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7 condom myths everyone needs to stop believing, according to a doctor


It’s time we got real about condoms.


When it comes to condoms, chances are pretty good that you think you know everything there is know on the matter. Like, you’ve been learning about safe sex since eighth grade health class. You’re good.

But where, exactly, does most of your current-day condom knowledge stem from? If it’s sourced from a mix of things your friends have told you, plus whatever memory of eighth grade health class you have stored deep within your temporal lobe, it may not all be entirely accurate. In fact, there are more than a few common condom myths floating around — some of which you may believe as fact.

INSIDER spoke with Dr. Logan Levkoff, a nationally recognized health and sexuality expert who works with Trojan brand condoms, to get down to the bottom of of what you should (and shouldn’t) believe about condoms.

Myth: Condoms haven’t evolved over the past few decades.

Condoms being tested.

Think that condoms haven’t really changed from the time that your parents (and even your grandparents) might have been using them? According to Dr. Levkoff, this couldn’t be farther from the truth.

“One of [the biggest myths] is when people say that condoms haven’t changed over time, that the condoms that are out today are the same as they were thirty or forty years ago. And it’s just not true,” Dr. Levkoff told INSIDER.

“There are have been a ton of innovations about condoms, condom shape, the use of lube, the thinness of latex, the ribbing. They’re so much better now!”

Myth: Condoms aren’t that effective.

Most of us have heard the same statistics — condoms, when used perfectly, are 98% effective. But “typical” condom use (aka the way most people use them) is 85% effective. Because of this, you may feel as though condoms aren’t so important.

“What we don’t typically tell people is that this “typical” number, that includes people who don”t use condoms all the time. So, is there a surprise that the number is lower if people don’t use them at all?” Dr. Levkoff told INSIDER.

“I think myths occur because we aren’t really clear on the numbers we’re giving and talking about.”

So, if you feel like you can skip a condom because it won’t make that much of a difference whether you use one or not, think again. If you use one, you’ll be in a much better position than you would be if you’d skipped one.

Myth: Sex with condoms isn’t as enjoyable as sex without condoms.

Condom sex = bad sex. Or, at least, this is a commonly-accepted narrative that you’ve probably heard two or three (or 10) times.

As it turns out, this isn’t true at all.

“Because we have these preconceived notions of what condoms are — thick latex, big smell — we perpetuate the message that condoms don’t feel good or condoms aren’t fun. And the reality is that condoms have lower latex odor today and they feel great,” Dr. Levkoff told INSIDER.

Dr. Levkoff also noted that a study done at Indiana University found that people rate sex with condoms equally as pleasurable as sex without condoms.

“And that’s really important, because condoms give us the ability to be fully engaged in the act of sex, to not worry and think about the ‘what ifs.'” Dr. Levkoff told INSIDER.

Myth: You can stop using condoms once you’re exclusive.

There’s something called a “condom window.”

Thinking about dropping condoms now that you and your partner have been dating for a few months? You might want to think again.

“In this business, we call this the ‘condom window,'” Dr. Levkoff told INSIDER. “We know that once someone is sexually active with a partner for a while all of the sudden, they’re like ‘Well, we don’t have to use these anymore.'”

“The reality is, we probably get rid of the condoms earlier than we should. There’s no question, in heterosexual relationship, that dual protection — condoms, plus [another form of birth control] — are really the best way to prevent STIs as well as unintended pregnancy. I would love to say that we live in a world in which we’re all super honest about what we do and who we do it with and what our sexual health status is, but we’re not always. So, until we get to a point where we can be, then it’s always worth having condoms, too.”

Myth: Young people are the only ones at risk for condom misuse and mistakes.

It can be easy to assume that, once you age out of the risk of becoming a teen pregnancy statistic, the rest of your sex life will be safe and surprise free. But if it’s important to be vigilant about safe sex, no matter how old you are — and, according to Dr. Levkoff, many people start to slip up as they get older.

“We are seeing numbers of sexual health issues arise, not just in younger populations, but certainly in aging populations too, who maybe are out dating again and are sexually active and aren’t as concerned about unintended pregnancy,” Dr. Levkoff told INSIDER.

