Advanced Sexual Counseling and How to Ask Patients About “Intimate Disclosure”

Figures & data

Table 1 Factors Associated with Frequency and Ability to Obtain Orgasm

Positively Associated	Negatively Associated	Neutral or No Association
Satisfaction towards relationship Discussion of sexual issues with partner Married Cohabitating Stimulation of vagina Stimulation of clitoris Duration of intercourse Sexual self-esteem Orgasm being important in sex	Vaginal dryness Painful Intercourse Partner orgasms too quickly Partner has erectile problems Constant anxiety/Distress Orgasm more easily obtained via masturbation vs intercourse Heavy Drinking	Education level Income Exercise Smoking Moderate alcohol use Mild mental health problems Number of steady relationships Number of sexual partners

Note: Data from Kontula et al.⁴

Table 2 Suggested Sentences for Clinicians

Initial	Communication and Relationship	Sexual Arousal and Activity
Can you tell me a little about your sexual activities?	How satisfied are you with the relationship with your partner?	Do you have any concerns with your level of desire or interest?
How’s your sex life?	How comfortable do you feel discussing sex with your partner?	Have you been able to achieve orgasm either by yourself or with partners?
Do you or your partner have any sexual difficulties or concerns?	Have you discussed what step or action you need to achieve orgasm with your partner?	Have you ever faked an orgasm with your partner?
How would you rate your sexual satisfaction on a scale of 1–10, with 1 being dissatisfied all of the time?	Are there any barriers or obstacles that are making it difficult for you to discuss sex and orgasm with your partner?	If so, why?
Have you discussed your sexual satisfaction with your partner?	Do you feel your partner is receptive to communication on sex and your satisfaction?	Does the level of satisfaction you get from sexual activity make you want to have sex again on other days?

Kontula O, Mäkinen M. Between Sexual Desire and Reality: The Evolution of Sex in Finland. Vol. 153. Publications of the Population Research Institute; 2009:49.

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