Difficult Conversation Starters: Talking to Your Doctor About Sexual Health

March 19, 2024

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As a teen, you probably thought the “birds and bees” conversation was the most awkward sex talk you’d ever have. But as an adult, you now realize that uncomfortable — and way more personal — sex chats are inevitable, especially when there’s a concern.

For many, having a heart-to-heart about sex with an intimate partner isn’t too hard to imagine. Opening up to your doctor about pain during sex, vaginal dryness or your lack of libido may be another thing altogether. But having those frank conversations can be critical to your health.

Amanda Shipp, MD
Amanda Shipp, MD

“Your health involves the whole person, which includes your physical health, mental health and sexual health,” says MU Health Care family medicine doctor Dr. Amanda Shipp. “Sex-related concerns are just like any other health concern, and addressing those issues sooner than later will benefit your overall health.”

To help us kick off our new Live Healthy series highlighting how to have difficult conversations with your health care provider, Dr. Shipp offers guidance for navigating a discussion about sex:

Why You Should Discuss Sex With Your Health Care Provider

You’re probably not rushing to share what goes on between the sheets with your primary care provider. But maybe you should be — there’s a strong association between your sexual health and your physical health.

“Things like desire, pleasure, erection and orgasm often have more to do with blood flow than with hormones,” Dr. Shipp says. “Your sexual issues are often closely connected to health issues that affect that blood flow, such as diabetes, high blood pressure, high cholesterol and atherosclerosis (clogged arteries). Some medications can also trigger issues with blood flow.”

Dr. Shipp says every sex concern should be thought of as a health concern and completely normal to discuss with your provider. Issues you should discuss include:

Your doctor is also a good resource for sexual health and safety. They can offer guidance for protecting against sexually transmitted diseases (STDs), domestic violence or unsafe sexual practices, such as asphyxiation (suffocation). These topics can all affect your physical health.

When to Talk to Your Doctor About Sex

Your annual wellness exam typically offers an opportunity to talk to your doctor about sex. Just be sure to let the doctor know at the beginning of the appointment that you have something to discuss.

But if you are having a sex-related issue and don’t have an appointment soon, you shouldn’t wait, Dr. Shipp says. You wouldn’t wait if you had other ailments such as trouble swallowing, ear pain or insomnia.

“We talk about sexual health as part of a wellness visit, but sex is also a valid reason to schedule a ‘problem visit,’” Dr. Shipp says. “If you don’t want to be specific with the receptionist when scheduling the appointment, say that you have a personal problem you’d like to discuss with your physician.”

Try to avoid tacking your sex conversation onto a sick appointment for a separate issue like a lingering cough. There may not be enough time to give your concern the attention it needs. Appointments are often allotted just enough time to address the primary reason for the visit.

How to Talk to Your Doctor About Sex Concerns

Once you’ve decided to discuss intercourse issues with your doctor, there are some things you can do to help the conversation go smoothly.

Remember, Dr. Shipp says, your doctor isn’t going to feel flustered by the discussion — there’s nothing they haven’t heard, talked about or seen before. But being prepared can help to make you more comfortable.

Dr. Shipp shares three tips to help you prepare:

1. Make an Honest List of Your Concerns

The last thing you want to do is have a conversation about sex and forget to mention something or fail to get your questions answered. But it’s natural to draw a blank when the moment presents itself — especially if you’re nervous.

“Make a list of the concerns you have while you are somewhere quiet where you can focus on the task when you aren’t flustered,” Dr. Shipp says. Don’t leave anything out, and be as honest as possible. Keep that list on your phone so there’s no chance of forgetting it on the day of your appointment.

2. Practice Your Opening Line

It’s normal to be nervous about broaching a sensitive topic like sex. But like anything else, the more you do it, the more comfortable you’ll be.

“Practice your opening sentence more than once before your appointment,” Dr. Shipp says. “Consider starting with something like, ‘This is kind of embarrassing, but I had a question about vaginal dryness (or decreased sexual interest or whatever the issue is).’” That first sentence will be the most challenging part. Most people relax once the conversation gets going.

3. Use Anatomical Names for Body Parts

Talking about sex often involves a lot of lingo and innuendo. But it’s critical to make your concerns clear to your doctor. The best way to communicate clearly is to use words that everyone understands.

“It’s important to use anatomic language — such as penis, vagina, labia or testicles — so that everyone is communicating in the same way and is on the same page,” Dr. Shipp says. “If using those words feels uncomfortable or embarrassing, practice saying them at home first."

What to Expect From Your Conversation

When you bring sex concerns to your health care provider, you can expect to walk away with a plan of action. But the details of that plan will vary depending on the issue.

It’s important to keep an open mind during the appointment, Dr. Shipp says. If you go in with a preconceived notion that a pill will fix your issue or that the problem is purely hormonal, you might be disappointed.

“We don’t typically recommend checking hormone levels as the first step because hormones fluctuate day to day and hour to hour, and hormonal treatments can have significant risks,” Dr. Shipp says. “More often than not, the problem isn’t sex hormones but has to do with lifestyle or stress.” That’s why your doctor may recommend exercise — which increases blood flow — as the first step in alleviating sexual health concerns.

“Sex is an important part of your health, and everyone deserves to have the pleasure and intimacy it provides,” Dr. Shipp says. “But treating sexual issues begins with an honest discussion with your doctor.”

Next Steps and Useful Resources



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