性生活史 Sexuality
(本網頁參考及摘譯自婦科教科書 Novack's Gynecoloy 13rd Ed.第11章)

性是每位女人一生中重要完整的一部份. Sexuality is an important and integral part of every woman's life.

自青春期到更年期,對於性的問題及關心跨越了女人一生. Questions and concerns about sexuality span a woman's entire lifetime, from questions about puberty to concerns about change in sexual function with menopause and aging.

婦產科醫師身為女性健康照護提供者,應例行在女性健康評估中包含性生活史. The obstetrician-gynecologist, as a primary health care provider for women, should include a sexual history as a routine part of a woman's periodic health assessment.

一般民眾對於性的關心是常見的. 調查顯示三分之二受調女性關心性事.
三分之一女性性趣缺缺. 20%認為性不總是樂趣. 15%有過性交疼痛. 50%經歷過困難喚起性趣. 50%困難達到高潮. 25%無法達到高潮.

儘管性事對於女性健康多麼重要,很多女性發現向她們的婦產科醫師談論性事問題是很難啟齒的,很多醫師也在和病患討論性事的問題時很不自在. Despite the importance of these issue to their health care, many women find it difficult to talk to their physicians about sexual concerns, and many physicians are uncomfortable discussing sexual issues with their patients.

71%的成人認為醫師會不理會她可能提出的性事問題, 68%認為討論性事問題會讓醫師困窘.從基層醫師的調查發現少於50%會詢問初診病患性生活史,很多醫師謬誤地用婚姻職業年紀種族社會經濟階層來判斷病患的性生活史.

詢問性生活史,讓醫師有機會教育病患如何預防性病,如何做好安全性行為,評估避孕方法的採用,破除錯誤的迷信與迷思.   Asking about sexual concerns gives physicians an opportuniy to educate patients about the risk for sexually transmitted infections(STIs), counsel patients about   safe sex practices, evaluate patients' need for contraception, and dispel sexual myths and misconceptions.

進一步,病患得到允許在專業隱密及無批判的環境下談論性事問題.即使最初病患覺得討論這麼敏感思密的事令她不舒服不自在,但她知道將來若有這方面問題時,醫師的態度是包容接受的. Even if patients are initially uncomfortalble discussing these senstive and private issues, they know that their physcian will be receptive if they want to disscuss sexual concerns in the future.

提出幾個開放式的問題來得到最基本的性生活史.

Sexual practices 性活動情形 初次年齡,性伴侶數,使用保險套,頻率,滿意度,同/雙性戀,性交方式,忠誠度
Sexual Response Cycle反應週期 渴望Desire phase, 興奮Arousal phase, 高潮Orgasm phase, 消散Resolution phase
影響因子 年齡,藥物,疾病,性功能障礙,冷感症,高潮障礙,性痙攣,性交痛,
Sex Assault Childhood, Rape

有些疾病和性伴侶數有關

性傳染性疾病(STIs) 愛滋病,梅毒,BC肝炎,HPV人類乳突病毒,披衣菌,淋病,巨細胞病毒,.............
腫瘤Neoplasms 子宮頸癌,攝護腺癌,直腸肛門癌,肝癌,Kaposi sarcoma,Non-Hodgkin lymphoma .......
   

性伴侶數若 = 0

在台灣,除非病情需要,而且病患書面同意,盡量避免內診及陰道超音波,以免處女膜破損