians. Moreover, comfort and confidentiality of the patient’s sex life are essential factors in sex history. Along with this, clinicians should be cautious regarding the past traumas and sex assaults the patient has ever faced and question accordingly.

Some Additional Doubts

Question: Should I ask about the sexual history of my partner?
Answer: Yes, sexual history can be asked between partners but only if your partner feels comfortable. It can’t be forced.

Question: What are the p’s of sexual history?
Answer: It’s a method to conduct the sexual history for the professional. It includes basic and necessary questions about partner, practices, past history of STDs, protection from STDs, and pregnancy intentions.

Question:. Does sexual history include questions regarding your sexuality?
Answer: Yes, sexual history includes questions about whether you are homosexual, heterosexual, or bisexual.

Question: How do you take a full sexual history?
Answer: To take a full sexual history, you should answer every question, from the number of partner to their past STD screening. Sexual history taken in healthcare centres should be detailed and include every aspect of sex life to get clarity.

Question: Why do I not feel pleasure during sex?
Answer: There could be many reasons, like being asexual or other complications like vaginismus or more. It is important to contact your healthcare provider.

Reference links: