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Sexual History

Sexual History. Ejay Harris. Where to start?. WIPE Open ended question……vaginal discharge. Vaginal discharge ….now what?. Causes; Physiological STI – Chlamydia trachomatis, Neisseria gonorrhoeae , Trichomonas vaginalis Infective – Bacterial vaginosis, candidal infection

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Sexual History

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  1. Sexual History Ejay Harris

  2. Where to start? • WIPE • Open ended question……vaginal discharge

  3. Vaginal discharge ….now what? Causes; • Physiological • STI – Chlamydia trachomatis, Neisseria gonorrhoeae , Trichomonas vaginalis • Infective – Bacterial vaginosis, candidal infection • Anatomical - fistulae • Malignancy - – cancer of cervix, uterus, ovaries • Inflammatory – Vulval dermatitis • Others – cervical polyps, foreign body, erosive lichen planus, allergy

  4. How to start a sexual history • Make it routine • Share your knowledge of incidence/prevalence • Ask the patient what they think • Offer resources

  5. 5 P’s of a Sexual History • Partners • Practices • Protection from STIs • Past history of STIs • Prevention of pregnancy • Failing all that…….who, what, when, with protection?

  6. Symptoms…Vaginal discharge • How has it changed? • Onset • Duration • Colour • Odour • Consistency --------------------------------------------------------------------- Dyspareunia/dysuria/abdominal pain/pyrexia Menstrual history PMHx Medications Dyspareunia/dysuria/abdominal pain/pyrexia

  7. Vaginal discharge ….now what? Causes; • Physiological • STI – Chlamydia trachomatis, Neisseria gonorrhoeae , Trichomonas vaginalis • Infective – Bacterial vaginosis, candidal infection • Anatomical - fistulae • Malignancy - – cancer of cervix, uterus, ovaries • Inflammatory – Vulval dermatitis • Others – cervical polyps, foreign body, erosive lichen planus, allergy

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