I seem to sweat more than most people—can I control this?
I have bumps on my buttocks that look like acne—what is that and can I get rid of it?
I have bright red blood in my stool, my hair is falling out in clumps, and hair is growing on my face. What can I do about these things?
I am passing a lot of gas—and I also have to urinate every 15 minutes. What’s going on?
Are you embarrassed? A lot of women do shrink away from asking questions like the ones above when they visit their doctor, according to Karen Keltner, marketing and communication manager at Porter Health System in Valparaiso. In fact, the foregoing questions were culled from many embarrassing questions Porter doctors receive on a regular basis, and were compiled recently (along with the answers) in an issue of Porter’s StayHealthy magazine.
But what are patients—and more importantly, their doctors—supposed to do when embarrassing questions are on women’s minds? Should doctors try to draw them out and answer them? Should women refrain from asking these kinds of questions to “save face”—even if it means ignoring potential health problems that worry them? And, most importantly, is there a way for doctors to create an atmosphere where women feel totally comfortable asking about absolutely anything?
Dr. Pamela Goodwin-Cole, who practices internal medicine at Methodist Hospital, says many of her female patients will sheepishly bring up embarrassing questions at the end of their exam. And many of those questions have to do with incontinence. Goodwin-Cole says she calmly explains the reasons: lowered estrogen, which thins the bladder wall; less muscular support of the bladder, often due to hysterectomy; over-hydrating with too many fluids, including too much alcohol or coffee; and even possible neurological problems.
“Many women are also embarrassed to discuss depression,” Goodwin-Cole says. “They feel it is a sign of weakness and they want to appear strong. They see it as a stigma, and want to feel that they can handle all the problems in life.”
Goodwin-Cole says it’s important to create a comfortable and talkative environment, and to be on the lookout for uneasiness during the whole exam with a patient, so that embarrassing questions are more likely to be presented and answered. And she has found that sometimes a somewhat “objective” approach can be implemented in order for embarrassing questions to be asked—and answered.
She uses medical history questionnaires, which she feels can be very significant in getting women to talk about what is really on their minds. Goodwin-Cole presents lists of questions for patients suffering from particular conditions such as heart disease and diabetes, as well. Patients can easily check off areas in which they feel they have problems, and that often leads to embarrassing questions, including often buried queries about all of the medications a patient is taking.
All in all, this checklist approach will often move right into topics that cause patients to be nervous and aloof, according to Goodwin-Cole, from foot odor to constipation to hemorrhoids.
Sometimes, though, a doctor’s experience is very important. “There are some topics that patients won’t talk about,” Goodwin-Cole says, “unless I talk about them first.”