Intended for healthcare professionals

Clinical Review ABC of sexual health

Management of sexual problems

BMJ 1998; 317 doi: (Published 28 November 1998) Cite this as: BMJ 1998;317:1509
  1. Margaret Ramage

    Editorial by Adler

    Sexual problems present in various ways, many indirect or covert. Patients do not like to come straight to the point. They fear looking stupid by using wrong words, or giving offence by being too explicit, or they have no way of conceptualising what it is that is wrong. A doctor can find himself or herself fumbling around in a slightly mad conversation in which nobody understands what is being said. A common language needs to be established first, particularly in sexual medicine, followed by a good history and a careful examination, if appropriate, before an assessment of relevant management can be made. Recurrent gynaecological or urological complaints, insomnia, depression, joint pains, and other symptoms have all been used as covert presentations of sexual problems.

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    Man, Woman and Fish by Emily Young

    Useful guides


    The mature couple's guide to love and intimacy. In the series Sex, a lifelong pleasure. London: Visual Corporation (tel: 01371 873 138)

    Lovers' guide (a series introduced by Dr Andrew Stanway). London: Carlton Home Entertainment (tel: 0181 207 6207)


    Zilbergeld B. Men and sex: a guide to sexual fulfilment. London: Fontana, 1986

    Brown P, Faulder C. Treat yourself to sex. London: Penguin, 1989

    Litvinoff S. Relate guide to loving relationships. London: Ebury Press, 1992

    Eid JF, Pearce CA. Making love again. Regaining sexual potency through the new injection treatment. New York: Brunner Maazel, 1993

    Quilliam S. Your sexual self. London: Cassell, 1997

    Once the presence of a sexual problem has been established, its severity and importance to the patient need to be understood before the most appropriate course of management can be offered. This can vary from straightforward education, by simply giving accurate information, to referral for psychiatric assessment (fortunately very rare). History taking is therefore the paramount skill …

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