How to talk to your patients about sex

The doctor's office is the logical—and sometimes the only—place where people can seek help with their most intimate problems.

By Gail Garfinkel Weiss
Senior Editor

You can talk about your patients' stool and urine, and you have no difficulty mentioning genitalia if the subject is, say, vaginitis or testicular cancer. But if you're like most physicians, you don't ask about patients' sexual functioning. Yet sexual dysfunction isn't rare, says Larry Maguire, an internist who runs a sexual wellness program in Lexington, KY. "We see it all the time."

Research bears Maguire out. A national study reported in JAMA in 1999 showed that 43 percent of women and 31 percent of men age 19 to 59 have had sexual difficulties. The main problem in women was low sexual desire (22 percent); in men, it was premature ejaculation (21 percent).

Nonetheless, physicians and patients both seem to have a tacit "don't ask, don't tell" policy when it comes to discussions about sex. A 1999 poll indicated that 68 percent of respondents were reluctant to mention sexual dysfunction to their doctor for fear of embarrassing the physician. And in the Global Study of Sexual Attitudes and Behaviors released by Pfizer last February, only 12 percent of Americans reported being asked about sexual difficulties during a medical checkup.