Essay on "Sex History Assessment and Evaluation"

Quoted Instructions for "Sex History Assessment and Evaluation" Assignment:

PLEASE READ THE INFORMATION BELOW CAREFULLY :

The format needs to be as a narrative not questions and answers

This should be a sexual history and assessment of an 30 years old white female who has an alcohol dependency problem who came to you with the concern of sexual dissatisfaction with her partner and wanted to know what her problem is. Make (or pretend) that you have that woman as a patient and do or pretend doing approximately 2hr of sexual history intake , you would find some guideline about that history intake style , that is not enough time for a comprehensive history and assessment how ever you can do a practical one suitable for working with that individual. After that interview the information that you gathered submit a written sexual history and assessment of that individual, it should take 4-5 pages and for the last page of the paper include your over-all professional impressions and assessments and any areas that you might pursue should you have the opportunity. Use pseudonyms or initials and guard for complete confidentiality and anonymity.

A HELPFUL GUIDELINE FOR THE SEXUAL HISTORY INTAKE:

Core sexual history components

Reasons for attendance

Symptom review

Last sexual intercourse (LSI) - date, patient gender, sites of exposure, condom use

Previous sexual partners - as for LSI

Previous STIs

For women - LMP, contraceptive and cytology history

HIV, Hepatitis B & C risk assessment

Establish mode of giving results

Presenting complaint

Symptom Review

History of the presenting complaint

In women:

Change in vaginal discharge

Vulval skin problems

Lower abdominal pain

Dysuria

Changes in menstrual cycle or irregular bleeding

Partners

Are they sexually active?

Sexual history should cover all partners within the last 3 months.

If no partners are reported during this time, then the last time the patient was sexually active should be noted.

If the patient is symptomatic, the sexual history should cover all partners during the incubation period of STIs that may cause current symptoms.

Where no unprotected penetrative oral, vaginal or anal sex is reported during this period, ask the last time that this took place.5

Check the relationship of symptoms to LSI or to intercourse with a particular partner.

Condom use - always, sometimes or never.

Type of sex - e.g. oral, vaginal, anal.

Symptoms or diagnosis of partner(s).

Sex with same or opposite sex partners - check directly *****"Have you ever had sex with another man?*****"

Sex work - *****"Have you ever been paid for sex?*****"

Partners from overseas in the last year.

Menstrual history and contraception

Check if contraception used and if so what method.

Check correct usage.

LMP/LSI in relation to cycle/possibility of pregnancy.

Menstrual abnormalities (intermenstrual or postcoital bleeding).

Previous STIs

Previous diagnoses (and dates)

Treatment

Compliance

Treatment of partner (consider risk of reinfection)

Psychosexual

Where a sexual *****'problem*****' or dysfunction has been identified, ask:6

How the patient sees the problem and what they consider the cause.

The duration of the problem and whether it is related to the time, place or partner.

Loss of sex drive or dislike of sexual contact.

Sources of stress, anxiety, guilt or anger.

Any physical problems e.g. pain.

Carefully exclude illnesses that may affect sexual performance (e.g. CVD, testosterone or thyroid deficiency, pelvic or spinal trauma/surgery, arthritis).

In addition:

Past medical and surgical history

Current medication, including over-the-counter and recreational drugs

Allergies

Smoking and alcohol use

IV drug use with needle sharing (ever) and last use