Adult Sex Ed

Talking to Your Doctor About Sexual Problems

AGWDM talking to your doctor about sexual problemsOften sexual problems can be physical and mental health problems that can and should be treated by a physician or therapist. However, talking about these problems with a health care professional can be embarrassing or awkward.

It can be awkward and embarrassing for health care professionals, as well, but there’s a lot that both patient and practioner can do “get over it” so that the problem can be treated.

Being honest about your problem is the first step in treatment.

“You can’t properly assess, diagnosis or treat the problem unless a patient is fully honest,” says Dr. Renee Horowitz, an OB-GYN of 25 years and the founder of the Center for Sexual Wellness in Farmington Hills, Mich. “Everything is private; they’ll respect what you have to say without judgment. It all comes down to having respect for the patient. If you feel that you can’t discuss your problem, then you probably have the wrong doctor.”

“Just say it,” echoes Dr. Scott Carroll, associate professor of child and adolescent psychiatry at the
University of New Mexico School of Medicine. “Trust me, we are highly trained at talking about sex and you probably can’t shock us. We tell people they are dying; we can handle a discussion on almost any aspect of sex. Plus, many health professionals are gay, bi and even transgendered, so if we are not knowledgeable, we can get you to someone that is.”

However, not all health care professionals are as trained in or feel comfortable talking about sex with patients as Dr. Horowitz and Dr. Carroll.

“Many MDs don’t get more than 4-6 hours of relevant training,” says Dr. Carol Queen, staff sexologist at Good Vibrations in San Francisco. “I attended the International Society for the Study of Women’s Sexual Health conference to do a presentation this year. They did a really interesting session, essentially a ‘stump the doctors’ about unusual sexual problems. It was so clear that some of the attendees were uncomfortable with sexual diversity.”

“We all come with baggage, even doctors,” Dr. Horowitz says, “Part of the problem is that doctors don’t ask about sex because they don’t have the knowledge, time or think that it’s important to a patient’s well-being.

“When I talk with residents who feel uncomfortable talking about sex, I tell them to stand in front of a mirror and say “penis,” “vulva” and “vagina” until it becomes as normal as reciting a grocery list. There are questionnaires about sexual issues that doctors can give to a patient before they meet with them.”

In many cases, it winds up being a patient’s responsibility to initiate and guide a conversation that they feel uncomfortable having. Like any relationship, it’s easier when you know and understand the other person’s shortcomings a well as their strengths. Doctors are not gods; they are not infallible.

Another important tip Dr. Carroll offers, “Say at the beginning of the appointment what your problem is and not the end when we are trying to wrap up to see our next patient. Since most medical appointment are only 5-10 minutes long and 15-30 minutes in psychiatry, we may need to reschedule you for a longer appointment so we can do your question justice. We are not blowing you off;we’re just trying to do the best that we can for you.”

One book that Dr. Queen has found very helpful for patients and health care providers in bridging the communication gap is Health Care Without Shame: A Handbook for the Sexually Diverse and Their Caregivers by Dr. Charles Moser. He specifically addresses the needs of those with diverse sexual lives.

Oftentimes, sexual problems, like STIs, require immediate attention. Others are manifestations of other medical conditions that must and should be treated. Avoiding a trip to the doctor because of embarrassment or fear of shame can lead to further complications if left untreated.

“For men, it can be diabetes or hypertension,” Dr. Horowitz says. “For women, low desire can be a sign of a thyroid problem or low levels of prolactin, a hormone that’s secreted from the pituitary gland. These just aren’t medical problems but problems that can do damage to relationships and well-being. They’re both very important.”

Think of finding and working with the right doctor is a lot like finding the right hairstylist or mechanic. If you don’t like how a doctor is handling you, especially when you’ve done your part in communicating honestly and appropriately, find another doctor. After all, you don’t stop getting your hair cut or give up on getting your car fixed because you didn’t like the hairstylist or mechanic.

Other recommended reading: No Sex in School … or in the Therapist’s Office

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