How to Talk to Your Doctor About Sexuality Issues

Most of my clients who have had cancer treatments complain about sexual difficulties. While there are some healthcare providers who are interested in hearing/talking about sexual side effects that you might be experiencing, you may encounter those who don’t seem open to this kind of conversation. Breast cancer survivors deal with sexual side effects such as low desire, vaginal dryness, and painful intercourse due to surgery, chemotherapy, and hormonal therapies. Most often I advise my clients to talk to their healthcare providers about physical changes that interfere with sexuality. One of my female clients looked surprised and said, “Am I allowed to speak to my doctor about sex? It sounds so wrong!”

It’s hard to talk to healthcare providers about sexuality. They’re often very busy and seem to have very little time for a conversation about sex. Sometimes there is no easy way to start a conversation about sex when the discussion is primarily focused on the illness and treatment. Besides, healthcare providers have varying degrees of comfort and training in matters related to sexual health.

Interestingly, one study on physician and female patient communication on sexuality revealed that 80% of the time the women, rather than the physician, initiated the conversation. The conclusion that we can draw from this study is that if you want to have a discussion about sexuality and sexual side effects with your healthcare provider, you may have to initiate it yourself. It’s important to know how best to bring it up in order to get the information you need.

Here are some tips that may be useful to you when you want to talk to your healthcare provider about issues related to sexuality:

  • Learn more about your particular sexual concern ahead of time. Go to a few reputable cancer information web sites or books and learn more about the issue that concerns you. For instance, if you’re struggling with low libido, you can learn whether the definition of low libido matches what you’re experiencing. You may also be able to read about suggested tips for low libido. This will give you the basic information and the language you may need to articulate your concerns to your healthcare provider.
  • Rehearse how you are going to bring up your concern. If you practice your question or concern a few times at home, you’re more likely to ask your healthcare provider the question in a pressured environment. For instance, if you’re suffering from pain during intercourse and you’re wondering if it’s related to a drug you’re taking, you can practice saying, ”Since I started taking [name of medication], sexual intercourse has been painful. Do you have any suggestions?”
  • You may feel a lot more comfortable bringing up issues related to sexuality if you’re assured of confidentiality. Ask your healthcare provider if he or she can keep the information confidential and not share it with other providers without your consent.
  • Most of us assume that because healthcare providers know so much about the body, they’re comfortable talking about sexuality. Due to variations in medical training and personal comfort, some healthcare providers may experience discomfort when the topic of sexuality is brought up.  Most of the time when healthcare providers become uncomfortable talking about sexuality, patients immediately feel the urge to protect them by suppressing the question. If you’re prepared for the possibility of your healthcare provider’s discomfort, you’re more likely to gently repeat your question and get the response you need.

If you need information about your sexual health, you may need to bring it up with your healthcare providers. Some preparation, persistence, and patience will get you the answers you need.

Have you ever been hesitant to talk to your doctor about sexual side effects? What did you do about it? We welcome your feedback.

Dr. Sabitha Pillai-Friedman is a relationship and sex therapist and the director of the Institute for Sex Therapy at Council for Relationships (CFR) in Philadelphia. She is an American Association of Sex, Educators, Counselors and Therapists (AASECT) certified sex therapist and supervisor who has over 25 years of clinical experience. Dr. Pillai-Friedman presents nationally and internationally on various topics related to relationships and sexuality and has written book chapters and journal articles on religion and sexuality, sexuality and chronic illness, aging and sexuality, and the use of EMDR (Eye Movement Desensitization and Reprocessing) in the treatment of sexual dysfunction. She is an engaging public speaker and has been interviewed on NPR, CN8, and NBC. She is also an adjunct assistant professor at the Thomas Jefferson/CFR Couple and Family Therapy Program.

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