“They might not have grown up in a time of HIV/AIDs and don’t think to worry,” she continued. “That’s also the group where, for the most part, if they saw condoms, they saw the condoms from the sixties, not the condoms from today. So there’s definitely some work to be done there.”

Myth: Condoms stored in wallets aren’t effective.

We’ve all seen that classic Reddit photo of the wallet that developed a permanent ring due to the fact that its owner stored a condom in there for the duration of his college years. And that probably means that you shouldn’t keep condoms in wallets at all, right?

Well, not exactly. Storing condoms in wallets certainly isn’t the best idea — ideally, condoms should be kept in a dark, cool, friction-free environment— but as long as you don’t keep a condom in a wallet for years and years, you should be fine.

“Condoms are medical devices. They’re regulated, so they have to be held to certain standards. But keeping it in your wallet for a little on the chance that you might have a great night, it’s not a big deal,” Dr. Levkoff told INSIDER.

What’s more important is to pay attention to the expiration date on the condom wrapper. “Condoms have expiration dates for a reason, because there is a window that they are most effective,” Dr. Levkoff said.

Myth: Condoms should only be the guy’s responsibility.

Do not rely on anyone for birth control.

If you are a person with a vagina who has sex with people with penises, you may feel that it is the penis-haver’s responsibility to provide the condoms.

Not so, said Dr. Levkoff. “I think there’s nothing more empowering than knowing you can carry a product that takes care of your sexual health. But there’s this idea that, because someone with a penis wears a condom, [they have to be in charge].”

According to Dr. Levkoff, it’s better to think about condoms as though both parties will be wearing them — because, technically, they are.

“If it’s going into someone else’s body, they’re wearing it too. It doesn’t have to be rolled onto you in order for it to be considered use,” Dr. Levkoff told INSIDER.

Complete Article HERE!


Doctors Are Failing Their Gay Patients


by Liz Posner

You’re supposed to be able to tell your doctor anything. But how are patients supposed to know what to tell their doctors if the doctors don’t ask the necessary questions in the first place? When it comes to sexual health screening, many doctors either missed the class in medical school that was supposed to teach them to ask patients about sexual health questions, or their lack of attention to sexual health is a conscious choice. Bespoke Surgical recently conducted a study of 1,000 Americans of various ages and sexual identities to hear what they’ve been asked by their doctor on the topic. The results suggest few doctors are asking questions about sexual health at all, and that LGBTQ patients, in particular, are being neglected.

The survey asked participants what kinds of questions their primary care physician focused on when they brought up sexual health during physical exams. The results varied based on the sexual orientation of the patient, as the graph below shows.

There are some outliers here that should be noted, but first, take a second to note how low these numbers are overall. Over half of heterosexual respondents said they were never asked about basic sexual health questions like HPV and STD exposure—a number that’s surprising, especially since 79 million Americans have HPV, a condition that can lead to cancer in both men and women. In general, it seems like doctors aren’t asking patients the right questions about sexual health.

But consider the shocking numbers revealed in the chart above. Of the physicians who saw homosexual patients last year, only 13 percent asked their patients if they had received the PrEP HIV prevention drug. Nearly half of all gay and lesbian respondents said their doctor had not asked them about HPV/Gardasil, anal pap smears, PreP/Truvada, or prior STD exposure. Only 40 percent of patients gay, straight and bi said they were asked if they used any kind of protection during sex.

When they do ask the right questions, the survey suggests doctors are asking them of the wrong people. In all but one of the above sexual health categories, bisexual patients were more likely to be asked about sexual health conditions. This could be because, as the Advocate explains, there’s a myth that bisexual people are more promiscuous than other people. The survey authors affirm this: “the ‘B’ in LGBTQ+ is often misrepresented in a variety of settings, including sexual promiscuity.”

