1.3 Informed consent

This is the phase in which all information is brought together. Are there physical obstacles to sexual fulfillment, or is there a lack of arousal due to inadequate sexual stimulation? What is the most significant determinant of the sexual problems? How does the patient – and the partner where appropriate – deal with that determinant? The problems are identified and clarified as necessary. The care provider offers additional information and insights. Discrepancies are discussed and, where appropriate, brought to the attention of the patient. Negative interactions are evaluated. The overall aim is to identify the exact nature of the problem(s) and to find new perspectives which may lead to solutions. Only if this is approached carefully and conscientiously will the patient and/or the partner be able to formulate their objectives: ‘what do we want to achieve, what are we able to achieve and what are the alternatives?’ The process is difficult and may well involve some emotional anguish, but in most cases this pales into insignificance alongside the misery of ongoing misconceptions, misunderstandings and denial.