2.2 Phys.examination

If the patient expresses concern about some anatomical aspect, this phase may also include an educational gynaecological or sexological examination which, if the patient is experiencing any pain, will involve an inspection of the pelvic floor musculature. This examination is not only intended to gather information but should also be used to provide information about physical sexual functioning, and to explain what is considered ‘normal’. Any negative self-image should be corrected and myths dispelled. The examination will only be conducted with the patient’s full consent and will take place in a setting which places the patient at ease to the greatest extent possible. Often, but not always, it is desirable for the partner to be present. This is something which must be discussed beforehand. Of course, the examination should be painless; stop means stop.
Although it may seem that this approach demands practice or special communicative skills on the part of the patient, this is far from the case. Of course ‘practice makes perfect’, but the aim is to encourage a certain attitude – one in which empathy and interest in one’s fellow human being is evident and in which there is a willingness to tackle the problem together. There is no benefit to the patient if only the care provider knows what is wrong and fails to share that information. For the most part, sexual problems exist between people and hence so do the solutions. The professional’s role is not to do something to the patient, but with the patient. It may indeed be necessary to broaden the patient’s perspective, but his or her views, norms and values – together with those of the partner – remain the most important underlying principle of the entire therapeutic process.