Most of us know that when our bodies are malfunctioning, we need to talk to a doctor. When we have a pain in our hip, or we can’t stop coughing, we book a medical appointment.
But when the problem is with sexual functioning, it’s somehow much harder. We might know there’s a problem, but it’s too confronting or awkward or just plain embarrassing to talk to a doctor. And this is hardly surprising; many people find it tricky to talk to their partners about their sexual issues, let alone talk to a professional in a surgery.
There is a false perception that sexual functioning is supposed to be easy, and that anyone with sexual difficulties is somehow deficient or weird.Credit:iStock
But we need to be able to talk to our doctors about sex. Whether we’re experiencing painful sex, or erectile dysfunction, or a loss of libido, sexual problems can deeply impact on our lives.
So why are they so hard to discuss?
According to sexologist Chantelle Otten, many doctors fail to raise the issue of sexual functioning in consultations. This could be because of limited time (a fifteen minute appointment doesn't leave much room for conversation) or their own limited education about sexual difficulties.
Doctors may worry that mentioning sexuality will offend their patients or be culturally inappropriate, or they may simply wait for the patient to raise concerns. And some doctors unwittingly stereotype their patients, deciding they look too well to be having sexual problems, or too ill, too old, too young or too disabled to be sexually active at all.
And all too often, we patients don’t raise the topic with our physicians.“Patients may have embarrassment and shame around the topic,” says Otten. “They might feel uncomfortable with themselves or have low self-esteem, or they might feel that they’re abnormal and alone.”
Some patients pick up on their doctor’s body language and reluctance to discuss sexuality, and some have had previous bad experiences with a health practitioner.
And, of course, there are cultural beliefs around sex and sexuality that make it hard to seek help. We see sex as recreational rather than necessary, so a person who cannot be sexually active may not see this as a legitimate problem. And there is a false perception that sexual functioning is supposed to be easy, and that anyone with sexual difficulties is somehow deficient or weird.
Otten challenges this perception, stressing that good sexual functioning is not "normal and easy", and that most people will experience some kind of sexual problem at some point in their lives. In fact, she tells me some illnesses – certain cancers, for example – almost inevitably lead to sexual dysfunction.
So how can people best discuss sexual issues with their medical professionals?
Otten recommends being prepared, and jotting down a basic script or a few dot points that include being up front about the issue (in detail) and how long you have been experiencing it.
It is important to stress to the doctor that you are seeking treatment, and that you are hoping for a solution. If you are concerned or worried, tell the doctor; if you are embarrassed or ashamed, you can acknowledge this too.
Finally, if you don’t get the answers you were seeking from your doctor, you should absolutely get a second opinion. And if you can’t get the help you need from a physician, Otten recommends you see a sexologist.
“It’s our job to understand the intricate details of sexuality,” she says, “and we will work on being a team to solve the problem.”
It might feel challenging to seek help about sexual functioning, but it is worth pushing through the discomfort. We all deserve to have fulfilling, enjoyable sex.
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