“I am ‘later in life.’ Do I still need to talk to my doctor about sex?”
Most of us who are 50 years and older are sexually active. Surveys continually show that sex is important in later life. Yet, most visits with doctors center around blood pressure, cholesterol and weight. Only a small percent of visits include a discussion of sex—a vital part of our health and well-being.
This is not always due to the patient:
- Many doctors assume that their older patients are no longer having sex.
- Some doctors feel insecure in their knowledge and competence in treating sexual issues. They are as embarrassed as the patient!
- If the patient doesn’t bring it up, some doctors assume sex must not be an issue.
- Doctors may hesitate to bring up the subject because of time constraints.
I can relate. As a young doctor starting my OB/GYN practice, it was difficult for me to ask later-in-life patients about their sex life. It took practice and a growing confidence in my own competence to be able to do so comfortably. As my practice grew and I became busier, I sometimes had days when there was more to do than there was time. I admit and regret that there were times when it was just faster and easier to not broach the subject.
Sometimes a lack of communication about sex is due to the patient:
- Patients feel shy or embarrassed.
- Some feel that they might be judged for disclosing certain things about their sexual relationships.
Is this reluctance to talk about sex putting one’s health at risk? Yes!
Why is talking to your doctor about sex so important?
Sexual changes can be related to underlying medical conditions. Let’s take two common concerns: painful intercourse for women and erectile dysfunction for men.
Painful intercourse can be due to dryness secondary to menopausal changes, vaginal infections, uterine tumors (fibroids), and ovarian cysts.
Erectile dysfunction (ED) can be the result of heart disease, high blood pressure, diabetes and high cholesterol. Sometimes diabetes is first diagnosed when a man seeks treatment for ED.
Apart from underlying medical conditions, there is another reason you need to talk to your doctor about your sexual health concerns. A healthy sex life is a vital part our physical, emotional and psychological health. You don’t have to shut the door on that part of life due to the changes that come with aging or illness. Your doctor has a part to play in helping you reestablish your sexuality following an illness or helping you find solutions to sexual challenges.
4 tips for talking to your doctor about sex
Now that you understand how important it is to speak up, let’s talk strategy.
Have you ever found yourself in the small, white, cold exam room, covered (almost) with a thin paper sheet, waiting, waiting and waiting? The doctor finally pops in, says hello and gets right to work with the pelvic exam or the prostate exam. He/she asks you if you have any questions while he/she is working. You manage to remember something but not everything. He/she finishes, says goodbye and is out the door. Only then do you remember what you forgot to ask!
Tip 1: When making the appointment, tell the receptionist the reason for your visit. Ask him or her to check with the doctor to see if extra time should be allowed.
Tip 2: Write down your questions so you don’t forget anything important. Doctor’s visits make people nervous and they tend to forget what they want to talk about. Be concise with your story.
Tip 3: When the doctor enters the exam room, ask him/her if he/she would like to go over your questions before or after the exam. I always appreciated patients who were prepared and organized. The patient who arrived with a list of medications and a concise history of illnesses and surgeries since her last visit was a treat for me.
Tip 4: If you feel your doctor isn’t listening to you, is critical and judgmental, and/or doesn’t care about your sexual health concerns, respectfully ask for a referral or change doctors.
Here is the take home message
Your sexual health is important. Talking about sexual concerns with your doctor not only improves your sexual health but also your overall health. Do not be shy or embarrassed.