275 Nursing Care of the Postmenopausal Woman, 3rd Edition
The nurse should introduce the subject of the sexual history during the health his- tory. The sexual history needs to be con- fidential and nonjudgmental and must reflect an understanding of the woman as an individual. The woman should be in
a private space so that she can be con- fident that no one will overhear her an - swers. See Table 1-3 for areas of focus during a sexual history and Table 1-4 for other potential sexual history questions.
Table 1-3. Areas of Focus During a Sexual History Review ● Gynecologic history:
○ Menstrual history. ○ Bleeding patterns. ○ Incontinence.
○ Pelvic pain. ○ Vulvodynia. ○ Vaginal dryness, dyspareunia, sexual pain. ● Obstetric history.
● Major medical problems. ● Psychological problems. ● Surgical procedures, especially involving the breasts, pelvic area, or genitalia. ● Sexually transmitted or other infections. ● Safer sex practices. ● Medications (allergic reactions). ● Relationships (current, past, quality, conflicts, abuse, coercion, etc.). ● Sexual orientation (sexual activity with men, women, or both). ● Partner sexual function. ● Substance use and abuse (tobacco, alcohol, illicit drugs). ● Social issues (life stress, work and family issues). ● History of physical, emotional, or sexual abuse. ● Concerns about aging (body image, weight gain). ● Sexual satisfaction (prior and current level of interest, arousal, orgasmic response, pleasure): ○ Factors associated with improved sexual satisfaction (vacations, date night). ○ Factors associated with reduced sexual satisfaction (fatigue, illness, lack of privacy). ○ Interventions tried to address sexual concerns and results.
Note . Adapted from North American Menopause Society. (2019). Sexual function. In Menopause practice: A clinician’s guide (6th ed.).
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