Sexual Health

Sexual health is an important component of overall well-being and plays a central role in general practice. It encompasses not only the prevention and management of sexually transmitted infections (STIs) and contraception, but also broader issues such as sexual function, relationships, consent, identity, and emotional health. Patients of all ages, genders, sexual orientations and backgrounds may present with sexual health concerns, and GPs are often the first and most trusted healthcare providers to whom they turn. Providing sensitive, inclusive, and non-judgmental care is crucial to addressing the diverse needs of individuals, including those related to sexual orientation, gender identity, cultural beliefs, and life stages - from adolescence through older age. Effective sexual health care requires strong communication skills, clinical competence in diagnosis and management, an awareness of safeguarding responsibilities, and the ability to create a confidential and supportive environment.  

• SX1. Consider both physiological and psychological causes when assessing and managing sexual dysfunction.
• SX2. Manage an individual’s sexual health, including risk assessment, diagnosis, treatment, and timely referral when necessary.
• SX3. Interpret laboratory and diagnostic tests in sexual health, including blood tests, swabs, cervical screening, and colposcopy.
• SX4. Promote proactive sexual health, including prevention, cervical screening, early detection, and screening for sexually transmitted infections (STIs).
• SX5. Competently and sensitively assess and manage cases of unplanned pregnancy, including providing evidence-based counselling on all available options.
• SX6. Understand the legal and ethical framework governing termination of pregnancy in Ireland, including appropriate referral pathways, and deliver patient-centred support that respects autonomy, confidentiality, and cultural diversity.
• SX7. Demonstrate a non-heteronormative and inclusive approach to sexual health by respecting diverse genders, sexual orientations, and relationship structures, and by providing non-judgmental care to all patients.
• SX8. Provide sexual health care to young people, addressing legal and ethical considerations, and assessing their capacity to make informed decisions.
• SX9. Recognise the importance of addressing sexual health in older adults, demonstrating sensitivity, openness, and the ability to discuss sexual wellbeing, relationships, and concerns without stigma, in order to provide holistic care across the lifespan.
• SX10. Demonstrate the ability to provide compassionate, trauma-informed care to individuals who have experienced sexual violence, including recognising their clinical, psychological and emotional needs, offering appropriate support, and facilitating access to specialised services when necessary.
• SX11. Coordinate sexual health care effectively, collaborating with other healthcare professionals and referring patients to appropriate services when further assessment or treatment is required.

For each problem or disease, consider the following areas within the general context of primary care:  

• The natural history of the condition, including whether acute or chronic
• The incidence and prevalence, including in different demographic groups
• Typical and atypical presentations
• Recognition of normal variations throughout life
• Risk factors, including lifestyle, socio-economic and genetic factors
• Diagnostic features and differential diagnosis
• Recognition of ‘alarm’ or ‘red flag’ features
• Appropriate and relevant investigations
• Interpretation of test results
• Management, including initial and continuing care, chronic disease monitoring and emergency care
• Patient and carer information and education
• Prognosis

Symptoms, Signs and Presentations

• Abdominal Pain
• Abnormal Vaginal Bleeding
• Anal discharge
• Anorgasmia
• Dyspareunia
• Dysuria
• Erectile Dysfunction
• Female Genital Mutilation
• Gender Dysphoria
• Genital Ulcers
• Genital Warts
• Loss of libido
• Pelvic Pain
• Penile Discharge
• Premature Ejaculation
• Presentation post sexual violence
• Psychosexual dysfunction
• Systemic Manifestations of STIs – Reactive Arthritis, Rash
• Vaginal Discharge
• Vaginismus
• Vulval Pain

Common and Important Conditions

• Bacterial Vaginosis
• Balanitis
• Candida
• Chlamydia
• Female Genital Mutilation
• Genital Herpes Simplex
• Genital Warts
• Gonorrhoea
• Hepatitis B & C
• HIV
• Lichen Sclerosis
• Pelvic Inflammatory Disease
• Sexual Assault
• Sexual Dysfunction
• Syphilis
• Trichomonas
• Unplanned/ Unwanted Pregnancy

Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

Self-Directed

Blended Learning Resources (Education Platform)

Men's Health in General Practice[KM2.1]

Managing Menopause in General Practice

Early Medical Abortion

Managing Common Problems in Pregnancy (not created yet)

Contraception Theory

Useful Websites

Sexual Assault Treatment Units

Faculty of Sexual And Reproductive Healthcare

British Association for Sexual Health and HIV

Free Home Testing for STIs - sh24

Antibiotic Prescribing.ie – STI Screening in Primary Care

Health Protection Surveillance Centre

Workplace Based Learning

Workplace-based learning provides valuable opportunities to develop practical skills and confidence in managing sexual health issues. In general practice, trainees will encounter a wide range of presentations, including contraception advice, STI screening, sexual dysfunction, and safeguarding concerns. Learning to take a sensitive, non-judgmental sexual history and to create a confidential, supportive environment is a key part of developing competence in this area. Where possible, trainees should seek opportunities to attend specialised services such as Sexual Assault Treatment Units (SATUs) and Genitourinary Medicine (GUM) clinics. These experiences offer deeper insights into the management of sexual violence, complex STI cases, HIV care, and specialist contraceptive services, and reinforce the importance of trauma-informed and inclusive care. Exposure to both primary care and specialist settings helps trainees build the knowledge, communication skills, and professional confidence needed to deliver holistic and affirming sexual healthcare.

Day Release

Day release sessions provide an excellent opportunity to explore sexual health topics in a collaborative and supportive environment. Through case-based discussions, trainees can deepen their understanding of common presentations such as STI management, contraception, and sexual dysfunction, as well as more sensitive areas like safeguarding, sexual violence, and gender and sexual diversity. Reviewing national guidelines, practicing sexual history-taking skills, and exploring communication strategies for difficult conversations helps to build both competence and confidence. These sessions also allow for reflection on personal attitudes, biases, and the importance of maintaining a non-judgmental, inclusive approach to sexual health care in general practice.

Registrar Tutorials

Registrar tutorials offer a focused, confidential space to explore sexual health in more depth, tailored to the trainee's needs and recent clinical experiences. These sessions are ideal for practicing sensitive skills, such as taking a thorough sexual history, discussing contraception options, or managing disclosures of sexual violence. They also provide an opportunity to review local referral pathways to SATUs, GUM clinics, and safeguarding services. With trainer guidance, trainees can reflect on how to handle complex or uncomfortable consultations professionally and empathetically, and ensure they are delivering care that respects patients' dignity and diverse backgrounds.

Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

EPA 17: Manage the integration of evidence-based therapeutics into patient care and prescribe and manage medications

For EPA 17, managing a patient diagnosed with chlamydia demonstrates competence in evidence-based prescribing, and safety netting. If discussed retrospectively, a CBD can be used to review the consultation

Core Knowledge Test (CKT)

• Management of Chlamydia / Gonorrhoea

• Choosing the correct window period for HIV testing after exposure

• LARC prescribing  

Clinical Competency Test (CCT)

• A patient with painful urination and genital lesions.
• A patient with side effects on current contraception.
• A patient with discharge coming from their penis.

Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.