5 Really Embarrassing Topics to Discuss with a Doctor

Lisa D. Ellis

Reviewed by QualityHealth's Medical Advisory Board

Going to the doctor can be stressful if you’re worried that your physician might ask you some personal questions about sensitive matters you’d rather not discuss. But you shouldn’t let your shyness get in the way of having an honest conversation, since the answers can provide important information about you and your health.

Embarrassing Issues

Here are five delicate topics that you may prefer to avoid, but which experts urge you to speak up about:

Urinary incontinence: You may not want to talk about it, but your doctor needs to know if you’ve been having trouble controlling your bladder. "Many people often try and manage it on their own by wearing pads or going to the bathroom more frequently to prevent accidents," says Vishal Bhalani, MD, urologist at Weiss Memorial Hospital in Chicago. But this condition is important to discuss with your physician, because it could be a sign of a bigger issue such as prostate problems for men, or a urinary tract infection for women.

Even when urinary incontinence isn’t a symptom of anything more serious, sharing your concerns will allow your doctor to help you to address the problem—often with simple interventions: "Urinary incontinence can often be managed with exercises to strengthen the pelvic floor muscles, and sometimes with medication," Bhalani says.
Anything anal: "Most patients are uncomfortable talking about anything anal, be it itch, hemorrhoids, fissures, general pain, protrusions, etc.," says Allen Kamrava, MD, MBA, a colon and rectal surgeon and attending staff at Cedars Sinai Medical Center in Los Angeles. "All of the above are incredibly common, and though it may not be good dinner conversation, it’s exactly what we specialize in and really there is little to nothing that that we haven’t already seen or heard in the past." Go ahead and bare your concerns so your doctor can diagnose and treat the problem. Common anal symptoms can often be easily resolved with medications, creams, or other topical treatments.
Bowel function: If you squirm at the thought of discussing your bowels, you’re in good company, since few people want to share such personal information. According to Kamrava, "The one symptom that goes wholly untreated due to embarrassment and seems to be increasingly present in the population is fecal incontinence." This is trouble controlling bowel movements, and subsequent leaking of stools. Yet despite the fact that no one wants to talk about it, this issue is quite common: "This problem afflicts women more often than men, as the sphincter muscles [the muscles that close the canal and prevent leakage] get weakened with pregnancy and delivery. A large percentage of elderly women live with some level of fecal incontinence and just accept it as a fact of life, seldom discussing it with a specialist or their primary care physicians," he says.

If you do muster up your nerve to talk about it, you could be pleasantly surprised that there are some easy ways to treat the problem. Many of the treatments for fecal incontinence focus on physical therapy, and "There are also other treatments, depending on the cause, that vary from silicon injections that bulk up the [anal] canal, surgical procedures that 'tighten' the muscles of the area, and a pacemaker that increases the resting tone of the sphincter muscles," he says.
Sexual performance: If your sexual response seems to be faltering, it’s certainly worth swallowing your pride and talking about it with your doctor. In fact, sexual dysfunction can sometimes be a symptom of a more serious problem. "With erectile dysfunction, men don’t mention it because they don’t want to admit that something might be wrong," explains Bhalani. "It’s a big self-esteem issue with men. But the condition can be related to a bigger issue like heart disease," he says. "When I discover a male patient with erectile dysfunction, I often refer him to a cardiologist for further evaluation."

Females can also experience sexual dysfunction as a side effect of cardiac issues, cancer, diabetes, neurological problems, and hormonal imbalances. For both sexes, your doctor needs to know your concerns and will ask you some questions to help narrow in on the cause and determine how best to address it. Oral and topical medications and hormone replacement therapy are a few common treatment methods to help you perform better.
Mental health issues: Sharing mental health concerns can be difficult for some patients, in part because "mental health is surrounded by stigma, fear, and shame," says Paula Anderson, LPC, LCPC, NCC, a clinical psychotherapist who practices in Maryland and Washington, DC. "These perceived barriers can hold someone back from seeking treatment," she adds, stressing that it’s important to communicate your mental health concerns, including sadness, depression, anxiety, and anger. When left untreated, the symptoms of mental health disorders can worsen and potentially interfere with your quality of life, family relationships, and work performance. But addressing the problem can make a big difference.

"Treatment for many mental health disorders, such as depression, has a very promising success rate," Anderson says. Professional counseling services and prescription medications are often effective treatment methods that can help patients to feel some relief and be able to function better.

What You Can Do

Here are some tips for overcoming fear or shyness about speaking frankly with your doctor about these and other sensitive issues:

Remember that any information you share is completely confidential.
Understand that what might seem like a big embarrassment to you probably won’t be a big deal to the physician, who has heard similar information from countless other patients, Kamrava says.
Try not to be overwhelmed by the idea of disclosing highly personal information. Anderson suggests trying to relax and just focus your attention on breathing. "We are all human at the end of the day," she adds. Keeping this in mind may help put you at ease.
Raise your concerns on the written health symptom questionnaire that your doctor’s office gives you at the beginning of your visit. Bhalani says that this can be a safe way to bring up a sensitive topic and it will give your doctor an opening to start a productive conversation with you.
If you find you really can’t talk to your doctor about your most private concerns, this can be a sign that it’s time to find a new practitioner with whom you can feel more comfortable.

Allen Kamrava, MD, MBA, Vishal Bhalani, MD, and Paula Anderson, LPC, LCPC, NCC, reviewed this article.