Look Who’s NOT Talking!

Doctor with gagI was shocked to discover some time ago that 86% of doctors in the USA do not ask their male patients about their erectile function or sex life. This is really surprising since it is now proven that erectile problems are the proverbial “canary in the cave” signalling trouble long before other symptoms appear. Heart disease, coronary disease, cholesterol, diabetes can all show up as erectile problems years before any other symptoms do.

I used to think that this lack of communication was a problem that existed only in men’s medicine. I assumed that women’s doctors were covering sexual issues far better than men’s doctors. After all, an OB/GYN is all about the vagina, right?

WRONG! It seems doctors are failing both genders when it comes to dealing with sexuality. An article in the Journal of Sexual Medicine, “What we don’t talk about when we don’t talk about sex” reports on a survey at the University of Chicago.

Apparently, most OB/GYNs do not ask their female patients about sexual dysfunction or sexual pleasure – despite there being strong correlations between sexual satisfaction and good health. In fact, only 29% of doctors inquired about sexual orientation!

Stacy Tessler Lindau, MD, associate professor of obstetrics and gynecology at the University of Chicago Medicine, and the study’s lead author said, “As a practicing OB-GYN, many of my patients say I’m the first physician to talk with them about sexual issues. Sexuality is a key component of a woman’s physical and psychological health. Obviously, OB-GYNs are well positioned among all physicians to address female sexual concerns. Simply asking a patient if she’s sexually active does not tell us whether she has good sexual function or changes in her sexual function that could indicate underlying problems.”

Then, Lindau went on to talk about discussions she assumed were occurring in men’s medicine. She says: “For men with prostate cancer, in comparison, the impact of treatment on sexual function is typically discussed as part of deciding which therapy to try.”

Sadly, she is incredibly misinformed. Most urologists do NOT discuss the impact of prostate cancer treatment on sexual function. In fact, most surgeons or oncology radiologists tend to oversell the treatments and minimize the sexual side effects of treatments.

Dr. Landau made the same mistake I did about sexual conversations between doctor and patient. We were both wrong. Most doctors are not talking to their patients about sexual issues, even though those issues may have a direct bearing on the patient’s health.

So, bottom line: The medical field is failing miserably at addressing sexual issues of both genders. Patients must self-advocate and realize that when they walk into a doctor’s office, that doctor may well have his or her own sexual hang-ups when dealing with sex.

Marcus Welby is dead. The only one thinking about your healthcare is YOU! If you can’t communicate with your doctor about your sexual history, difficulties, interests and activities, find another doctor. There are lots of good doctors out there. Find one you can tell everything to!


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