Does the idea of talking about sex with your doctor make you cringe?

You’re definitely not alone. Many of us were raised not to talk about it—with anyone, really—and those taboos can persist throughout our lives. Unfortunately, they also can prevent us from getting the holistic health care we need and deserve.

Why? Because sexual health and overall health are interconnected. A change in our physical health can impact our sexual health; a change in our sexual health can impact our mental health. Yet many primary care providers neglect to ask about or assess sexual health as part of routine care.

That’s why it’s so important to normalize these discussions with your health care team. And it’s up to you to start the conversation.

Confronting fears and societal stigmas around sexual health can be challenging, but remember this:  Sexual health issues can happen for all of us, no matter how well we take care of ourselves. Problems can arise due to medical conditions, hormone levels, prescription medications, and other factors.

If you are experiencing common issues such as vaginal discomfort, erectile dysfunction, or low libido, know that millions of others are experiencing them, too. And, importantly, there are a variety of treatments and approaches you can use to ease your symptoms.

Having the sexual health conversation

During a series of focus groups that National Council on Aging (NCOA) held on the topic of sexual health, many participants mentioned that their physicians didn’t discuss matters of sexual health with them.

As one participant commented: “I think they are not aware that we are still viable people.” Another emphasized how important it is for older adults to bring up the topic of sexual health during a medical exam.

“I really believe you have to advocate for yourself" this focus group participant said. "In life, you can’t wait for anyone to get involved. You have to know. You’ve got to know what you need and get out there and get it one way or the other. You cannot sit back.”

It may help to know that any time your health status changes, your sexual health status may change as well. Be as open and honest with your doctor as possible. No question is out of bounds. If your primary physician isn’t screening you for some of the common issues related to sexual health, be assertive and advocate for yourself. If your provider can't address all of your questions or concerns directly, ask for referrals to other medical professionals who can.

Still a little unsure or uncomfortable? Here are some general questions you can use to start the sexual health conversation, whether you currently have an issue  or not. Be sure to write your specific questions down ahead of time and take them with you to your appointment.

Sexual health conversation starters: Questions for your health care team

• Can you make sure to include sexual health as part of my annual check-ups?
• Sexual intercourse is painful or impossible for me due to ________________ (vaginal dryness / incontinence / erectile dysfunction, / chronic pain / low libido / other specific factor). What steps can I take to remedy this?
• What are the potential side effects of my medications on my sexual health?
• What impact will this (treatment / surgery) have on my ability to have sexual intercourse?
• Since I have/have had ________________ (list past or current illnesses, chronic conditions, surgeries, etc.), what changes related to my sexual health should I be on the lookout for?
• What do I need to know about sexually transmitted diseases? What questions should I ask my partner(s) to understand their exposure to these diseases?

The same rules that apply to speaking with health care professionals apply to speaking with your partner(s): Be open and honest.

As the Sexuality in Midlife and Beyond report recommends: “Approach a sexual issue as a problem to be solved together rather than an exercise in assigning blame.” The report goes on to emphasize how important it is to find the right time to talk and to create an atmosphere of kindness for any discussion related to sexual health.

Sexual health is vital to your well-being across your entire life span, plain and simple. Sexual health is important because it is tied to your overall health—your physical, emotional, and mental health. And communicating openly with your health care team and your partner about it is an important part of your health care plan.

Sources

National Institute on Aging. Sexuality. Found on the internet at www.nia.nih.gov/health/topics/sexuality

1. Sexuality in Midlife and Beyond. Harvard Health Publishing. Found on the internet at https://www.health.harvard.edu/healthy-aging/sexuality-in-midlife-and-beyond