When was the last time your doctor asked you how your sex life was going?
I thought so.
In a new study, a team from the University of Chicago surveyed over a thousand OB/GYNs about whether they talk with their patients about sex. The results may not surprise you, but they won’t reassure you, either.
- 63 percent routinely ask whether their patient is sexually active. (Good, but fairly superficial.)
- 40 percent routinely ask if the patient is having any problems regarding sex. (Which means that 60 percent don’t ask about sexual problems.)
- 28.5 percent ask about sexual satisfaction. (Which means that two out of three doctors don’t ask.)
- 28 percent ask about sexual orientation or identity. (Yikes! Two out of three don’t even know if their patient is gay or bisexual.)
- 13.8 percent ask about sexual pleasure. (Which means that 86 percent don’t ask whether the patient enjoys having sex.)
Even more distressing was that 25 percent of OB/GYNs reported expressing disapproval of a patient’s sexual practices. Foreign doctors, older doctors, and very religious doctors were more likely either not to address the issue of sex or to express disapproval. Female doctors and those whose practice focuses on gynecology rather than on delivering babies were more likely to do some sexual assessment, although it was often insufficient.
Dr. Stacy Tessler Lindau, a practicing OB/GYN and lead researcher in the study, points out that OB/GYNs are the most appropriate health care provider to be asking these questions, and if they aren’t, it’s unlikely that anyone else is. Which means, as we have found repeatedly, that women tend not to mention sexual problems, to assume that a doctor can’t help anyway, and to suffer with or adapt to sexual problems on their own.
Doctors should be talking about sex with their patients because
- Sex is an intimately linked to overall quality of life and the quality of one’s relationship.
- One-third of younger women and one-half of older women report having some sexual issues, from lack of desire to painful intercourse
- A change in sexual patterns can indicate an underlying health problem, such as depression or thyroid problems.
- Women with ongoing sexual issues are more likely to feel self-conscious, isolated, embarrassed, ashamed, or guilty.
- Assuming that a patient has a heterosexual orientation is alienating to patients who are lesbian or bisexual and can result in miscommunication and misdiagnosis.
- Common medications, such as those for depression and breast cancer, for example, can cause sexual problems, such as low libido. Women are often not told about sexual side effects of medications and are therefore unprepared to cope with them.
The researchers hypothesize that doctors don’t talk about sex because, like everyone else, they’re embarrassed or they may worry about embarrassing their patients. Talking about sex isn’t part of their medical training, and although they may treat a woman’s sexual organs, they aren’t equipped to assess and treat her sexual problems.
So what’s a frustrated patient to do?
Take the initiative, counsels Dr. Lindau. If you trust your doctor, but he or she hasn’t asked about your sex life, you can, and should, begin the conversation.
- Formulate your questions ahead of time. What, exactly, do you want to ask your doctor about sex? Do you have specific issues, such as painful intercourse or low libido? Are you anxious about entering menopause and need information about what to expect? Write down your questions and be as specific as possible.
- Acknowledge your discomfort, advises Dr. Michelle Curtis. It clears the air. “I know this is a little embarrassing, but I have some questions about sex I’d like to discuss.” Don’t worry about embarrassing the doctor, says Dr. Curtis. It’s his or her job to answer your questions.
- Empower yourself. The medical profession will change as women take responsibility for their own sexual health and begin asking questions and expecting thoughtful answers. You can ground yourself in basic information with websites like MiddlesexMD.com or others backed by solid medical organizations, such as the Cleveland Clinic or Mayo Clinic. Then you can approach your doctor with good, informed questions.
And if your doctor doesn’t respond in kind, avoids your questions, or seems uninformed, you can consider finding another doctor. We’ll discuss that process in a future post.
Hello Rose,
I am new to this site, but would like to share these words.
Whether or not money is involved always listen to your instincts first. When we listen closely, our instincts do not lead us in a wrong direction. It is when we fail to listen 
Susan -- I love the idea of the wrap, and thank you for the cinnamon tip. We must have the same house guests who show up each summer.
Hi Louise--I have met with a group of women on Whidbey Island and have started a discussion about the options and needs. Many of us would like a spiritual (not religious) tone to the community and that is drawing the most interest.
I lived in Ashe
Hello, Morgana,
Welcome to the discussion. (There are two threads, but let's stick with his one vs. the original from 12/7/12.)
Yes--we liked that article from NPR. Posted it on our website & retweeted. It will get lots of people thinking, so h
Barb, very interesting, but it doesn’t surprise me. Within the last six months I found a new doctor. I’m 63. On the form I had fill out when I first became a patient, it asked what form of birth control I used. I replied: menopause and old age, and laughed to myself. I learned in my 20s that doctor don’t ask about my sex life. To be honest unless I get an infection that I need them to treat, I don’t talk to them about sex. Most don’t seem to know as much as I do about it. I find my own answers.
After menopause I found that sex is much better than it ever was before, but I had to reintroduce my body to it. I had severe hot flashes for a long time, and sex was painful. I stopped using HRT when my sister developed breast cancer from hers. I tried all kinds of natural things, and they didn’t work. So when sex became an option again, I had to stretch everything out. Adam and Eve sell great toys. My husband loves it because he says I’m like a virgin. All the religious hang ups I had about enjoying sex are gone. I’ve become a lot more playful.
I live in a mostly rural county, and the doctors I’ve found here treat everyone like they have zero intelligence. Arrogance rules. So I find my own answers and am doing fine.
My experience is the same as Vi’s seems when you reach a certain age your not supposed to want or have sex. As for rural Dr’s and staff I heartily agree you’re talked to like your in Mayberry RFD
Even big city docs don’t want to take the time and they have their prejudices too. Not easy getting help out here.
Julia44,
I think there isn’t much help by competent people anywhere. Even in Mayberry these days, they have clinics that just shuffle one through, take your money etc. and in the end, the medication doesn’t work, and you’ve wasted your time. It took me several tries to get a doctor who could actually help me with my blood pressure. I’m slim and exercise to keep in shape, so it shouldn’t have been that difficult. And one doctor gave me a medication for my bp that had sulfa in it when I told him I was allergic. I reacted. I called in. No one called me back. He was pissed when I called him on it and denied sulfa was in the formula. But I looked it up online and found it. My husband had no problem with him. He was older and treated me like he had the hots for me. Strange. Doctors have to earn my trust, and for the most part I can’t find any to trust, so I look things up online and handle it. All these ads on tv say, “Contact your doctor.” And I say why? They won’t know anymore than I do.
I actually did have a female Primary Care doc ask me that question.