Managing psychosexual problems: essential skills for gynaecological consultations

The objective of this article is to stimulate interest in the acquisition and development of skills in psychosexual medicine. It is commonplace for obstetricians and gynaecologists to see patients with sexual difficulties, either as the primary reason for referral or, not unusually, as an unspoken covert problem. However, for a variety of reasons, which may be patient-related, doctor-related or both, sexual issues are not always recognized or explored. Such instances of not getting fully and expeditiously to the root of a patient's problem can be reduced in two ways. First, by enhancing doctors’ awareness of the possibility of a psychosexual problem and, second, by augmenting their skills in handling these patients. The negative impact of failing to recognize or help patients with sexual difficulties is significant both to the patient and the National Health Service.

As obstetricians and gynaecologists, our aim should be not just to learn some relevant but basic communication skills, but also to go on developing them throughout our working careers. We need to be able to use the psychosomatic approach to patients on an equal footing with our ingrained medical model approach, recognizing the benefit, on occasion, of using both approaches in tandem within a single consultation. As in any other area of medicine, if for whatever reason we are unable to address a patient's particular needs, then we should refer them to someone who has the necessary skills.