Undoubtedly, doctors aren’t asking their patients a full range of questions because they aren’t able to spend enough time with them in the first place. People of all sexual orientations have experienced the rotating door model of doctor visits. Some primary care doctors say they treat 19 patients a day. With a full roster of 2,500 patients total, the Annals of Family Medicine says each doctor would have to “spend 21.7 hours per day to provide all recommended acute, chronic and preventive care” for that many patients. A 2016 study found that most doctor’s office visits only last 13-16 minutes. Professor Bruce Y. Lee at Johns Hopkins calls the average crammed doctor’s visit “archaic” in an article for Forbes, and says, “there is little time to actually listen or talk to patients and maybe not enough time to carefully examine them.”

The LGBTQ population seems to be catching on to the fact that primary care physicians may not know the right questions to ask their patients. That would explain why gay, lesbian and bisexual respondents were 20-30 percent more likely than straight respondents to rate having a doctor with the same sexual identity as them as “very important.” LGBTQ people are especially vulnerable to discrimination and may face barriers to health care that heterosexual people don’t. Some technology, like the entrepreneurs who launched an app to connect LGBTQ patients to gay-friendly doctors, is helping to make this easier. But it’s a quick fix to a much more systemic problem, considering so many primary care physicians don’t ask about sexual health problems at all.

Complete Article HERE!


Our shame over sexual health makes us avoid the doctor. These apps might help.


We’re taught to feel shame around our sexuality from a young age, as our bodies develop and start to function in ways we’re unfamiliar with, as we begin to realize our body’s potential for pleasure. Later on, women especially are taught to feel ashamed if we want “too much” sex, or if we want it “too early,” or if we’re intimate with “too many” people. Conversely, women and men are shamed if we don’t want nearly as much sex as our partner, or if we’re inexperienced in bed. We worry that we won’t orgasm, or that we’ll do so too soon. We’re afraid the things we want to do in bed will elicit disgust.

This shame can also keep people from getting the health care they need. For example, a 2016 study of college students found that, while women feel more embarrassed about buying condoms than men do, the whiff of mortification exists for both genders. Another 2016 study found many women hide their use of health-care services from family and friends so as to prevent speculation about their sexual activity and the possibility that they have a sexually transmitted infection (STI).

While doctors should be considered crucial, impartial resources for those struggling with their sexual health, many find the questions asked of them during checkups to be intrusive. Not only that but, in some cases, doctors themselves are uncomfortable talking about sexual health. They may carry conservative sexual beliefs, or have been raised with certain cultural biases around sexuality. It doesn’t help that gaps in medical school curriculums often leave general practitioners inadequately prepared for issues of sexual health.

So how do people who feel ashamed of their sexuality take care of their sexual health? In many cases, they don’t. In a study on women struggling with urinary incontinence, for example, many women avoided seeking out treatment — maintaining a grin-and-bear-it attitude — until the problem became “unbearable and distressing to their daily lives.”

Which may be why smartphone apps, at-home testing kits and other online resources have seen such growth in recent years. Now that we rely on our smartphones for just about everything — from choosing stock options to tracking daily steps to building a daily meditation practice — it makes sense people would turn to their phones, laptops and tablets to take care of their sexual health, too. Websites such as HealthTap, LiveHealth Online and JustDoc, for example, allow you to video chat with medical specialists from your computer. Companies such as L and Nurk allow you to order contraceptives from your cellphone, without ever going to the doctor for a prescription. And there are a slew of at-home STI testing kits from companies like Biem, MyLAB Box and uBiome that let you swab yourself at home, mail in your samples and receive the results on your phone.

Bryan Stacy, chief executive of Biem, says he created the company because of his own experience with avoiding the doctor. About five years ago, he was experiencing pain in his genital region. “I did what a lot of guys do, and did nothing,” he says, explaining that, while women visit their gynecologist regularly, men generally don’t see a doctor for their sexual health until something has gone wrong. “I tried to rationalize away the pain, but it didn’t go away.” Stacy says he didn’t want to talk to a doctor for fear of what he would learn, and didn’t know who he would go to anyway. He didn’t have a primary care physician or a urologist at the time. But after three months of pain, a friend of his — who happened to be a urologist — convinced him to see someone. He was diagnosed with chlamydia and testicular cancer. After that, he learned he wasn’t the only one who’d avoided the doctor only to end up with an upsetting diagnosis. “What I found is that I wasn’t strange,” Stacy says. “Everyone has this sense of sexual-health anxiety that can be avoided, but it’s that first step that’s so hard. People are willing to talk about their sexual health, but only if they feel like it’s a safe environment.”

