How to Talk to Your Doctor About Sexual Health

Why is it hard to bring up sexual health — and why should I anyway?

Many people stay quiet about sexual health concerns due to embarrassment, fear of judgment, or not knowing the right words. Meanwhile, untreated STIs often have no symptoms and can cause long-term complications if left unaddressed. Sexual pain or dysfunction can signal an underlying medical condition. Your clinician considers sexual health as routine as blood pressure or cholesterol — the topic just doesn't always come up on its own 3Ref 3Centers for Disease Control and Prevention (2024).Guide to Taking a Sexual History.The Five P's framework (Partners, Practices, Protection, Past STI history, Pregnancy intention) that clinicians use when taking a sexual history; confirmation that routine checkups do not automatically include STI testing; guidance that patients should ask.

How do I start the conversation?

You do not need a perfectly phrased opener. Any of these work:

• 'I have a symptom I am a bit embarrassed about — it is related to my sexual health.'
• 'I would like to talk about STI testing — I am not sure where to start.'
• 'I have some questions about my sexual health that I have been nervous to ask.'

If you are worried about forgetting what you want to say, write it down on your phone and show it to the clinician. It is also completely fine to say 'I am not sure how to describe this' — a trained clinician will ask follow-up questions that help you both get to the right place. If a clinician responds dismissively, you are entitled to see a different provider.

What questions will my doctor ask about sexual health?

A clinician evaluating a sexual health concern will use a structured sexual history framework — sometimes called the Five P's — to understand your situation: Partners, Practices, Protection from STIs, Past STI history, and Pregnancy intention 3Ref 3Centers for Disease Control and Prevention (2024).Guide to Taking a Sexual History.The Five P's framework (Partners, Practices, Protection, Past STI history, Pregnancy intention) that clinicians use when taking a sexual history; confirmation that routine checkups do not automatically include STI testing; guidance that patients should ask. Expect questions like:

• How many partners you have had recently
• What types of sexual contact you have had
• Whether you use condoms, and how consistently
• What your specific concern is
• Whether you have had any past STIs or testing

You do not have to share more than you are comfortable with, but more accurate information leads to better care.

How do I ask for STI testing specifically?

Routine check-ups do not automatically include STI testing unless you ask 3Ref 3Centers for Disease Control and Prevention (2024).Guide to Taking a Sexual History.The Five P's framework (Partners, Practices, Protection, Past STI history, Pregnancy intention) that clinicians use when taking a sexual history; confirmation that routine checkups do not automatically include STI testing; guidance that patients should ask. The clearest way: 'I would like to be tested for STIs — can we go through what makes sense based on my history?'

Your clinician will ask about your recent sexual activity and recommend which tests are appropriate. A standard STI panel often includes testing for gonorrhea and chlamydia, HIV, and syphilis 1Ref 1Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA (2021).Sexually Transmitted Infections Treatment Guidelines, 2021.STI screening panel recommendations by risk factor and population; partner types and practices as determinants of which tests to order. Depending on your history and risk factors, hepatitis B and C, herpes antibody testing, and trichomoniasis may also be included.

Practical tips for a more comfortable appointment

Book enough time. If you are adding a sexual health concern to a routine visit, call ahead to say you have an additional topic. A rushed appointment makes sensitive conversations harder.

Bring a written note. If nerves make it hard to find words in the moment, a short note on your phone is completely acceptable to hand the clinician.

Know that your visit is confidential. What you share with your clinician stays between you. One nuance: if you are on a family insurance plan, Explanation of Benefits (EOB) documents can sometimes reach the policyholder. If this is a concern, ask the clinic about confidential billing options before your appointment 2Ref 2Krist AH, Davidson KW, Mangione CM, et al. (US Preventive Services Task Force) (2020).Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections: US Preventive Services Task Force Recommendation Statement.USPSTF Grade B recommendation for behavioral counseling to prevent STIs in all sexually active adolescents and adults at increased risk; ACA coverage implications for STI counseling as a no-cost preventive service.

Telehealth is an option. Many sexual health concerns — including STI testing orders and counseling — can be handled by video visit, which some people find easier. The USPSTF recommends behavioral counseling to prevent STIs for all sexually active adolescents and adults at increased risk 2Ref 2Krist AH, Davidson KW, Mangione CM, et al. (US Preventive Services Task Force) (2020).Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections: US Preventive Services Task Force Recommendation Statement.USPSTF Grade B recommendation for behavioral counseling to prevent STIs in all sexually active adolescents and adults at increased risk; ACA coverage implications for STI counseling as a no-cost preventive service.