Does Your Doctor Ask about Sexual Issues?

MichaelCastleman

Posted: Feb 28, 07 12:13pm

I have a very nice primary care physician. She's accessible, charming, up on the latest research, and thorough—well almost thorough. Only occasionally does she ask about my sexual functioning.

My doctor is more sex-focused than many physicians. For years, sexuality authorities have fretted about physicians' poor understanding of and discomfort with sexual issues. The latest hand-wringing comes from a recent article in the British medical journal, The Lancet, co-authored by distinguished sex researcher Rosemary Basson, a clinical professor of psychiatry at the University of British Columbia and director of the Center for Sexual Medicine there, and Weijmar Schultz of the University of Groningen, the Netherlands. They say that "sex is a legitimate part of medicine," but that doctors have "largely kept it separate from the rest of medicine."

Basson and Schultz note that many conditions involve sexual dysfunction: heart disease, stroke, many cancers, diabetes, depression, chronic pain, and multiple sclerosis, among others. In addition, recent studies show that sex problems, particularly erection impairment, can be the first symptom of these conditions. Doctors who are reluctant to ask about sexual difficulties or don't follow up on them may miss important diagnoses.

Of course, 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 much longer than they should.

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 agenda, so that both of you become more comfortable discussing it.
• If you have a sex problem, anything from low desire to erection or orgasm issues to pain during sex, mention this and urge your doctor to follow it up with tests and/or a referral to a gynecologist, urologist, or other specialist.
• Ask if your physician knows a local doctor who specializes in sexual medicine. This is a small but growing medical specialty. If your doctor knows a sexual medicine specialist, great, that physician is available in case you need help. If not, your question encourages your doctor to check around for a sexual medicine specialist in your area.
• When medical conditions affect sexual function, often the best approach involves combining medical treatment with sex therapy. Sex therapists generally know more than doctors about the fine points of treating sex problems associated with medical conditions. To find a sex therapist near you, visit the American Association of Sex Educators, Counselors, and Therapists. Click the map of the U.S. and Canada and get a list of all the AASECT-certified sex therapists in your state or province.

So, here's a question for you: Do you talk to your doctor about sex?