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Taking a sexual history.

Many doctors feel uncomfortable about their ability to take an appropriate history from a patient with a sexual problem. In part, the discomfort lies in the doctor's feelings of embarrassment and the patients ambivalence about bring up the topic. Patients may feel ashamed or even humiliated at having to ask for help with a sexual problem that they consider private and that they should be able to cope with themselves. This is particularly so with men, especially young men, who have to admit to erectile dysfunction and therefore, as they see it, the loss of their masculinity. Some physicians have found that they can avoid this initial difficulty by giving patients a waiting room preconsultation written questionnaire. Many patients like this but some dislike its anonymity and apparent coldness. As with other history taking, the doctor must carefully choose words, avoid closeended questions, be nonjudgmental, avoid labels with hidden meaning and carefully observe body language.