Dr. Sarrel shares why women benefit from talking to their doctors about sexual problems.
Well, the starting point is to recognize that women have been hesitant to initiate a dialogue, to come into a doctor’s office, let’s say it’s their family practitioner or maybe it’s a gynecologist, and say, “The reason I am here today, Doctor, is because I am experiencing a loss of sexual desire.” That’s very rare for a woman to do that.
Usually she will bring up the subject with a doctor who knows her. It’s hard if you are a new person in town, and you are going to someone for the first time, you have no idea if they are going to look at you like you are a nut or if they are going to dismiss you or say something that’s derogative, but most of the time you have a working relationship with your physician and the people in her office or in his office.
So it’s someone who knows you over time and who is going to be open to you as a person. So that’s an important starting point. Another important starting point is the doctors themselves have been inundated with education only in recent years about the importance of sexuality and sex life in our population–in American population.
Most physicians are aware that patients are presenting who have problems related to sex. The statistics are at any given moment in time, any adult between the age of 18 and 49, 43 percent of the women have a sex problem at any given time . That’s our national data.
Doctors aren’t stupid; nurses read this. This is the National Institutes of Health basic study of sex in America. So they are aware, but they are hesitant to bring up the topic because they don’t want to embarrass you; they don’t want to put you on the spot.
What I teach doctors and nurses to do is have a little questionnaire as a way of initiating an appointment, and on that questionnaire because the sex problems are almost universal–over 80 percent of all adults are going to have a problem at some time in their adult life, and as I said, over 40 percent at any given moment. So simply ask in your list of questions.
You know, if you are asking about hot flushes and sleep disturbance and headaches and chest pain and shortness of breath and memory problems and problems with depression or anxiety, have a little question that says, “Have you seen any change in sexual desire?” More and more doctors are doing that. That will open the door for you.
I told other doctors, one way you can help patients to feel at ease asking about sex is put a book about sex on your desk or put it somewhere in your consultation room that’s obvious because it’s sending a message. This has been particularly worthwhile to do with psychiatrists because you know that people in psychiatry don’t routinely ask about sex.
I am a professor of psychiatry. I can talk about that, and I know what’s involved in teaching young psychiatrists, what do you do to open the door so the patient who is distressed about her sex life or his sex life, will say something? But little, simple things can be done so that a dialogue can be initiated. Most doctors say the reason they don’t ask about sex is they don’t want to impose on the patient. Most patients say, “I don’t ask about sex because I don’t want to impose on the doctor.” Great disconnect.
It doesn’t take long. It takes a lot less time to say to a doctor or to the nurse, “I have a problem with a loss of sexual desire, and this is what I have noticed. It is significant, and it is a distress to me.” We know the average takes about 90 seconds. People are worried, “If I start this dialogue I won’t have enough time.”
The doctors think, I won’t have enough time to deal with the issues, and I say them no, that’s not true. If you just sit back and let your patient tell you the story and don’t interrupt her, it will take her less than 90 seconds to say what’s going on that’s significant.
Unfortunately, in studies of doctor-patient interrelations or interactions, what we know is the average healthcare provider interrupts the patient at about 18 seconds. So we have to recognize the patient herself is going to have to overcome that and say, “Wait, let me finish what I have to say.”
About Dr. Sarrel, M.D.:
Philip M. Sarrel, M.D., completed his medical education at New York University School of Medicine, his internship at the Mount Sinai Hospital, and his residency at Yale New Haven Hospital. In addition to his many years on the faculty of the Departments of Obstetrics and Gynecology and Psychiatry at Yale University School of Medicine, Dr. Sarrel has also been a Faculty Scholar in the department of psychiatry at Oxford University, Visiting Senior Lecturer at King’s College Hospital Medical School at the University of London, Visiting Professor in Cardiac Medicine at the National Heart and Lung Institute in London, and Visiting Professor in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York. He is currently Emeritus Professor of obstetrics, gynecology, and psychiatry at Yale University.