How to Talk About Sex with Your Doc

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There’s so much more to sex than just coming

By ADINA LAKSER

“How about sex?” my boyfriend asked the orthopaedic cast technician after they listed all the activities he should refrain from while his broken leg is healing. The tech blushed, looked down and stumbled through a half answer consisting basically of “just be careful.” 

I recently facilitated a discussion around sexuality with a peer support group of women living with mental health issues. I asked them if their doctors had asked them about how mental health has affected their sexuality, or vice versa. Not one woman had had a frank and open discussion with their doctor on the subject. 

Sex is a normal, healthy part of life (as is abstinence), and most health practitioners would readily agree. Yet somehow most of us are not having the talk with our doctors. Even medical school blogs readily admit that sex is not discussed often enough in the doctor’s office. As the blog of the Albert Einstein College of Medicine notes:  

“Physicians and other clinicians know that sexuality and sexual well-being are important topics for many patients – often, more patients than we care to acknowledge. There are many factors that hinder physicians from routinely asking patients about sexual issues and concerns.”

Studies have shown that physicians may ask about sexual activity, especially related to sexually transmitted infection prevention and pregnancy, but other issues – like desire, pleasure and satisfaction – are often not addressed. Even among obstetricians and gynaecologists who specialize in female reproductive health, “the majority . . . report routinely asking patients about their sexual activities, but most other areas of patients’ sexuality are not routinely discussed,” according to a recent study in the Journal of Sexual Medicine.  

Clearly, when even vagina doctors find it difficult to talk about sex, we are still living in a culture where sex is taboo. There is no shortage of barriers to thorough and nonjudgmental conversations about our sexual health, including our shame, doctor’s discomfort, quick in-and-out appointments, and the lack of comprehensive sexual education during medical training. 

Sure, it may be difficult, but it doesn’t lessen the need. Dr. Stacy Tessler Lindau, the lead author on a 2012 study exploring physician and patient interactions around sex, concluded that doctors should take the lead. Some of us may be fortunate enough to have a clinician who opens the door, but what about the rest of us? What can we do to make sure our sex lives are getting the attention they need?  

You deserve to talk about your sexual health

Unfortunately, an unintended side effect of this silence is to further the stigmatization and shaming of sexual activity. It’s okay if you’re having sex and it’s okay if you aren’t. It’s okay to be a sexual human being in whatever ways you express. It’s okay to care about your sexual health. It’s okay to want a satisfying sex life. It’s okay to want to find alternatives if medication is impacting you sexually. It’s okay to want to know if sex is safe when you are recovering from an illness or accident. It’s okay to want to learn more about how sex impacts your chronic illness. Basically, even if your practitioner isn’t bringing the subject up, know that you are entitled to express your sexual needs and deserve to have them addressed. 

There may be others who can help

Sexuality bears a complex relationship to our physical, emotional, spiritual and psychological health. As such, a physician may not be able to address the whole, vast package that constitutes our sexual selves. If you are struggling with a sexual issue – lack of desire, erectile dysfunction, inability to orgasm, body image challenges – certainly talking to your doctor may be helpful, but know you may want to look beyond the office for support. Sometimes, sexual issues can be related to relationship breakdown or past trauma, in which case a therapist or counsellor may be helpful. Pelvic floor physiotherapists, sex coaches, massage therapists and pharmacists are some of the professionals who may be able to help you work through whatever is going on. 

Know what you want to know

Bringing up issues around sex may not be easy. Some practitioners respond positively, but others may respond more grudgingly. Especially given the short appointment times, you will get more from your visit if you are clear about what you want to know. Try as much as possible to be straightforward and clear about what’s happening and what you would like addressed. For example, if a medication you are taking is affecting your erections, say it straight out. “This medication stops me getting hard. Can we look at alternatives?” The clearer and more matter-of-fact we can be, the better a physician can understand and hopefully address our concerns. 

       

I’d love to hear from you. Contact me at adinacoach@gmail.com with comments and questionsor if you’d like to know how working with me can help you advocate for your sexual wellbeing.

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Adina Lakser is a Winnipeg-based sex coach, writer and mother. Visit her at nakedparts.wordpress.com or her Aquarian column Pillow Talk

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