So Stacy set out to create that environment. With Biem, users can video chat with a doctor online to describe what they’re experiencing, at which point the doctor can recommend tests. The user can then go to a lab for local testing, or Biem will send someone to their house. The patient will eventually receive their results right on their phone. Many of the above-mentioned resources work similarly.

Research shows there’s excitement for tools like these. One study built around a similar service that was still in development showed people 16 to 24 years old would get tested more often if the service was made available to them. They were intrigued by the ability to conceal STI testing from friends and family, and to avoid “embarrassing face-to-face consultations.”

But something can get lost when people avoid going in to the doctor’s office. Kristie Overstreet, a clinical sexologist and psychotherapist, worries these tools — no matter their good intentions — will end up being disempowering in the long run, especially for women. “Many women assume they will be viewed by their doctor as sexually promiscuous or ‘easy,’ so they avoid going in for an appointment,” she says. “They fear they will be seen as dirty or less than if they have an STI or symptoms of one. There is an endless cycle of negative self-talk, such as ‘What will they think about me?’ or ‘Will they think that I’m a slut because of this?’ If people can be tested in the privacy of their own home without having to see a doctor, they can keep their symptoms and diagnosis a secret,” Overstreet says, which only increases the shame.

As for the efficacy of these tools, Mark Payson, a physician and co-founder of CCRM Northern Virginia, emphasizes the importance of education and resources for those who do test positive. These screening tests can have limits, he says, noting that there can be false negatives or false positives, necessitating follow-up care. “This type of testing, if integrated into an existing physician relationship, would be a great resource,” Payson says. “But for patients with more complex medical histories, the interactions of other conditions and medications may not be taken into account.”

Michael Nochomovitz, a New York Presbyterian physician, shows a similar level of restrained excitement. “The doctor-patient interaction has taken a beating,” Nochomovitz says. “Physicians don’t have an opportunity to really engage with patients and look them in the eye and talk to them like you’d want to be spoken to. The idea is that tech should make that easier, but in many cases, it makes it more difficult and more impersonal.” Still, he sees the advantages in allowing patients to attend to their health care on their own terms, rather than having to visit a doctor’s office.

Those who have created these tools insist they’re not trying to replace that doctor-patient relationship, but are trying to build upon and strengthen it. “We want people to be partnering with their doctor,” says Sarah Gupta, the medical liaison for uBiome, which owns SmartJane, a service that allows women to monitor their vaginal health with at-home tests. “But the thing is, these topics are often so embarrassing or uncomfortable for people to bring up. Going in and having an exam can put people in a vulnerable position. [SmartJane] has the potential to help women feel they’re on a more equal footing when talking to their doctor about their sexual health.”

“If you come in with a positive test result,” says Jessica Richman, co-founder and chief executive of uBiome, “it’s not about sexual behavior anymore. It’s a matter of medical treatment. It’s a really good way for women to shift the conversation.”

This can be the case for men and women. While many will use these options as a means to replace those office visits entirely, their potential lies in the ability to improve the health care people receive.

Complete Article HERE!


What it’s like to talk to your doctor about sexual health when you’re bisexual


There’s a misconception that bi people are just going through a phase — but what if our doctors believe it too?

“Are you sexually active?”

I’d been dreading this question since losing my virginity to a female friend a few weeks earlier, not long after my 16th birthday. Somehow, the harsh fluorescent lights in my doctor’s examination room made this query seem even more menacing.

“Yes,” I said, but there was an ellipsis in my voice. A hesitation. An unspoken “but . . . ”

“You’re using condoms, right? So you don’t get pregnant?” she prompted, and I didn’t know what to say, because we weren’t. We didn’t need to. It was the wrong question.

“Uh, I’m not having sex with a guy,” I managed to stammer.

My doctor peered at me over her wire-rim glasses, “Oh,” she replied.

