Talking to Your Doctor About Sexual Issues
The number one reason women visit a gynecologist or a women’s health-care professional are concerns regarding pelvic health or sexual function. It is estimated they account for approximately 10 million office visits each year. This number could even be higher if all related issues including trauma and other discomfort were included.
For many women, it can be embarrassing or difficult to discuss vaginal or sexual issues with a doctor. You are not alone! It is suggested that only 22% of women have talked with their health care provider about sexual issues since they turned 50. Many women feel their symptoms and issues are just normal side effects of age or other health conditions, not realizing their symptoms could be treated with the proper attention.
Opening the conversation
Sometimes, it can help to have a script in your mind or something written down to take the pressure off the conversation. Here are a few statements to help start a conversation with your Medical Provider regarding your sexual health and wellness.
- I am just not interested in sex, do you have any advice?
- I am interested in sex but have lost the desire.
- I am feeling sad lately and my partner is complaining I never want sex.
- Lately I have been having trouble with intimacy. What can I do?
- I have been experiencing pain during or after sex.
- When I exercise or sneeze, I've noticed I sometimes urinate a little.
- I am having some concerns about my sex life.
- I do not enjoy sex like I use to.
- Getting older has affected my love life. What can I do?
Tips on how to talk about your concerns
- Try to be specific. Describe the type of pain, if any. Notice where sensations may be coming from and when they tend to happen the most.
- It may help to keep a calendar of your mood, sexual activity or pelvic pain. Was there a point in time when things changed for you?
- How long have you been feeling this way?
- Does the problem feel emotional, mental, physical or all of the above?
- Be sure to make yourself heard and avoid minimizing your own concerns. If you feel your doctor isn't hearing you, say so, or try finding another doctor who is receptive to your concerns.
- Be sure to mention issues that you may not think are associated with your sexual health such as constipation, stomach pain, sleeplessness, exhaustion, depression, anxiety or headaches.
What they may ask you
Your doctor may ask a number of very personal questions and may want to include your partner in the interview. If you are feeling nervous, try to take a few, deep slow breaths and remember that these questions are intended to ultimately help you.* To help your doctor determine the cause of your problem and the best course of treatment, be ready to answer questions such as:
- When did you first become sexually active?
- Do you experience any pain with intercourse?
- Are you using any form of birth control? If yes, what form?
- For how long have you had difficulty reaching orgasm?
- If you've had orgasms in the past, what were the circumstances?
- Do you become aroused during sexual interactions with your partner?
- How much are you bothered by your lack of orgasm?
- How satisfied are you with your current relationship?
- What medications are you taking, including prescription and over-the-counter drugs as well as vitamins and supplements?
- Do you use alcohol or recreational drugs? How much?
- Have you ever had surgery that involved your reproductive system?
- Have you been diagnosed with any other medical conditions, including mental health conditions?
- Have you ever been the victim of sexual violence?
- What were your family's beliefs about sexuality?
What to expect at the exam
Your doctor will probably do a general physical exam to look for physical causes, such as an underlying medical condition. Your doctor may also examine your pelvic area to see if there are obvious physical or anatomical reasons.
Each sexual issue is treated differently. Some sexual issues may overlap and the treatment can be quite complex. Treatments may include diet changes, exercise, lifestyle changes, physical therapy, changing certain medications or prescribing new medication. You may be referred to another health care provider for other tests or specialized treatment.
You may be referred to a Pelvic Physical Therapist. From the Pelvic Guru: “Pelvic physical therapists are musculoskeletal experts in the areas associated with the pelvis (sacrum, sacroiliac joints, coccyx), including vulvar and vaginal, penile and scrotum, colorectal regions.”
You may also be referred to a sex therapist. Sex therapists can help individuals work through various issues such as emotional, physical and interpersonal aspects. They may recommend couples counseling to address interpersonal issues or individual therapy to assist with building sexual confidence and providing an understanding of how your past experiences can affect your sexuality today.
*If there is ever a point where you feel your doctor has crossed the line and is being inappropriate, say so!