Talking About Sexual Matters with Your Doctor: Why It’s a Good Idea

Talking with your doctor about your health can sometimes be intimidating, particularly if you have questions or concerns related to sexual matters. But asking those questions and discussing sexual issues is more important than you might think.

Why it’s important to bring up sexual health

Sometimes people make the mistake of assuming that difficulties in their sex life are a normal part of aging, and they give up. Others might feel uncomfortable bringing up the topic with their healthcare provider. But in reality, there could be ways your healthcare provider can help address issues you may be having with your sexual health.

While some sexual changes can be a normal part of aging, some symptoms or situations could be early warning signs of a health issue. For example, problems getting or maintaining an erection could be a sign of worsening diabetes, or a sign of blood vessel inflammation, which could be an early sign of developing heart disease. Other symptoms, such as changes in sexual interest, body functions, or how you feel about sex in general, could be related to normal life changes, such as menopause, age-related prostate changes, or a loss of your sexual partner due to death or divorce.  However, some of these same symptoms could also be signs of depression, which is why it is important to bring them up with your doctor.

If you are experiencing problems that are interfering with your sex life, it can help to discuss them with your doctor so you can work together to solve it.

What types of things should I discuss with my doctor?

• General questions about your body and how it works: If you’ve noticed a physical change or feel like something is missing; if you are wondering about changes due to a new phase of life such as menopause, relationship status, or retirement; or you notice changes after a medical procedure or test.

• New symptoms or problems: If you experience something that has never been there, such as sexual pain or a loss of something you previously had such as desire, lubrication, or getting or maintaining an erection. Changes aren’t always negative. A few medications can cause an increase in sexual desire, and for some people that may seem alarming if it is sudden or unexpected.

• Safety or well-being issue: If you have concerns about your relationship, personal safety, or are experiencing a personal struggle between how you feel and how you were raised. If you start dating after not having done so for a while, it’s a good idea to discuss safe sex and ask about how to prevent sexually transmitted diseases, which can affect people regardless of their age.

How do I discuss sex—it’s embarrassing!

It might not be easy to come up with the right question. But by being as specific as you can about your concern, it may be easier to ask about it during your appointment. No matter what your question is, chances are pretty good that your doctor or nurse has heard it before. Here are suggestions:

• “I’ve been having trouble keeping an erection. Can we talk about that?”

• “Over the past few months it has started to be very painful when I’m intimate with my partner. What do you think it might be?”

•  “I just haven’t felt like myself lately. Even how I feel about having sex with my husband has gone down.  Where can I go for help?”

• “Lately I’ve been having sexual feelings toward a man I know. I worry about it because I haven’t had sex since my husband died three years ago. Can we talk about that?”

Can sexual issues be treated or resolved?

Treatments for sexual problems are as varied as the problems themselves. Some solutions may be as simple as learning how your body should be working at your age and then making adjustments. For example, people who have pain connected to an age-related change such as arthritis or chronic back pain might be able to avoid pain by trying new sexual positions. 

Sometimes addressing a medical issue can improve symptoms. For example, a change in your sex drive after starting a new medicine might be related to a side effect of that drug. By working with your provider to adjust the dose or change to a different type of medicine, your symptoms may improve. 

Surgery or certain procedures can also affect sexual health. For example, surgery to remove the prostate can affect a man’s ability to get an erection. Also, some women notice a decrease in desire or have sexual pain after having surgery to remove their uterus. 

Even if your healthcare provider is not able to answer your questions directly, he or she can refer you to specialists such as urologists, gynecologists, therapists, or counselors.

Having a discussion with your doctor can help you decide together whether something is a serious health worry or not. Your doctor can help you make a plan to deal with sexual health issues—but your doctor needs to know about it first.

For more advice on talking with your healthcare providers or preparing for a medical visit:   

• Questions to Ask Your Doctor

• Talking with Your Doctor

• Sexual Dysfunction: Talking It Over

• Healthy Sexual Function

• Sexuality in Later Life

Sources

Sexual Dysfunction in Older Adults, UpToDate, 

http://www.uptodate.com/contents/sexual-dysfunction-in-older-adults?

source=search_result&search=talking+to+patients+about+sexual+health&selectedTitle=29%7E150

National Institute on Aging, US Dept of Health and Human Services: Sexuality in Later Life. 

https://www.nia.nih.gov/health/publication/sexuality-later-life

Sexual Dysfunction: Talking It Over, Joslin Diabetes Center
http://www.joslin.org/info/sexual_dysfunction_talking_it_over.html

Healthy Sexual Function, Indiana University Bloomington
http://healthcenter.indiana.edu/answers/healthy-sexual-function.shtml

These articles are not a substitute for medical advice, and are not intended to treat or cure any disease. Advances in medicine may cause this information to become outdated, invalid, or subject to debate. Professional opinions and interpretations of scientific literature may vary. Consult your healthcare professional before making changes to your diet, exercise, or medication regime.