There are a lot of things a teenager might be nervous to disclose to their doctor — a marijuana habit, some worrying mental health symptoms, a secret relationship their parents don’t know about. While we should all feel free to tell our doctors what’s really going on with us, it’s particularly egregious that so many of them are still in the dark about something so basic as sexual orientation, making these already-difficult situations even more challenging.

The day of my first difficult conversation about my sexual health, my doctor didn’t give me any medical advice on the sex I was having. She didn’t suggest my partner and I use dental dams or latex gloves. She didn’t suggest we get tested for sexually transmitted infections (STIs). She didn’t ask whether my partner was cis or trans. She didn’t ask what sexual orientation I identified as (bisexual, for the record). She didn’t even ask me if I had any questions for her. She just moved on to the next part of our checkup.

I didn’t recognize these as problems at the time; I was too young and nervous to question the approach of my all-knowing doctor. Everything I later learned about safer sex — with the other cis girl I was seeing at that time, and with other partners later on — I learned from the internet. And while the internet can be a great resource for such information, doctors should be a better one.

Bisexuals are told all the time — both implicitly and explicitly — that we’re not queer enough to align ourselves with queerness, or that we’re too queer to align ourselves with straightness. I still find it hard to push back against these stereotypes today, at 25.

These presumptions are particularly upsetting in medical situations, where many of us already feel nervous and unempowered and, for many queers, apprehensive. The medical system has oftentimes failed us and our queer foreparents: inequitable health care access due to poverty, doctors’ lack of knowledge about LGBT identities and sexuality and the pathologization of queerness are just a few examples.

Two years later, in a different relationship with a person of a different gender, I returned to my doctor. I was a girl on a mission.

“I’m seeing someone new and I’d like to get an IUD,” I told my doc, with all the bravery and resolve I could muster as a meek 18-year-old still coming to terms with her sexuality.

“I thought you were a lesbian?” she replied coolly, barely looking up from her computer screen.

“No, I’m bisexual,” I clarified, my voice only shaking a little.

Medically speaking, it shouldn’t actually matter what word(s) I use to define my sexual orientation; my doctor should want to know, instead, what sexual activities I am participating in. I could’ve been a lesbian having sex with a man (they do exist!). I could’ve been having sex with a trans woman or a nonbinary person who had the ability to get me pregnant. There was no reason for my doctor to assume I was a lesbian in the first place, nor that a risk of pregnancy during sex meant my existing sexual orientation was being challenged.

I was reminded of a story I had read online. An American photographer I followed, Brigid Marz, wrote on Flickr that she and her girlfriend went to a hospital to get treatment for her flu symptoms. A staff member asked Brigid if there was any chance she might be pregnant, and she laughed, indicated her girlfriend, and said no. She’d dated and had sex with men before, but not recently enough that she could be pregnant. Months later, she received a $700 medical bill, $300 of which was for a pregnancy test she’d neither authorized nor needed.

“I am so sick of being treated differently just because I have boobs,” she wrote, but I would argue she was treated differently because she is non-monosexual – she is neither completely straight nor completely gay. Our medical system seems to assume everyone is one or the other, sometimes even when we’re loudly asserting otherwise.

In the end, my doctor refused to prescribe me an IUD on the basis that I was “just casually dating” and should wait until I was “in a serious relationship” before committing to a long-term birth control method that reflected my relationship status. She prescribed me the pill instead — the hormonal content of which exacerbated my mental health conditions for years, something the non-hormonal copper IUD may not have done.

What rankled me was that I was in a serious relationship at the time. My doctor may have assumed my relationship was casual because I was now with a man and I was previously with a woman, or she may have simply thought I was too young for the IUD — but I think it was because of negative stereotypes about bisexual people.

Bi folks’ relationships and attractions are often written off as “just a phase” or “just for fun.” We’re told we don’t know what we really want or who we really like — or, worse, that we’re intentionally playing with partners’ hearts, never intending to pursue commitment or depth in our relationships.

In my experience, this is about as true for bisexual people as it is for straight or gay people — some folks are looking for serious relationships and some just aren’t — but this assumption weighs most heavily on bisexuals. Whether or not my doctor was consciously aware of the stereotypes she was affirming that day, it’s clear to me that my relationship would not have been written off as “casual” if I identified as straight or gay.

