Unless a sexual problem seems explicitly ‘medical’ (aka: biological) it might not be obvious that we need to have a chat with our doctors about it. But anything that involves our bodies, health and wellbeing (emotional as well as physical) is worth running past our GP (General Practitioner) just in case there’s something they need to have awareness of or if there’s something they can do to help. Some sexual issues can be a sign of an underlying medical problem that needs treatment to ensure you don’t become unwell, so it’s important to check.
However, for a lot of people, the idea of talking to a stranger about their sex life can be quite intimidating. Especially if the stranger is someone you’ve been taught to respect and see as the unquestionable expert. But doctors got into this because they wanted to make sure people are healthy and happy. Here’s how you can approach an appointment to make that easier for both of you.
Setting up the appointment
Who is your GP? Are they someone who you saw for your baby vaccines? Or are they whoever is available when you make your appointment? Whether you know them by first name or don’t know them from Adam, your relationship with them could impact what you feel able to discuss with them.
If you feel uncomfortable about the idea of discussing your sex life with a particular doctor, it’s really worth thinking about why and looking at other options if you can. It’s completely ok to request a different GP in the practice, or a GP of a different gender than the one you usually see. You can even ask the receptionist who they would recommend.
The bottom line is, you don’t have to see the same doctor as usual if you don’t want to.
Fortune favours the prepared
You’ll want to start your appointment by telling your doctor why you’re there. They may be unlikely to ask about sex unless you bring it up, so it’s important to say that that’s part of your concern. It might help to have something written down in advance and then read it out to the doctor. This can be helpful if you’re feeling nervous or don’t want to forget anything, because the more information you can give, the more useful your doctor can be to you.
What should you include? Here are some ideas:
What the problem is
How long you’ve had the problem
Where on your body the problem is located (the more specific, the better)
What the problem feels like, the symptoms associated with it
What solutions you’ve already tried
Anything that makes the problem better or worse
The type of contraception you’re using, if at all
Any other medications you’re currently taking
If you feel it’s relevant, how your sexuality and/or gender identity might affect what you’re experiencing
If you feel comfortable bringing it up, whether you’ve ever experienced sexual assault or abuse. It might be totally irrelevant, but it may help your doctor if they’re aware of it.
Don’t be afraid to be specific, including about where on your body the problem is. Every doctor has not only heard of all the body parts you want to talk about, but they’ll have seen them all too, possibly multiple times that week.
What do you want?
What expectations are you taking into the appointment? Do you want information, reassurance, a specific medication or treatment regime? A referral to a specialist? Or just to know your options? It’s really important to raise this with your doctor. Often they’ll be happy to explore them with you - and explain when they may not be appropriate. If they refuse you something you would like and you disagree with their decision, ask them to add their decision (and reasons for it) to your notes. This means their decision is accountable to other professionals who may see your notes in future, and there’s a record of the request you made.
Don’t go it alone
You can bring in a friend, partner or family member if you think you might want some support. They don’t have to say anything, they can just be a friendly presence, or they can point it out if you seem uncomfortable with something but are struggling to say so yourself.
It’s important to make sure that this person is someone you can speak freely in front of about anything the doctor may ask, and someone who will help you push for what you want and not for what they want. They shouldn’t talk over you and should take their lead from you. If you start to struggle to disclose something in front of them, it’s time for them to go back to the waiting room.
There are no stupid questions
It doesn’t always occur to people to ask questions of their doctors - but that’s what they’re there for. What does that word mean? What do you think might be happening? Why do you recommend this and not that? What are the possible side effects? Anything that is unclear to you is worth asking.
You can even ask them to write their responses down (or give you a moment to write them down) so that you can revisit their answer later if the question was important to you. And if you have your own theory or ideas about what’s going on, share it with them and see what they think. You can ask questions to understand their answer and improve your knowledge.
Be open minded
You might go in with a clear goal and be offered or told something else. This is why it’s important to ask questions, so you can understand why this is. You may disagree, but you may learn something useful.
Many doctors will try low risk interventions before trying anything that could potentially harm you or that might waste your time and resources. If there was something else you were hoping for, ask when that is likely to be an option. It may be they have to eliminate some possibilities before you get to that. Be prepared for the possibility of needing a few appointments to solve your problem.
The possibility of having their genitals examined (either internally or externally) can put people off speaking to their doctor about sexual issues. It’s still important to speak to a doctor, and if they suggest doing an examination, you can ask what this will involve and if you feel nervous, make another appointment to come back and do it another time so that you have time to prepare (including bringing a friend or partner if that would help you feel more comfortable, or arranging a chaperone from the staff in the practice, which is an option for every appointment).
Examinations should always go at the pace of the patient and allow for you to dictate what happens. A lot of doctors are taught that speed is important in intimate examinations, but this depends so much on the patient and what is needed with everyone is consent and communication - just like sex.
If you’re feeling nervous about an examination, especially if you’ve experienced sexual abuse, rape or traumatic medical experiences, you can request any of the following: Going slowly and checking in with you before moving to the next stage of the exam, and stopping and reducing contact if you need them to (this should always happen, but you might want to emphasise it as they’re not always trained this way)
Going through the examination with your clothes on first so you know what to expect
Using your hands to show them your genitals so they don’t touch you
If something needs to be inserted in you (such as a speculum or ultrasound wand), you do the insertion and removal
Anything else that you think will help you feel comfortable
If they say no, they should explain why (for example, it may prevent the examination being done properly) and suggest alternatives. You can put the exam off for another day (or another doctor!) if you still don’t feel comfortable.
If you’re worried about the smell or appearance of your genitals during an examination, have a shower first if that would reassure you. Don’t forget though - your doctor knows that all genitals are different. If they notice something that seems unusual, that could be relevant to the issue you came in with, and they’ll raise it with you sensitively.
A lot of GPs can be utterly blasé about anything you come in to talk about, which can be seriously off-putting if for you it’s quite a big deal! Chances are the GP you see will be exhausted from having seen patients every 10 minutes for the last few hours, rather than actually being indifferent to whatever brought you in. As long as you get the treatment or information you need, don’t let it put you off.
That said; your doctor should never be judgemental, should always treat you with dignity and respect, and should explain their decisions to you when asked, even if it’s not the decision you wanted.
Now go forth, and be healthy!