Thinking about the consultation makes the doctor aware of the differences between his or her agenda and that of the patient. Opportunities can then be made for the patient to express her or his own ideas and anxieties. The patient’s agenda may consist of fairly straightforward questions that are easily asked provided the doctor allows [...]

It is not always possible to identify and deal with problems as they arise in the consultation although such immediate management would be ideal. The constraints of time are inevitable: the average appointment in general practice is seven to ten minutes in length, and in a clinic the pressure from the other staff to keep [...]

Mrs X., an attractive 43-year-old woman, attended her doctor regularly for repeat prescriptions of the progestogen-only Pill. At a recent visit she looked tense and complained that intercourse was painful. She wondered if she should stop the Pill as it seemed to be causing dryness. She had no other menopausal symptoms and physical examination was [...]

It is clear from the continued upward trend in requests for sterilization, from the experience of doctors and from the literature, that the procedure is seen as safe and as having a successful outcome. In the great majority of instances both sterilization and vasectomy are safe and satisfactory operations. They remove both the fear of [...]

Although there is a general impression that having sex means sexual intercourse, it is a fact that for some people it is not physically possible due to severe disability. Some exploration of the concept that there can be more to sex than sexual intercourse may then be indicated, and people can be encouraged to develop [...]