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The Importance of Obtaining Sexual History in Older AdultsA Teachable Moment

Educational Objective
To describe the value of obtaining a nonjudgmental and thorough sexual history and the frequency with which this is performed in the ambulatory setting among older adults.
1 Credit CME

A man in his 70s with a medical history of noninvasive bladder cancer presented to his primary care clinic with significant weight loss. He had lost 30 pounds unintentionally during the previous 6 months, which he attributed to poor appetite. He denied dysphagia, abdominal pain, diarrhea, melena, hematochezia, and urinary abnormalities; the remainder of his review of systems yielded negative results. Bladder cancer had been diagnosed 9 years prior and treated surgically; surveillance cystoscopy with biopsy 1 year prior had yielded normal results. Subsequently, he was lost to follow-up.

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Article Information

Corresponding Author: Joshua Khalili, MD, 757 Westwood Plaza Drive, Los Angeles, CA 90095 (jkhalili@mednet.ucla.edu)

Published Online: October 7, 2019. doi:10.1001/jamainternmed.2019.4480

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information.

References
1.
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2.
Lindau  ST, Schumm  LP, Laumann  EO, Levinson  W, O’Muircheartaigh  CA, Waite  LJ.  A study of sexuality and health among older adults in the United States.  N Engl J Med. 2007;357(8):762-774. doi:10.1056/NEJMoa067423PubMedGoogle ScholarCrossref
3.
Omole  F, Fresh  EM, Sow  C, Lin  J, Taiwo  B, Nichols  M.  How to discuss sex with elderly patients.  J Fam Pract. 2014;63(4):E1-E4.PubMedGoogle Scholar
4.
Gott  M, Hinchliff  S, Galena  E.  General practitioner attitudes to discussing sexual health issues with older people.  Soc Sci Med. 2004;58(11):2093-2103. doi:10.1016/j.socscimed.2003.08.025PubMedGoogle ScholarCrossref
5.
National Association of Community Health Centers and National LGBT Health Education Center. Taking Routine Histories of Sexual Health: A System-Wide Approach for Health Centers. https://www.lgbthealtheducation.org/wp-content/uploads/COM-827-sexual-history_toolkit_2015.pdf. Accessed June 17, 2019.
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