How to Advocate for Your Sexual Health at the Doctor's Officeby Emily Depasse Patient Expert
So many people claim to have a vested interest in their health when it comes to hitting the gym or eating well, but they may fall short when it comes to taking care of their sexual health. Doctors’ offices can be daunting, and an evaluation of your sexual health may bring up even more feelings of discomfort.
But whether you’re worried about the doctor, the examination itself, or fear of an unwelcome or unforeseen diagnosis, you shouldn’t let that stop you from seeking care. The following tips can help prepare you for a more productive meeting with your practitioner.
Know what to expect at your appointment: Do your research
Due to overwhelming societal stigmas, it’s not uncommon to be afraid to share our sexual and reproductive health histories with our doctors. “What will they think? Will they judge my number of partners? What if I test positive?” Oftentimes, it becomes easier for patients to ask, “Can you just test me for everything?” rather than give their doctor a detailed sexual history. Unfortunately, the definition of “everything” is not as broad as most patients believe.
For example, I’ve encountered many people who are surprised to discover that herpes tests are excluded from most sexually transmitted infection (STI) panels. Herpes is not currently included in the Center for Disease Control and Prevention’s (CDC) testing recommendations for STIs in sexually active individuals. This means that if you ask to be “tested for everything,” herpes likely is not included in the test you receive. Although the internet can be a treasure trove of uncertainty, using recommended resources to inform yourself about the risks and realities of sexual activity can assist in guiding discussions with your doctors.
Although condoms offer some level of protection against STIs, the only way to eliminate risk entirely is to abstain from sexual activity. The American Sexual Health Association (ASHA) offers guidelines for navigating these risks and setting boundaries, just as you do with many life decisions. One in two people will contract an STI before the age of 25, according to ASHA. Given this statistic, it is likely that you will come into contact with an STI at some point in your sexual life, no matter how “safe” the sex you have is. To maintain proper care of your sexual health, it is important to check in with a health care professional at least annually.
Good communication with your doctor is key
Like any good relationship, your relationship with your doctor requires good communication to be successful. In a world that highly values medical experts’ opinions, it is easy to forget that we as patients provide a valid voice and resource to our practitioners about our own bodies, just as they fulfill our need for updated medical information. Assuming that we visit our doctors once per year to discuss sexual health matters, a lot of the realities of “us” can be lost in translation.
Last year, I visited a total of five doctors over seven months for the same abnormal vaginal bleeding issue. I left unsatisfied after each diagnosis because I felt that doctors did not adequately address my described symptoms and history. I felt that no one truly listened to me and my experience as a patient. I felt invalidated and alone — like I was just another body.
But my current gynecologist took detailed notes of my medical history and personality. For example, he noticed that my Type-A tendencies probably meant that I was one to take my birth control pill on time each day. He was able to eliminate some possible factors of my abnormal bleeding. He offers recommendations and options for care, but never puts me in a position in which I feel that I am pushed to uncomfortable absolutes (like being forced to choose one form of birth control over another).
If you are unsatisfied with the level of communication you have with your doctor, don’t be afraid to leave them in favor of one who listens to you, accepts you, and that you feel has a vested interest in your health. Taking it upon yourself to try new doctors until you find the right fit can be empowering, although I realize not everyone has access to health care that makes this possible.
Keep records of your medical history
Growing up, I watched my father collect and file his medical test results neatly away. At the time, I thought it was unnecessary, but I have grown to appreciate his record retention. In a time when most medical practices have their own online patient portals, it is easy to let our results remain in an online abyss. While patient portals are convenient, not all doctors use the same one, which leaves medical results scattered and requires patients to remember multiple passwords to access their records — if they ever do.
This year, I learned the importance of knowing what I was tested for, maintaining a medical file, and presenting the appropriate results to my doctors. In my search for the “right” gynecologist, I needed records of my prior Pap smears (tests that screen for precancerous and cancerous cells in the cervix). When I looked in my previous provider’s portal, none of my Pap tests were there. I immediately called the office and discovered that it was not one of the records kept in online portals. My results were forwarded via snail mail several days later.
Having knowledge of prior test results can help give you and your providers a better overview of your medical history, especially when seeking a new provider. Although intake sheets can be informative, they do not always ask the questions that are most pertinent to your visit.
Your sexual health doesn’t define you
Test results are helpful, but they don’t define you. You know your body best and deserve to find a doctor who values your inner voice, as well as your belief system. By doing your research, communicating openly with your practitioner, and sharing your documented health history, you are more likely to create better relationship and system of care for yourself.