Sexual problems

While you might feel a bit embarrassed or uncomfortable talking about sex, sexual issues and your sexual history with your GP or other healthcare provider, they’ll be ready to talk if you open up a conversation. Many people delay for months or even years due to feelings of embarrassment, shame, hope that the problem will go away, or reluctance to involve their doctor or nurse in a conversation the healthcare provider might find difficult. 

However, there may be a simple explanation for your concern. If not, by talking about it your healthcare provider can help to identify what’s going on and make a start on finding a solution to your problem sooner rather than later. You can also be assured that anything you do discuss with your healthcare provider will be kept confidential.

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Below are some things that might make a conversation easier for you.

When you make a doctor’s appointment, you’re not always guaranteed of seeing your regular GP. If you’re offered a spot with someone you don’t know or don’t have a relationship with, it might affect what you feel able to talk about with them. So, make sure you book ahead to see a person you know and trust.

If you don’t know a healthcare provider well, or they don’t make you feel at ease, you could ask a whānau member or friend if they can recommend someone they like and trust. If you’d prefer to talk to a man or a woman, you could ask to see someone different at your general practice clinic.

Some doctors specialise in sexual health. Check your GP’s website for doctor or nurse profiles, ask the receptionist or try a specialist at a different place altogether.

Remember, your appointment doesn’t have to be face-to-face. If you’re a bit shy, you might feel more comfortable with a telehealth appointment or phone call. However, if your issue is physical, you may need to be seen in person if an examination is needed.

If your healthcare provider isn’t able to help, they can refer you to someone who can (eg, a sex therapist).

Appointment times with healthcare providers are often 15 minutes long and it can be hard to talk about everything (or even more than 1 thing) in a standard appointment slot. If you book an appointment just to talk about your sexual concern, and don’t tag it on the end of a consultation about your medicines or a health condition, you’re more likely to have the time to focus on what you want to say, and it will be less rushed and difficult.

Booking a double, or longer, appointment will also mean your healthcare provider is feeling more relaxed about getting into a discussion rather than feeling the need to cut you short so they can see their next patient.

Try starting with a general introduction. Here are some examples:

• I want to ask you about a men's/women's/personal health issue
• I'm having some problems in the bedroom/with sex
• Can I talk to you about a sexual problem?

Try not to be embarrassed – the more information you can give, the more likely your healthcare provider can help.

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It might be useful to write down what you are experiencing and any questions you’ve got before you go to your appointment. This will help you find the words you need and get the answers you’re after. If you find you can't talk about the issue at all, you can give the piece of paper to your healthcare provider to read.

This might include:

• what the problem is
• how long it’s been going on
• what you’ve already tried
• specific questions you have.

For example, if you’re a man, you might say "I can’t get an erection anymore," or "I don't seem to be able to keep an erection long enough for sex". If you’re a woman, you might say "sex is painful," "I don't experience the same kind of sensations during sex as I once did" or “I don’t really feel like having sex anymore”.

If you can, try and be as specific as possible. Don’t forget to mention any medicines or herbal remedies you’re currently taking. There’s a link between some medicines and sexual problems.

If you’ve ever experienced sexual assault or abuse, and you’re able to talk about it, tell your healthcare provider. It all helps them to work out how best to help you. If you would like counselling because of a past (or current) abuse situation you can ask for a referral or find somebody to contact yourself. Find out more about how to get support for sexual abuse.

It might help to ask your spouse or partner (or a good friend) to come with you to the appointment. If you prefer, they could also ask the questions for you, either on the phone or in person. It can be useful to have someone there if you are finding it difficult to talk about something, but it's also useful to have another person as a 'second set of ears'. We don't always remember important points or details when we're feeling stressed. 

You might go to your healthcare provider expecting to hear one thing and be told something else. You might be offered a medicine or treatment you haven’t considered. You might also need a physical examination or be tested for a sexually transmitted infection (STI). If you’re not sure why, or what’s going on, ask plenty of questions so you can understand what the plan is and any expected outcomes.

• Your healthcare provider will be open to talking to you once you make the first move.
• They're likely to have seen other patients with the same or similar concerns – it’s suggested that 20 to 40% of the adult population are concerned about sexual difficulties.
• There are no stupid questions!
• Anything you talk about is confidential between you and your healthcare provider.
• If you’re still worried, or the problem’s not resolved, ask for a follow-up appointment or see a different healthcare provider next time.

Most healthcare providers will be supportive and helpful when you talk about sexual problems. By being open and prepared, you can both get the best out of your appointment.