gynecology-stirrupstalking about sex with your gynAre you able to talk to your gynecologist or internist about problems “down there?”  Many women do not feel comfortable talking to their doctors about their sexual activity. And, it turns out that our doctors aren’t very comfortable talking about the topic either.

A 2012 University of Chicago* survey of more than 1,000 obstetrician-gynecologists found that less than half of the doctors asked their patients about sexual problems. And, only two-thirds of them asked how sexually active their patients were. As I would have expected, the older doctors, 60 and up, were less likely to ask about sexual activity, though that has not been my personal experience.

Approximately 25% of the doctors in the survey expressed disapproval of patients’ sexual practices; primarily those with strong religious beliefs or foreign medical graduates. Many women don’t ask about sex for fear of embarrassing the doctor, according to Michelle Curtis, ND of the American College of Gynecologists.   I find it hard to believe that we worry about embarrassing our doctors. Isn’t it more likely that we are more concerned about judgment and our own embarrassment or shame?

Should You Talk to a Doctor about Your Sex Life?

At every stage of life we should have a doctor we trust and feel comfortable enough with to discuss our sexual activity and sexual health. But we also have to realize that he or she may not know how to discuss sex or give helpful advice.

If you want help from your medical doctor you will need to be very specific and direct. If you’re going through menopause and want advice tailored to that phase, it might be better to find a midlife physician or one who specializes in menopause. The research indicated that older doctors didn’t initiate the conversation but I think an older female doctor or medical practitioner would have the advantage of sharing the menopausal experience.

I no longer see a gynecologist, though we have an excellent midlife center at my preferred hospital. I’m three years past my last period, have never had a questionable Pap smear and have no other issues. My internist can do my pap smears and breast exams—I trust her and know she would refer as needed. You need to choose your doctor based on your own medical history and preferences. That may not be the case for you—each of us has different needs and comfort levels when it comes to medical practitioners.

I share my sexual history with my doctor and have asked for STD and HIV testing before going into a new relationship. She’s someone I trust—but we’ve never discussed sexual issues. My sense is that she knows I would speak up if I had questions.

If your questions are related to orgasms or the quality of your sexual experience you might be better off seeking answers elsewhere. Do see a doctor first to rule out any significant medical issues.

There are good online sources for information geared to women of all ages and specifically to older women.  I often have women who reach out to me with their questions. We talk or email about what’s going on and sometimes the very act of discussing the problem can lead to beginning solutions. I know my limits and don’t pretend to be medically trained in the field. Know who you’re talking to. There are people out there who aren’t what they appear to be. Their goal is to push their own paid programs or a sponsored drug/product. Beware of false experts and the well-meaning types who offer advice tinged with judgment. That’s not what you’re looking for.

Finding the right person to turn to will depend on your needs. Sexuality isn’t something that many physicians are going to be comfortable talking about. The idea that sexual health is connected to our physical well-being is taking hold, but slowly. Always rule out physical issues by seeing a doctor then you can begin to search for others to give you support, resources or counseling depending on your needs. If you’d like to reach out to me you, send me an email at

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