Does Your Doctor Ask About Sexual Issues?
Sex is a legitimate part of medicine, largely kept separate from the rest of medicine.
I have a charming primary care physician who’s up on the latest research, and quite thorough—well, almost. She never asks about my sexual functioning.
My doctor is typical. For years, sexologists have fretted about doctors’ discomfort with sexual issues. An editorial in the British medical journal, Lancet, says “sex is a legitimate part of medicine,” but doctors have “largely kept it separate from the rest of medicine.”
Many conditions involve possible sexual dysfunction: heart disease, stroke, cancer, diabetes, depression, and chronic pain, among others. In addition, recent studies show that sex problems, particularly erection impairment, can be the first symptom of several of these conditions, notably heart disease. Doctors who are reluctant to ask about sexual difficulties or don’t follow up on them may delay or miss important diagnoses.
American culture cherishes a myth that doctors step out of Normal Rockwell paintings and have all the time in the world to chat about what’s bothering their patients. In fact, doctors are under tremendous time pressure, and are less likely to chat than to reach for the prescription pad. When Viagra was released, doctors suddenly had a drug to treat erectile dysfunction (ED), so ED became a subject they would discuss—quickly, while writing the prescription. The same thing happened when research showed that low-dose antidepressant medication could delay ejaculation. Suddenly, there was a medical treatment for premature ejaculation (PE) and doctors were willing to discuss it.
Unfortunately, few physicians know much about sex counseling. Several studies have shown that erection medication works best when combined with sex therapy. Studies also show that with some sex information and perhaps sex therapy, most men can cure PE without drugs. In addition, sex therapists can help treat many problems for which there are no pills—and therefore, little interest from doctors, among them: arousal problems, orgasm difficulties, desire differences in couples, and the sexual changes that begin after 40.
In all fairness, physicians are not the only ones who feel uncomfortable discussing sex. Many people cannot bring themselves to raise sexual issues with their doctors. As a result, many sex-related problems go uninvestigated and undiagnosed, and cause misery much longer than they should.
Talk Your Doctors About Sex If They Don’t Talk To You
The next time you visit your physician:
• Mention your sexual functioning. You don’t have to have a problem. Just check in with your doctor about your sexuality, even if you say that all’s well. The idea is to put sexuality on the medical agenda, so that both of you become more comfortable discussing it.
• If you have a sex problem, mention it and urge your doctor to refer you to a colleague who specializes in sexual medicine, a small but growing medical specialty. If your doctor knows a sexual medicine specialist, great. If not, you might mention the Sexual Medicine Society of North America. You might also contact SMSNA yourself to find a sexual medicine specialist near you.
• When medical conditions affect sexual function, the best approach usually involves combining medical treatment with sex therapy. To find a sex therapist near you visit the American Association of Sex Educators, Counselors, and Therapists.
Questions & Answers
I’ve answered more than 12,000 sex questions from people around the world, of all ages, for free. Here are a few that relate to the topic of this post. If you’d like to ask me a question of your own, please go to GreatSexGuidance.com.
I am a 53-year-old woman and I have much less interest in sex than my husband. This has been going on for quite some time. None of my doctors seem to understand the toll this has taken on my marriage. I need some serious help before my husband ends up divorcing me after a 30-year relationship. He has just one thing on his mind. Is there an answer for me? Please help. I don’t know where else to turn. Read my response…
I’m a 45-year-old man, married since 1995 with 2 kids, 9 and 14. For a few years now I’ve suffered from erectile dysfunction. For the past year, I have not been able to have intercourse with my wife. My penis does not get firm enough to enter her. Sometimes it becomes somewhat hard but within a few seconds it lost its strength. I’m so frustrated that I cannot concentrate to my work. I have seen my doctor several times here in Bangladesh. Read more and my response…
I suffer from a mild depression and anxiety. My doctor put me on Wellbutrin, since Zoloft took my sexual drive completely. But Wellbutrin made my irate, extremely angry and made me cry. Is three something else that controls depression and anxiety and does not take away my sexual drive? Read my response…
Hi, my erection was fine, then 6 months before my marriage, I received treatment for baldness from a dermatologist who prescribed “finasteride 1 mg” for 3 months. I took it for 2 months and started experiencing loss of erection even though I was aroused. My quality of sperm become similar to a transparent sticky fluid. Immediately I stopped taking that tablet, but then nothing changed. I checked with the doctor. Read more and my response…