If I could go back and talk to myself when I was a shy and shaking 16-year-old in my doctor’s office, I’d tell her to advocate for herself. I’d tell her to ask the questions she wanted answered, and double-check the answers on Scarleteen later. I’d tell her it was okay if she didn’t even know what questions to ask.

I’d tell her to be unashamed of her burgeoning bisexual identity, because it’s nothing to feel shifty about. But mostly, I’d wish I didn’t have to tell her all these things. Her doctor shouldn’t have made her doubt all this in the first place.

Complete Article HERE!


How To Talk To Your Doctor About Sex When You Have Cancer


More people are surviving cancer than ever before, but at least 60 percent of them experience long-term sexual problems post-treatment.


So you’ve survived cancer. You’ve endured brutal treatments that caused hair loss, weight gain, nausea, or so much pain you could barely move. Perhaps your body looks different, too—maybe you had a double mastectomy with reconstruction, or an orchiectomy to remove one of your testicles. Now you’re turning your attention back to everyday life, whether that’s work, family, dating, school, or some combination of all of those. But you probably aren’t prepared for the horrifying side-effects those life-saving measures will likely have on sex and intimacy, from infertility and impotence, to penile and vaginal shrinkage, to body shame and silent suffering.

More than 15.5 million Americans are alive today with a history of cancer, and at least 60 percent of them experience long-term sexual problems post-treatment. What’s worse, only one-fifth of cancer survivors end up seeing a health care professional to get help with sex and intimacy issues stemming from their ordeal.

Part of the challenge is that the vast majority of cancer patients don’t talk to their oncologists about these problems, simply because they’re embarrassed or they think their low sex drive or severe vaginal dryness will eventually go away on their own. Others try to talk, but end up with versions of the same story: When I went back to my doctor and told him I was having problems with sex, he replied, ‘Well, I saved your life, didn’t I?’ And many oncologists aren’t prepared to answer questions about sex.

“Sex is the hot potato of patient professional communications. Everyone knows it’s important but no one wants to handle it,” says Leslie Schover, a clinical psychologist who’s one of the pioneers in helping cancer survivors navigate sexual health and fertility. “ When you ask psychologists, oncologists and nurses, ‘Do you think it’s important to talk to patients about sex?’ they say yes. And then you say, ‘Do you do it routinely?’ They say no. When you ask why, they say it’s someone else’s job.”

Schover spent 13 years as a staff psychologist at the Cleveland Clinic Foundation and nearly two decades at the University of Texas MD Anderson Cancer Center. After retiring last year, she founded Will2Love, a digital health company that offers evidence-based online help for cancer-related sex and fertility problems. Will2Love recently launched a national campaign called Bring It Up! that offers three-step plans for patients and health care providers, so they can talk more openly about how cancer treatments affect sex and intimacy. This fall, the company is collaborating with the American Cancer Society on a free clinical trial—participants will receive up to six months of free self-help programming in return for answering brief questionnaires—to track the success of the programs.

Schover spoke to Newsweek about the challenges cancer patients face when it comes to sex and intimacy, how they can better communicate with their doctors, and what resources can help them regain a satisfying sex life, even if it looks different than it did before.

NEWSWEEK: How do cancer treatments affect sex and intimacy?
LESLIE SCHOVER: A lot of cancer treatments damage some of the systems you need to have a healthy sex life. Some damage hormone levels, and surgery in the pelvic area removes parts of the reproductive system or damages nerves and blood vessels involved in sexual response. Radiation to the pelvic region reduces blood flow to the genital area for men and women, so it affects erections and women’s ability to get lubrication and have their vagina expand when they’re sexually excited.

What happens, for example, to a 35-year-old woman with breast cancer?
Even if it’s localized, they’ll probably want her to have chemotherapy, which tends to put a woman into permanent menopause. Doctors won’t want her to take any form of estrogen, so she’ll have hot flashes, severe vaginal dryness and loss of vaginal size, so sex becomes really painful. She’ll also face osteoporosis at a younger age. If she’s single and hasn’t had children, she’s facing infertility and a fast decision about freezing her eggs before chemo.

