The screening sexual history. Getting to the problem.

"Getting to the problem" is a critical hurdle that doctor and patient must overcome to allow effective therapeutic intervention. When "the problem" has anything to do with the topic of sexual functioning, that hurdle becomes even greater for a number of reasons. The reticence among elderly patients and their providers regarding this topic frequently constitutes an actual barrier to open and effective communication. If, however, a good screening sexual history is routinely elicited, much useful clinical data will be obtained. Furthermore, the patient may be sensitized to a number of issues of which he or she might not have been aware. Perhaps most importantly, the door has been opened so that if concerns or problems about sexual functioning arise in the future, the patient will feel more comfortable discussing them with the clinician. In sum, the benefits for both patient and clinician far exceed the costs in time and effort when a screening sexual history is obtained from a geriatric patient.