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Why Aren't We Talking To Our Doctors About Our Sexual Health?
The Debrief: Is our reluctance to talk to doctors about our sex lives putting our health at risk?
Header note:Developed in partnership with and sponsored by HRA, manufacturer of ellaOne. The healthcare professionals included in the discussion do not endorse any specific brands.
My friendly local GP doesn't rank very highly on the list of people I want to discuss my sex life with, so it didn't come as a huge surprise when two recent studies revealed that young women hate talking to their doctors about sexual health. After all, there's not much that's less relaxing than a lubed-up speculum, and no one wants to discuss their sex life with the family GP who once treated you for chicken pox. Pharmacists can also be tricky - even though we know that they sell condoms and pill prescriptions all day long, we all know someone who has tried to ‘casually’ buy the Morning After pill by asking the nice lady in the white coat to throw in half a dozen lollipops and a big box of surgical gauze.
It is a bit worrying though that so many of us have reached semi- responsible levels of adulthood and just can't bring ourselves, as one of the studies suggests, to say 'vagina' to a medically trained expert.
So what is it that makes us come over all coy in the face of healthcare professionals and, more importantly, are we putting our health at risk by ignoring embarrassing symptoms downstairs or refusing to have a proper conversation about our contraception choices?
It doesn't take a huge amount of imagination to work out why we're reluctant: 'GPs are generally middle-aged or older, often married, and a lot of women feel like they would be judged for disclosing certain things about their sexual relationships,' says 25-year-old Amy*.
'I think people are also put off by the possibility of having to have an examination. Speaking from experience, having someone ask about your holidays from underneath your dress is pretty awkward and embarrassing! I can see why many people would rather suffer in silence than go to their G￼￼P,' she says.
But where does all this embarrassment come from? Dr Helen Webberley – a GP for the NHS and Oxford Online Pharmacy, and a member of the Faculty of Sexual and Reproductive Health at the Royal College of Obstetricians and Gynaecologists – thinks we're just not talking enough about sex.
'In the Netherlands they've done a lot of work on this and sexual health is just ok – it's ok to talk about sex education, it's ok to get the morning-after pill, and sex is just talked about more freely,' she says. 'We're getting better at it in this country, but it is still taboo. We're not talking about it with our young people enough.'
It’s not just about how we deal with doctors – it’s the same reason why we still stutter and blush when buying condoms in Superdrug or asking the pharmacist for the Morning After Pill. We can’t quite bring ourselves to admit that we’re having sex. Or in the case of the Morning After Pill, that we’ve certainly had sex in the last couple of days.
Sexual health educator Hari Wells says ‘When I go into schools and colleges to talk about sex education, I always stress that pharmacists are our unsung heroes. They’re trained people, unflappable, unshockable and used to dealing with people who are in the throes of an emergency. They don’t just see a load of little old ladies buying cough drops. They’re not going to judge you, because they’re professionals. If you need to get hold of the Morning After Pill, you probably won’t be the first person to ask for it from them that day, and you certainly won’t be the last.’
Sexpression:UK is aiming to address the stigma through sex and relationship lessons in schools. Their communications officer, 20-year-old Mehnoor Khaliq, tells me: '[We need to] remove the stigma attached to young women having sex and bring the topic of sexual health into the public domain, so young people feel comfortable discussing sex.'
Of all the women I spoke to, those who said they'd never felt embarrassed chatting about sexual health had both grown up in medical families, where everything was open for discussion.
'My father is a doctor and my mother a nurse, so I've grown up feeling comfortable around medical jargon and the powers of diagnosis,' says 24- year-old Alex. 'The basic truth is that, no matter how freaky or embarrassing the patient finds their complaint, the doctor will have heard it before.'
Likewise, 30-year-old Emma says: 'My grandma was a family planning nurse – she had a pin board she took around schools, with all the different types of contraception pinned onto it. It was propped up behind the sofa in the living room! Our family had a very straightforward attitude: you're going to have sex because you're an adult, so you may as well make sure you're healthy.'
Dr Helen sees doctors' attitudes as a big part of the problem. 'We as the medical profession have to treat everybody equally and have our doors open to give people advice without judgement," she says. "Sexual health is something that even medical schools are embarrassed to teach doctors, so the doctor is often just as embarrassed as the patient – and it's evident to the patient that they're really uncomfortable talking about it.'
To check this out, I spoke to junior doctor Ellie*, 26, who graduated from medical school last year. 'We had special communication sessions [during my degree] but I can't remember if any of them included sexual health. We did have a fairly uninhibited senior lecturer, who taught reproductive health, which I think made us all realise we shouldn't get embarrassed,' she says.
Despite this, she adds: 'I am embarrassed discussing sexual health with my own doctor, even at dedicated sexual health centres. I feel like I should know better as a health professional!'
When it comes to contraception, part of the problem is that asking for it from a medical professional feels like walking up to a highly educated person and saying ‘Hello, I just made a really silly mistake.’ But Nakita Halif, the FPA’s Director Of Health And Wellbeing says ‘Sometimes there are inevitable situations, like a condom splitting, or you forget to take a pill...it’s irresponsible not to help young people prepare for these.’ Doctors, pharmacists and health professionals know that life happens and even the most informed, sensible people sometimes make mistakes. You wouldn’t be embarrassed to buy a pencil with a rubber on the end, so you shouldn’t be ashamed of asking for emergency contraception. And increasingly, pharmacies are offering us the option of ordering it online, so if you’re worried about getting a red face you can still deal with an unprotected sex situation quickly and responsibly.
It's pretty clear we all need to get used to talking about sexual health and contraception with our doctors and pharmacists as much as, if not more than, we talk about our sexual conquests. It’s up to us to be proactive and responsible about our bodies, our sex lives and our contraception. But medical professionals aren’t robot experts - they’re human beings who want to help, and it’s not their job to judge us, but to make sure we can easily, safely access what we need, especially when it comes to emergency contraception.
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