ABSTRACT
The reassuring thing to remember is that although this may not be an area of special interest or further training for most GPs, there is nothing 'special' about the communication skills required to deal with psychosexual problems. The practitioner should be reassured that he or she is unlikely to add to the patient's problems by staying within the patient's level of disclosure on general questioning. In general, it makes sense for the health professional to deal with issues that he or she would usually accept within the remit of general practice, refer relationship problems to Relate (formerly the Marriage Guidance Council), and refer long-term problems outside his or her expertise to a local specialist. Clues about general health problems, particularly anaemia and hypothyroidism, should be included in the history. History and examination are needed to exclude endometriosis, adenomyosis and pelvic inflammatory disease.
