One opening line doesn't fit every consult. The general-purpose script covered elsewhere in this series works well as a default, but a few common consult types benefit from a more tailored opening, one that borrows credibility from whatever brought the patient in that day.
The routine check-up or annual review
"As part of your general check-up, I always ask about sexual health too, is that something going okay for you at the moment?"
This is the broadest version and works well as your default when nothing else about the visit points to a more specific angle. It borrows the low-stakes framing of a routine review, the same category as blood pressure or cholesterol.
The chronic disease review (diabetes, cardiovascular, mental health)
"Since [the condition/medication] can sometimes affect sexual function, I like to check in on that as part of our review, has anything changed for you?"
This version does more work than the general script because it gives the patient an external reason for the question that has nothing to do with anything they may be self-conscious about. It also opens the door to a conversation the patient may not have realised was relevant to their condition at all.
The new prescription (antidepressant, antihypertensive, hormonal)
"One of the things this medication can affect is sexual function, so I want to flag that now rather than have it be a surprise. If that happens, it's worth telling me, since there's often something we can do."
This is the most important of the three to build into habit, because sexual side effects are a leading, under-discussed reason patients quietly stop taking medications they need, often without telling their GP why. Raising it before it happens, rather than waiting for the patient to bring it up after they've already stopped, changes the entire dynamic of that later conversation, if it happens at all.
Choosing which script to use
The through-line across all three is the same principle: link the question to something already happening in the consult; the condition, the medication, the review, rather than raising it as an unrelated, separate topic. That link is what makes the question feel expected rather than intrusive, regardless of which specific wording you use.
Building fluency
None of these need to be recited word for word. What matters is having a version ready for the two or three consult types you see most often, so the opening never has to be improvised under time pressure. That is where a rehearsed opening earns its value: not in getting the words exactly right, but in removing the hesitation that comes from not having them ready at all.
Want to rehearse this exact conversation before trying it in clinic? The Sexual Health Clinician course includes AI-simulated patients so you can practise the wording risk-free.
