Patients and Partners – about sexual problems

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Asking sexual partners about each othera��s sexual function is often very useful. Women ranked a�?partner sexual difficultiesa�? as a common sexual concern. If both members of a couple are in the office, it becomes easy to introduce the topic by asking a�?How are you two doing together? How are you doing with sex?a�? If only one member of a couple is available, questions can still be asked about the present patient as well as the partner. When a sexual dysfunction is identified, talking to the partner can reveal a different picture that may substantially affect management and can also have a therapeutic effect. Relationships have a profound effect on sexual health and often need to be explored to amplify the likelihood of successful resolution of the problem.

If the patient or partner initiates discussion about sex or has a specific question, this requires attention equal to that of other patient complaints. If the clinician is lucky, the concern will be voiced early in the visit, allowing for some exploration of the issues. More often, if the patient or partner is not asked about sexual issues, they will discuss problems at the end of the visit. Although this may seem like an afterthought, for many, it may be one of the major (if not the major) reasons for the visit. An initial impression that their problem is being dismissed can considerably delay or prevent them from seeking further help.

Partner issues vary widely. Patients may be having sex with one partner, multiple part-ners, partners of the opposite sex, partners of the same sex, or a combination of these. Issues around partner choice, partner participation in sexual activity, and partner physiol-ogy may impact sexual function. All of the emotional components of a good relationship contribute to continued sexual satisfaction. Relationship factors often play a role in mena��s sexual problems. Early in relationships, partners try to please and be sensitive to one another. After time, these efforts may be abandoned and sex may become perfunctory in both form and function. Sildenafil citrate canadian pharmacy

Successful treatment of sexual problems is most likely to occur when couples have a good relationship and are able to communicate their positive and negative feelings to each other. Many men may prefer to be evaluated and treated for sexual problems alone, but when a partner is present, patient education may convince the man of the importance of including the partner in further management.

If inadequate time exists to discuss the issue, recognition should be made of the patienta��s problem or concern and another time should be scheduled to further discuss the issue. Merely spending time clarifying the nature of the problem can lead to more effective treatment and may, in itself, be therapeutic. Alternatively, the patient can be given a referral to another clinician if the primary care clinician is uncomfortable, but even a proper referral requires some further exploration.