Sex in Midlife, Let’s Talk About It! (With Your Healthcare Provider)

I’m working on a book for midlife women who want to invite desire back into their lives. One of the things I write about is the tools, skills and resources a woman needs for a satisfying sex life, and that includes having a healthcare professional that she can trust. Unfortunately, talking to healthcare practitioners - particularly about intimate matters - can be hard for women.

Our “plumbing,” for one, is much more complicated than that of our male counterparts - and when we need help, we want to be able to find someone that we trust and who understands what we’re going through. Midlife, with all its changes, requires us to look at our bodies in different ways. The doctor we used in our pre-menopausal years has a different knowledge base than the doctor we might choose for menopause and age-related issues.

It can be very hard to discuss medical issues with a healthcare practitioner. Often, women don’t feel comfortable talking about intimate issues, even with their partners. So, how do you talk to a relative stranger, even if he or she is your doctor? Here we'll take a look at some tips.

Discussions With Doctors and Partners

Women have shared some of their midlife horror stories with me. For example, the doctor who told his female patient that he felt sorry for her husband when she shared her lack of interest in sex. That same doctor then shared her revelations with her husband who is also his patient. Women report feeling shamed when talking about new sex partners or being told they are too old for certain things.

Of course, I also hear positive stories about doctors - like the female doctor who talked to a woman about her issues with orgasms, suggesting that she practice with a vibrator. The advice was encouraging and mostly helpful, although the patient walked away uncertain about specifically how to use the vibrator and what kind to buy. (Fill in the blanks. Read: Our Top Tips for Buying Your First Vibrator and How to Use a Vibrator.)

Is All the Blame on Healthcare Professionals?

We can’t completely blame medical practitioners. First, many medical schools don’t teach much about sexuality or how to discuss sex with their patients. Second, there is the aging factor. Doctors, like many other segments of society, have biases. The assumption that older adults don’t engage in a lot of sex results in doctors underestimating the need for age-appropriate information for their patients.

If we want relevant, useful information from our healthcare practitioners, we have to find the right doctor for our needs and we have to start the conversation. We can’t expect them to be proactive about our sexual health, even if they’re gynecologists.

Talking to Your Healthcare Practitioner

So how can you bring up sex with your healthcare professional? Here are a few tips:

• If you want to bring a topic up with your doctor, be prepared with a list of concerns. Write then down just in case you feel flustered. Having notes allows you to stay focused, and it shows the doctor that you’re prepared.
• Compile specifics about your issue. The more specific you are, the easier it is to pinpoint and diagnose the problem. For example, if you’re having pain during intercourse, can you tell where it is or when it happens? Were you using a lubricant? Is your partner’s penis large? Is it painful deep inside your vagina, or as he’s entering, etc.
• It’s OK to ask for clarification. “When you say I should use a vibrator, what exactly do you mean? Do you any resources that might guide me?” There’s no guarantee they will have an answer, but you are asking for what you need and your provider may begin to realize that they have to provide more information to their patients.
• Ask questions. If the doctor recommends a test or medication, ask why. “What are you looking for?” “What is this pill for?" "How will it affect my libido?” “What are possible side effects?”
• If your doctor can’t address midlife questions that relate to menopause, bladder, or other specific concerns, ask for a recommendation to a specialist. There are healthcare practitioners that specialize in midlife issues.
• Many doctors are sensitive to the possibility of sexual trauma, and will make sure you know what they’re about to do at each step of the examination. However, there are some who aren’t. Your job is to say something if it is uncomfortable or you’d like the exam to stop. If you want, you can bring a friend to the exam and ask that they be in the room with you.

Remember that your doctor is there to be of service to you, not the other way around. If you’re not happy, you have the right to find a different healthcare professional.