A focused and comprehensive sexual health assessment is a critical aspect of assessing the female reproductive system.
This is inclusive of an interview to collect subjective data, and a physical assessment to collect objective data. Diagnostic tests may be adjuncts that provide additional information. All health assessments are to be taken in partnership with the woman, as outlined in the National Safety and Quality Health Service Standards (2017), Standard 2. Ensuring person-centred approaches to the woman enables accurate and individualised questions to be asked.
An important aspect of all care provided is documentation. As defined in Standard 6 of the National Safety and Quality Health Service Standards (2017) it needs to be accurately detailed so all information and risks are disclosed, ensuring the woman’s safety.
Being mindful of potential embarrassment or fear in the woman, an assessment should be performed in a sensitive, open and objective manner. This includes being aware of and considering psychological, social and cultural factors that affect sexuality and sexual activity.
Simple and impartial language is essential so no perception of judgement or offence is felt, but only safety and professionalism.
As part of the health assessment determining sexual health, the following aspects should be included in the interview:
- Duration, frequency, precipitating and relieving factors, treatment so far.
- History, inclusive of menstrual, obstetric, contraceptive, sexual relations and cautions.
- History of smoking – as it increases the risk of circulatory problems, as well as the risk of cervical cancer, when the woman is taking oral contraceptives.
- Chronic conditions that may impact the reproductive system (eg. diabetes raises vaginal infection and dryness risk).
- Family history.
- Explore particular issues further, such as vaginal bleeding or discharge.
- Sexual activity and devices used for contraception and satisfaction.
As registered nurses and midwives, it is important that we maintain a professional approach and attitude when performing a sexual health assessment of women we care for and do not allow our own issues, embarrassment or caution to impede or impact this process.