Does the thought of opening up about your personal life to a stranger in a white coat make your palms sweat? Do you dread the yearly hernia checks more than Thanksgiving at the in-laws? You are not alone, my friend. It can be tough to bare your man parts to a complete stranger. Nevertheless, your health is important. Just like taking your car in for an oil change, you need to take your body in for a check up. Here is my list of 10 things every gay man should not be afraid to discuss with his medical provider.1. Your Sexual Orientation
Are you gay? bisexual? Undecided? It’s all good. However, it’s important to be open with your medical provider about your sexual orientation. Believe it or not, in some cases, it changes ever so slightly the list of all the possible diagnoses he is thinking about as you talk about your symptoms. If you are concerned your provider will be judgmental, relax! He has probably heard everything. If he is judgmental and condescending, get a new provider. After all, you are paying for a service. You wouldn’t go back to a restaurant where you were treated unfairly!
2. Your HIV Status
If you are HIV positive, you probably see a specialist who prescribes your medications and checks your viral counts. However, next year when you get the flu and drop by an urgent care, be up front about your HIV status. Your urgent care provider might need to draw additional labs to check your blood counts. In addition, he or she will need to make sure any new prescriptions don’t interact with your current medications. Finally, if you have not been taking your HIV medication as directed, your provider may need to order additional labs tests or imaging to check for more serious infections.
3. The Number or Partners You Had This Year
You know that irritating question about your sexual history? Yeah, seems a bit invasive, huh? Really, this is not some underhanded attempt to shame you. It helps your provider understand your risk for sexually transmitted infections. In addition, it may prompt her to recommend additional screening and risk reduction strategies with you. I have had patients who present with an upper respiratory infection and end up leaving with a prescription for Truvada after being counseled about PrEP.
4. Your Penis
That little bump on your penis may just be an infected hair follicle, but it could something more serious. It’s better to get it checked out. While the thought of discussing your man parts with a strange person in a white coat might be mortifying, try not to let it stress you out. Your medical provider has had this discussion with hundreds of men before you. As special and unique as your penis is to you, it’s not that unique to him. Medical providers are fairly non- judgmental, I promise! If you feel uncomfortable discussing your penis with the person who schedules appointments or the nurse who takes your vitals, it’s ok to say you are there for a personal reason.
5. Your Depressive Symptoms
Depression is not a sign of weakness. You should never be ashamed about feeling depressed. It is often a treatable medical condition having to do with neurotransmitters in your brain. There are various treatment options to include medications, psychotherapy and life style changes. Occasionally, depression is due to an illness. Your provider might check your thyroid hormones or blood titers for Epstein Barr virus. Sometimes depression is even transient due to situational stressors in your life. Regardless, it’s important to discuss it so you can get better. Most importantly, if you ever feel like you want to hurt yourself, tell somebody. You can go to any emergency room, anytime, and they will get you the help you need to feel better.
6. Your Problems with Drug, Alcohol, or Sexual Addiction
The good news is there is help available for those who struggle with addiction. It takes being honest with yourself and admitting you have a problem. If you don’t know where to begin, start with your primary care provider. He has access to community resources to help get you get started in recovery. In certain cases, he can refer you to addiction specialists or detox treatment programs and then take care of any medical issues that come up as you move into sobriety.
7. Your Recent Sexual Indiscretions
Everybody makes mistakes, but it’s important to take responsibility if you recently engaged in high-risk sexual behavior. See your medical provider right away. She might recommend you taking PEP, or post-exposure prophylaxis. This is a combination of antivirals taken for about 30 days that can decrease the chances of contracting HIV. In addition, she will give you a time frame to follow up for additional STI (sexually transmitted infection) screening and/or treatment.
8. Your Prostate
Ahhhh, the prostate…friend to every gay man….until it’s not. Whether it’s enlarged and keeping you up at night with frequent urination or it’s inflamed due to an infection, the prostate can be both friend and foe. This walnut shaped gland sits right under the bladder and continues to grow throughout adulthood, sometimes causing difficulty with completely emptying your bladder. About half of men in their 50’s suffer from BPH (benign prostate hyperplasia.) Fortunately, there are medications that can help. The prostate can also become inflamed or infected as in prostatitis. This is usually treated with antibiotics. If you have pain in the pelvic area (right behind your scrotum), it’s important to discuss it with your doctor.
9. Your Sex Drive
If you have difficulty getting an erection or even just a decrease from your usual sex drive, it’s important to get checked out. You might benefit from the little blue pill or perhaps testosterone supplementation therapy. Low testosterone can occasionally be caused by a serious illness or tumor in or near the pituitary gland in your brain. So it shouldn’t taken lightly, especially if it’s associated with other symptoms, like breast enlargement.
10. Your POOP
Your poop speaks volumes…really! Blood in your stool, or black stool, like tar can be a sign of bleeding somewhere in you gastrointestinal track. Prolonged diarrhea can be a sign of an infection. Thin stool, like a pencil, can mean you have a tumor in your colon or rectum. So make sure you check out your poop from time to time and don’t be afraid to discuss it with your health care provider. (Oy Vey! The poop stories I have heard….)
So, it’s your body. You know it well, right? Don’t ignore it. If something doesn’t seem right, don’t be embarrassed or afraid to bring it up. Remember, you are paying for a service when you see your provider. You deserve to be treated with respect and taken seriously. You shouldn’t accept anything less…really!