Not every woman feels confident talking about her intimate health, but you shouldn’t let shyness or embarrassment put you off getting the help you need. Health Psychologist Dr Deborah Lancastle explains the concept of ‘doorknob problems’ – and how we can get the most out of communication with our GPs.
‘Doorknob problems’ are medical problems that patients don’t talk about until they are leaving the consultation room. The patient’s hand is ‘on the doorknob’ before they say “Oh, by the way…” and then tell the doctor about the real reason for the appointment. Or perhaps the doctor has said “is there anything else?” at the end of the appointment and that is when the patient talks about her main worry.
This is more likely to happen when the patient is embarrassed or scared, and hasn’t managed to raise her main concern when she first arrived. There may not then be enough time for the GP to fully deal with the problem during that appointment and the patient may need to make another.
And perhaps that second appointment will not be made…
If you’re struggling with more intimate menopause symptoms like urinary changes, vaginal dryness, painful sex, or changes to your periods, you might know this situation all too well. But if you don’t speak out about your symptoms, healthcare professionals can’t help – and that’s what we are here for after all! So what can you do if you’re finding it hard to talk about intimate symptoms?
5 tips for getting the most from communication with your GP
#1 – Prepare in advance
You may feel more confident and in control if you have found out about your problem before you see your GP. For example, you could read about your problem and the advantages and disadvantages of different treatments before you go to your appointment.
Perhaps read through some articles on this website such as the ‘how to talk to your GP about menopause symptoms’, explore some decision aids+ and discuss your thoughts about treatment options with your family and friends to get things clear in your head.
#2 – Think about how long you might need
If you need to discuss a number of issues with your GP, ask the receptionist if it is possible to book a longer appointment. GPs may have a time limit on appointments, but if you’ve booked extra time in advance you won’t feel rushed and will be able to take your time to explain everything that’s going on.
#3 – Book an appointment with a GP you are comfortable with
You may have more of a rapport with one or two GPs at your practice. If so, find out if it is possible to book an appointment with that GP. You may have to wait to see a named GP, but if your symptoms are not urgent and you would be more comfortable talking to a particular doctor you may prefer not to rush.
#4 – Work out your goals for the appointment
One strategy that has been found helpful by women (5) dealing with another medical challenge is to write down brief answers to these 2 questions before you see your doctor:
Q1: “What is the main thing I want to achieve in this appointment?”
It is best if this is about the issue that is worrying you most and/or is having the biggest impact on your quality of life (e.g., discuss HRT, find out about counselling to help you deal with other demands in your life, get some advice about urinary incontinence).
Q2. “What are the questions I want to ask?”
Write down a few questions that will be particularly helpful to you. Make these relevant to the priority you have decided upon in Question 1. E.g., If your priority is to sort out urinary incontinence you might want to find out if there are any particular exercises you can do and if there is a health professional who can help you to check if you are doing these correctly.
#5 – What if you ‘just can’t get the words out’?
Sometimes people find that once they get to the doctors they are suddenly unable to talk about the reason for their appointment. If you find this happening to you and you have prepared brief answers to the 2 questions suggested in Tip 4, just slide this piece of paper over the desk to the GP! The GP will then be able to follow up with questions that get to the heart of your worries.
What is a ‘Decision Aid’?
Decision Aids are guides about different types of health concerns that you can work through on your own before discussing with your family and GP. They are good sources of help because they are based on research evidence and are kept up to date. There should be a date on a Decision Aid telling you when it was last reviewed and revised.
For example, The Decision Aid called “Menopause: Should I Use Hormone Therapy (HT)?” by Healthwise.Net (see link at the bottom of this page) has sections dealing with these common questions about the menopause: What is menopause? What is hormone therapy? What if you don’t take hormone therapy? What are the benefits of taking hormone therapy? What are the risks from taking hormone therapy? Why might your doctor recommend hormone therapy?
Decision Aids are written to be easily understood and can be a great starting point for you to think of questions you can ask your GP that give you the extra information YOU really need to help you decide on what can be done to help.
About Dr Deborah Lancastle
Dr Deborah Lancastle (PHD) is a Health and Care Professions Council (HCPC) registered and British Psychological Society (BPS) Chartered Health Psychologist with special interest in the psychosocial aspects of women’s reproductive health. Her extensive knowledge and experience of the psychological principles explaining how women cope with reproductive health issues means she’s well-placed to advise across a range of women’s reproductive health concerns.