British Columbia

Sexual health conference aims to make it less awkward for doctors to talk about sex

Sexual problems and issues with sex are one of the most common issues patients talk about with their doctors, yet many health practitioners find it just as awkward to talk about as anyone else.

Experts say medical discussion around sexuality is rapidly changing

Sex researchers say that almost half of us will experience a sexual problem at some point in our lives. (Getty Images)

Sexual problems are some of the most common issues patients would like to talk about with their doctors, yet many health practitioners find the subject just as awkward to discuss as their patients do.

That's part of the premise behind a two-day medical conference that just wrapped up in Richmond, B.C.

"Sex and sexuality are so prevalent in the media, but as clinicians and as patients they're still not comfortable topics to talk about," said conference chair Marisa Collins. 

Marisa Collins is the medical director for Options for Sexual Health and the chair of the sexual health conference. (Options for Sexual Health)

"And so part of that is just increasing confidence and competence and comfort levels with those areas."

Collins, who is also the medical director for Options for Sexual Health (formerly Planned Parenthood), started the conference in 2015 in response to what she saw as a gap in physician training. 

The conference covers a broad array of topics ranging from the latest research on medications and treatment to topics on cultural aspects of sexuality. 

Increasing research

Sex researcher Lori Brotto was one of the presenters of the conference, offering a synopsis of what she considers to be the five key articles on sexuality from the past year.

Brotto says advances in research technology have lead to a rapidly changing understanding of the nature of human sexuality. 

"There has been more research on sexual functioning since Viagra came out 15 years ago than there had been in the last century," Brotto said. 

Lori Brotto is a UBC professor and the executive director of the Women's Health Research Institute at UBC. (Lori Brotto/Twitter)

The studies she discussed ranged from a meta-analysis on a new medication recently approved in the U.S. to treat women's low sexual desire (spoiler alert: Brotto says results show it's not much more effective than a placebo) to the latest research on the effectiveness of intrauterine devices (IUDs). 

Brotto hoped her presentation would offer doctors some hard skills on how to treat and talk about sexual issues with their patients. 

"The problem is that many health care providers don't ask, and by the same token many individuals are also reluctant to bring it up to their health care providers," she said.  

Studies show almost half of the population experience a significant, ongoing sexual difficulty in their lifetime, Brotto said — including low sexual desire, trouble gaining erections or pain during sexual activity.

Dismantling desire

Sexual desire is the topic at the centre of keynote speaker Emily Nagoski's book, Come as You Are: The Surprising New Science That Will Transform Your Sex Life.

The book dismantles traditional thinking about women's sexuality, and how desire changes for women over time. 

Come As You Are is the latest book by U.S. sex researcher Emily Nagoski. (Emily Nagoski)

Essentially, Nagoski says that when researchers asked older women if they still enjoyed sex, despite a lack of spontaneous urge to have it, most of them said yes — it just took them a while to get revved up. 

"That's actually normal, healthy sexual functioning. It's called responsive desire. It emerges in response to pleasure," she said. 

Nagoski says sexual desire — especially for women — is one of the most prevalent issues patients discuss with their doctors, but it remains one of the most misunderstood. 

"Doctors, in America anyway, their sex education is no better than anyone else's sex education," she said. 

"They are just as entrenched in cultural myths and misunderstandings in particular about women's sexuality as everybody else is."

More women researching

Nagoski's biggest sore point is when doctors dismiss complaints from female patients of pain during sexual activity.

"The cultural narrative is that sex is just supposed to hurt sometimes for women, and can't you just have a glass of wine and relax," she said. 

She argues that if men were to approach their doctors with the same issue, they wouldn't be as easily dismissed. 

Emily Nagoski is a sex researcher and the author of several books. (Jon Crispin)

Part of the reason why Nagoski thinks sex research has changed so much in the past few decades is because more women are entering the field, thereby transforming the nature of the science. 

Which is why she sees another recent shift in sex research as so important — approaching discussions about sexual health from the perspective of pleasure instead of desire. 

"The idea of sexual desire as the centre of sexual wellbeing is profoundly entrenched," she said, adding that it's just as difficult for patients to let go as doctors.

"We want to conform with these culturally constructed aspirational ideas of what our sexuality is supposed to be, and letting go of that is a long, slow, difficult process."

About the Author

Maryse Zeidler

@MaryseZeidler

Maryse Zeidler is a reporter for CBC News in Vancouver, covering news from across British Columbia. You can reach her at maryse.zeidler@cbc.ca.