A Cheat Sheet For Talking To Your Doctor About Sexual Issues

Talk to your doctor! You have likely heard this before. While It’s important to talk to your providers about your sexual health, this is much easier said than done.

Sexual health is a broad term used to describe your overall functioning and satisfaction with your body, sexual identity, and intimate relationships. Both medical and mental health professionals use what you tell them to build a treatment plan, and if you are leaving out details they may not be able to give you the best possible treatment.

Listen, I know that talking to your doctor is difficult. As a medical family therapist, I literally teach people how to advocate for themselves within the medical system, and I still find myself not being able to say what I need to say in my doctor’s office. Here are some common thoughts that make me hesitate to tell my doctor things.

"What if they don't take me seriously?"
"It's really not that big of a deal."
"I should just wait until I see my gynecologist." *never sees GYN

"What if I tell them, and they are clearly uncomfortable?" 
"I will give it a few more months to see if it resolves itself."

"I will bring it up at the end of the appointment." *never brings it up 
"Oh my god, I'm gonna cry when I say this, I I just know it."

And last but not least, I just forget. I went in the appointment with the intention to bring it up, and find myself back in my car saying, “Dang! I didn’t bring up that thing I meant to talk about.” If any of this looks familiar, I’m here to help.

So, here they are! Cheats you can use to talk to the doctor.

1. Write it down. Have it written down before you go in for your appointment. Just write it down in a notes app or send yourself a text message of what you want to say. When you are ready, just read it word for word. Also, saying it to your doctor shouldn’t be the first time you ever say it out loud. Practice saying it a few times (even if in the car ride to your appointment) to ease your nerves. Additionally, if you are nervous, you will be less likely to hear the doctors response. I would also suggest typing down the doctor’s answer while you already have your phone out.
2. Talk to a nurse first. For many people it’s easier to speak with a nurse than with a doctor. When a nurse comes in to get vitals and other important information, tell them you want to talk to the doctor about sexual health issues but you are nervous. The nurse can then relay the message to the physician and they can take the lead on the conversation. A second option is to get a different provider to advocate for you if needed. As a therapist, I have sent many faxes on behalf of clients who needed an extra advocate to help them communicate with their medical providers. The additional benefit of this is the fax should also get put into your medical file for documentation.
3. Send them a secure message in a secure portal. If this is an option, take advantage of it and send them a message either before or after your appointment. Tell them in the message that you want to talk about the issue, but you are afraid to bring it up and you would appreciate it if they took the lead and asked you about it first.
4. Tell them how it affects your quality of life. Quality of Life (i.e QOL) is a term used a lot in the field of medical and behavioral health. Sometimes, if you tell a provider you have an issue, but they don’t know how it affects your quality of life they may not want to change your current treatment. Let me give you an example, let’s say your doctor recently changed a medication and you start having symptoms of vaginal dryness. The vaginal dryness is causing some communication issues with your partner, and you also notice you have had more bladder infections lately. These are things you need to bring up with the doctor when you talk about your side effect of vaginal dryness, because it is clearly having an impact on your physical and relationship health. Introducing a sexual lubricant may be helpful, but your doctor may also need to consider a medication change if the symptoms persist.
5. Ask them to document. If they dismiss your symptoms, request they document in your file that you brought it up and they feel the symptoms you described do not need treatment. This one may seem to be for the bold, but it will definitely get their attention and let them know you are serious.
6. Find a new doctor. If you have had a bad experience with your doctor saying or doing something that didn’t feel great, consider finding a new doctor. I know it’s a headache to peruse your insurance website, make calls, and book a new appointment. Let me just reassure you that it IS worth it to have a doctor that you can be open and honest with. Your body and mind will thank you. If this is the route you think you need to take, call your old doctor’s office and get them to send your new doctors office your file. Doing it this way is free and simple, and your new doc will already have your records when you get started with them.