Obstet Gynecol. 2017 Jul;130(1):e42-e47. doi: 10.1097/AOG.0000000000002161.
Sexuality involves a broad range of expressions of intimacy and is fundamental to self-dentification, with strong cultural, biologic, and psychologic components. Obstetrician-gynecologists often are consulted by patients about sexual health and are in a unique position to open a dialogue on sexual health issues. Several obstacles to frank conversations with patients about sexual health exist, including a lack of adequate training and confidence in the topic, a perception that there are few treatment options, a lack of adequate clinical time to obtain a sexual history, patients' reluctance to initiate the conversation, and the underestimation of the prevalence of sexual dysfunction. However, data on reproductive and sexual health morbidity suggest sexual health is an important health care issue. Each year, an estimated 45,000 new cases of human immunodeficiency virus (HIV) and approximately 20 million sexually transmitted infections occur, 3 million women experience unintended pregnancies, and 1 million women are sexually assaulted. Openly discussing sexual health has the potential to prevent these unnecessary sexual health-related outcomes. Clinical conversations should acknowledge the contributions of sexuality, relationships, and sexual behavior to overall health. Obstetrician-gynecologists can address sexual health issues across a lifespan with their patients and encourage a strategic foundation for women's sexual health issues, resulting in improved public health overall. Obstetrician-gynecologists also can support policies that broaden the coalition for effective prevention of sexually transmitted infections and promote healthy sexuality, with the ultimate goal of improving health outcomes and public health.
性取向涉及广泛的亲密表达，是自我认同的基础，具有强烈的文化、生物学和心理成分。患者经常就性健康问题咨询妇产科医生，而妇产科医生处于开启关于性健康问题对话的独特位置。与患者就性健康进行坦诚对话存在若干障碍，包括缺乏关于该主题的充分培训和信心、认为治疗选择很少、缺乏获取性病史的足够临床时间、患者不愿开启对话以及对性功能障碍患病率的低估。然而，关于生殖和性健康发病率的数据表明，性健康是一个重要的医疗保健问题。每年，估计有45000例新的人类免疫缺陷病毒（HIV）病例以及约2000万例性传播感染发生，300万妇女意外怀孕，100万妇女遭受性侵犯。公开讨论性健康有可能预防这些不必要的与性健康相关的后果。临床对话应承认性取向、人际关系和性行为对整体健康的作用。妇产科医生可以与患者讨论一生中的性健康问题，并为女性性健康问题奠定战略基础，从而整体改善公共卫生状况。妇产科医生还可以支持各项政策，扩大有效预防性传播感染和促进健康性取向的联盟，最终目标是改善健康结果和公共卫生。
