When was the last time you had “the talk” with your doctor?

Before you answer, let’s define what we mean by “the talk.” No, your doctor asking you if you are sexually active, and you muttering an awkward reply does not count as “the talk.” When was the last time that you and your doctor actually discussed how often you have sex? Whether it is painful or pleasurable for you? Whether you are having safe sex? Or even your own sexual orientation?

If you are like the majority of American women, your doctor never asks you these kinds of questions. “Good!” you may be thinking. “The last thing I want to do is discuss orgasms with someone wearing a lab coat and latex gloves.”
If you feel like this, it’s no surprise. A recent survey showed that 68% of people thought their doctor would be uncomfortable talking to them about sexual health problems. And yet, who else besides your doctor should you be expected to turn to for accurate answers to your questions about sex and sexual health?

Research overwhelmingly shows that sexual health is closely linked to overall health and well-being. Nor are sexual health issues rare. Some recent studies have found that up to one-third of younger and middle aged women and up to half of older women experience problems such as minimal sexual desire, pain during intercourse, or a lack of sexual pleasure.

In some cases, women don’t realize that their problems in the bedroom may be caused by medications prescribed by their own doctor. Drugs intended to treat conditions like breast cancer and depression often have known side effects which lower libido. When doctors recommend drugs with similar side effects for men, they typically discuss those side effects with them beforehand so that they can make an informed decision. Unfortunately, this same care is seldom extended to women.

Sex and health are deeply and intimately linked. So doctors should be working hard to make their patients feel comfortable discussing sex and sexual health with them, and asking them detailed questions about their sex lives.
But studies show that they don’t.

A report by the University of Chicago found that only 40% of OB-GYN’s ask their patients questions about sexual dysfunction, only 29% ask their patients if they are satisfied with their sex lives, and only 28% ask about their patients’ sexual orientation. Given how fundamental sexual orientation is and how it affects a wide range of sexual behaviors, this last statistic is especially worrying.

Since the conversation between doctors and patients about sex is so important, why isn’t it happening more often? Doctors aren’t learning how to. While American doctors are learning about a lot of things in med school, for sexual health often isn’t one of them. The average amount of time spent in med school on sexual health topics is – get ready for this – eight hours. And that’s if the school teaches it at all! Just over half do.

The bottom line is that doctors don’t want to talk about sex with their patients because their training simply hasn’t prepared them to do so. That means that the burden of starting that conversation is most likely going to fall on you, the patient.

Since it is a conversation worth having, here are a few steps you can take to help it go smoothly during your next visit to the doctor:

1. Make up a list of questions you want to ask your doctor ahead of time, and write them down. This will help to keep you from forgetting something important during your conversation.

2. Set the tone for the discussion early. Before the doctor breaks into their usual check-up routine, say, “Doctor, I’ve been having some concerns regarding my sex life recently. I wonder if we could take a few minutes to talk about them today?”

3. Be specific. This will help your doctor, especially if they seem uncomfortable. If you are experiencing discomfort during intercourse, for example, describe exactly how and where it happens.

4. Encourage your doctor and be sure to thank them for their advice.

5. Ask the doctor if the two of you can follow up on this discussion at your next appointment. This will let them know that this is a topic you want to continue to discuss in the future.

6. Don’t be afraid to do your own research as well. When you learn something that you have questions about, jot it down, and bring it in to ask the doctor next time.

It’s not always as easy as it should be to talk with your doctor about your sex life. But your sexual health is an important part of the story of your personal well-being.