Help Your Doctor Talk about Sex

Menopause care specialists gather at the annual North American Menopause Society’s meeting to share information about the latest research and standards of care. I always appreciate the opportunity to catch up with colleagues, and to share experiences and helpful resources. Much of what I hear is affirmation of what we’ve recently discussed here at MiddlesexMD, but there are also new information and perspectives, which I’ll share as I work through my notes from several very full days!

Dr. Sharon Parish, who teaches at Weill Cornell Medical College, educated about “epidemiology and classification.” She also talked about how doctors like me can improve at communicating with our patients—women like you—about sexual health. The fact that this presentation was offered to a room full of professionals who are caring for midlife women confirms an issue we’ve discussed for a number of years: Not every doctor is comfortable with a conversation about sex.

The presentation also makes clear: We in the medical field recognize the issue and we’re working on it. In the meantime, you can help your doctor by anticipating what she or he needs to know to be helpful to your managing your sexual health. These are the highlights of what Sharon recommends doctors include in an assessment; when you’re headed to an appointment, think them through, make some notes, and if you’re not asked, still tell!

The nature of the problem. What’s the “presenting issue”? Pain with intercourse? Uncomfortable dryness? Lack of desire?

When the problem occurs. Are there specific times or steps in a process when you see symptoms? Do you experience the symptom all the time or only during some activities?  

Lifelong vs. acquired. Is the problem something you’ve always dealt with but it’s now worse? Or is it entirely new? Did it come on gradually or suddenly? What did you first notice and when?

Contributing factors. It can be difficult to identify these in yourself, but spend some time reflecting. Are you depressed or anxious? Have you suffered a trauma? Is there stress or discontent in your relationship? Have you changed your lifestyle in any way?

Exacerbating and alleviating factors. What makes symptoms better? What makes symptoms worse? What have you tried thus far, if anything, and what’s been the effect?

Impact and distress. What’s the impact of this problem on your health, relationship, and life? What is it that motivates you to seek help now?

When you bring this information in to a conversation with your health care provider, he or she will have a solid starting point to addressing your problem--and you’ll have signaled that you’re entirely comfortable with talking about sex. Which, in 2018, is apparently still a step we need to take.