What about a 60-year-old man with prostate cancer?
A lot of men by that age are already starting to experience more difficulty getting or keeping erections, and after a prostatectomy, chances are, he won’t be able to recover full erections. Only a quarter of men recover erections anything like they had before surgery. There are a variety of treatments, like Viagra and other pills, but after prostate cancer surgery, most men don’t get a lot of benefit. They might be faced with choices like injecting a needle in the side of the penis to create a firm erection, or getting a penile prosthesis put in to give a man erections when he wants one. If he has that surgery, no semen will come out. He’ll have a dry orgasm, and although it will be quite pleasurable, a lot of men feel like it’s less intense than it was before. These men can also drip urine when they get sexually excited.

Why are so many people unprepared for these side-effects?
If you ask oncologists, ‘Do you tell patients what will happen?’ a higher percentage—like in some studies up to 80 percent—say they have talked to their patients about the sexual side-effects. When you survey patients, it’s rare that 50 percent remember a talk. But most of these talks are informed consent, like what will happen to you after surgery, radiation or chemotherapy. And during that talk, people are bombarded by so many facts and horrible side-effects that could happen, they just shut down. It’s easy for sex to get lost in the midst of this information. By the time people are really ready to hear more about sex, they’re in their recovery period.

Why is it so hard to talk about sex with your oncology team?
It takes courage to say, ‘Hey, I want to ask you about my sex life.’ When patients get their courage together and ask the question, they often get a dismissive answer like, ‘We’re controlling your cancer here, why are you worrying about your sex life?’ Or, ‘I’m your oncologist, why don’t you ask your gynecologist about that?’ Patients have to be assertive enough to bring up the question, but to deal with it if they don’t get a good answer. Sexual health is an important part of your overall quality of life and there’s nothing wrong with wanting to solve or prevent a problem.

What’s the best way for people to prepare for those conversations?
First, because clinics are so busy, ask for a longer appointment time and explain that you have a special question that needs to be addressed. At the start of the appointment, say, ‘I just want to remind you that I have one special question that I want to address today, so please give me time for that.’ Bring it up before the appointment is over.

Second, writing out a question on a piece of paper is a great idea. If you feel anxious or you’re stumbling over your words, you can take it out and read it.

Also, some people bring their spouse or partner to an appointment. They can offer moral support and help them remember all the things the doctor or nurse told them in answering the question.

So you’ve asked your question. Now what?
Don’t leave without a plan. It’s easy to ask the question, get dismissed, and say, I tried. Have a follow-up question prepared. For example, ‘If you aren’t sure how to help me, who can you send me to that might have some expertise?’ Or, ‘Does this particular hospital have a clinic that treats sexual problems?’ Or, ‘Do you know a gynecologist or urologist who’s good with these kinds of problems?’ If you want counseling, ask for that.

What happens if you still get no answers?
I created Will2Love for that problem! It came out of my long career working in cancer centers and seeing the suffering of patients who didn’t get accurate, timely information. When the internet became a place to get health info, it struck me as the perfect place for cancer, sexuality and fertility. Sex is the top search term on the Internet, so people are comfortable looking for information about sex online, including older people or those with lower incomes.

Also, experts tend to cluster in New York and California or major cancer centers. I only know of six or seven major cancer centers with a sex clinic in the U.S. and there are something like 43 comprehensive cancer centers!

We offer free content for the cancer community, including blogs and forums and resource links to finding a sex therapist of gynecologist. We also charge for specialized services with modest fees. Six months is still less than one session with a psychologist in a big city! We’re adding telehealth services that will be more expensive, but you’re talking to someone with expert training.

What can doctors do better in this area?
For health care professionals, their biggest concern is, ‘I have 40 patients to see in my clinic today and if I take 15 extra minutes with four of them, how will I take good care of everybody?’ They can ask to train someone in their clinic, like a nurse or physician’s assistant, who can take more time with each patient, so the oncologist isn’t the one providing sexual counseling, and also have a referral network set up with gynecologists, urologists and mental health professionals.