When -- and how -- to talk about sex with your healthcare provider
Most women and men will experience sexual problems -- even just minor ones -- at some point in their lives, or have questions about whether something to do with their sexuality is "normal" or "healthy." Medical conditions and life changes (such as aging, menopause or pregnancy) can cause sexual problems. Other times sexual problems are themselves signs of medical conditions, such as diabetes or cardiovascular health issues.
Talking to one's healthcare provider about sexuality can feel daunting, even though questions and curiosities about sexual health are quite common. Here is some information to get you thinking about when -- and how -- to address sexual health issues with a healthcare provider.
- Erection problems. Although most men will experience occasional erection problems due to stress, alcohol use, performance anxiety, medication side effects or fatigue, men who notice frequent (or worsening) problems with getting or keeping an erection should check in with their healthcare provider. Erection problems can be a sign of heart disease, diabetes or other health conditions. A healthcare provider can help to rule out these problems and suggest treatment options that may include counseling, education and/or medication. Although men might feel embarrassed to check in with a healthcare provider, encouragement from a partner (or even going together to one's doctor) can be helpful.
- Vaginal dryness. When women notice significant changes related to vaginal dryness -- either during daily activities or sexual intimacy -- they should let their healthcare provider know. Vaginal dryness can be caused by aging, menopause, other hormonal conditions, or may be the result of certain medical treatments (such as cancer treatments). Healthcare providers can help to rule out medical conditions and may recommend a vaginal moisturizer, personal lubricant or spending more time in foreplay to increase natural lubrication, which can make sex more comfortable, pleasurable and less likely to cause tearing during sex.
- Genital pain. As many as 15 percent of women may experience chronic vulvar or vaginal pain. Vulvovaginal pain may be the result of genital skin disorders, allergic reactions, cancer treatments, nerve disorders or other conditions, and it should always be looked into. Women can find support and information through The National Vulvodynia Association (www.nva.org). Many women with vulvodynia (vulvar pain) see several healthcare providers before they get an accurate diagnosis, which can be challenging and stressful (not to mention expensive!), and the support of friends or a partner can be important and helpful.
- Genital changes. Women and men both should look closely at their genitals to check for any changes such as itching, inflammation, redness, white spots, sores, dark spots, new moles or lumps. It's important to mention any changes to your healthcare provider as they may be the sign of a genital skin disorder, a sexually transmissible infection (STI) or, in rare cases, a more serious condition such as cancer.
- Everything is 'Fair Game'. No matter what the sexual question is, a person's healthcare provider is often a wise place to start. That's because most sexual health issues (including orgasm, desire, ejaculation, erections, lubrication and arousal) are affected by -- or can themselves affect -- our physical health.
- You've got to start somewhere! Asking a healthcare provider questions about sexuality is difficult for many people, particularly if they feel rushed at office visits. When you make an appointment, you might request a larger block of time than usual. Once you're in the exam room, you can open a conversation by saying that you have a question about something private, or that you saw something in a magazine that you have a question about. Another option is to write on the intake form that you have a question for your healthcare provider (which usually will prompt the provider to ask what your question is). If you have concerns about confidentiality, ask your healthcare provider to explain their rules about confidentiality, particularly if your healthcare provider also treats your spouse, partner or other family members. Even if it feels embarrassing, asking about one's sexual health is important, and can get you the help and attention that you need.
Debby Herbenick is associate director of the Center for Sexual Health Promotion in Indiana University Bloomington's School of Health, Physical Education and Recreation and a sexual health educator at the Kinsey Institute for Rearch in Sex, Gender and Reproduction. A researcher and highly sought after educator, Herbenick has appeared on national television and her columns are read in newspapers and magazines nationwide. Herbenick can answer your sexual health questions at http://www.kinseyconfidential.org/blog/ and you can visit her blog at http://www.mysexprofessor.com/.