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Recently an exhibition on Diabetes was held in Mumbai. At such exhi
bitions usually, there are stalls where blood sugar and such other tests
are done. There are panels showing various complications of diabetes, such as blindness and other eye complications, care of the foot and what
happens if you neglect your feet and heart and kidney failure, skin problems and effects on brain. There are also stalls showing care of diet in diabetes and how to prevent diabetes. For the first time at this exhibition, a Mumbai based Sexologist Dr.Saroj Gumaste in collaboration with Council of Sex Education and Parenthood International conducted a special module on Sex Problems in diabetes. The module displayed excellent eye catching posters on Human Sexuality and also a beautifully produced film on erectile dysfunction in a diabetic male. The whole module was naturally a major attraction of the event and there were long lines to go through the exhibits.
What transpired during counseling sessions with the visitors was that none of them were asked about their sex life by the doctors treating them. Even the patients had not informed the consultant about their sex related problems. Many of them felt that diabetes and impotency are not related. Some of them felt that the problem was due to aging. Few of them felt that a physician would not be able to help in such problems. A most surprising fact which came to light was that there was a very, strong fear about visiting a sexologist for this problem.
Most common reason for avoiding visiting a sexologist was one of shyness. Most of us feel shy about most matters relating to sex. Many women feel shy to purchase a packet of sanitary napkins from a chemist shop.
Some hand over a list of items like tooth paste and soap and along with the name of this item. Even the chemist wraps it up in a old newspaper. Purchasing a condom is even more embarrassing for many men. They wait for a time when there are no other customers and then whisper their requirement. Many chemist shops keep them right in front under the glass counter so that the customer can point out to the one he wants without actually asking for one.
In my practice whenever I ask a patient to purchase some sex related item, they often request me to buy for them. It is therefore natural for them to feel shy to visit a sexologist. Even if they want to consult a sexologist, they do not know to whom to go to. Many of them have 'heard horror stories about misbehaviour by some of them or bad reputation about such clinics. Many feel distinctly uncomfortable itting in the waiting room of a sexologist, being stared at by the others, especially when they are walking out of the doctor's consulting chamber. Very often it requires a lot of courage to admit that one has a sex problem.
Many men would never go to a sexologist, if their wives would not hiwe forced them to do so. This happens most often if the couple are childless. Very often the reason for avoiding a visit to this specialist, is the dilemma about which words to use while describing the problem. Many patients are not aware of the right word for certain parts or certain activities. Even if they are aware of some words, they do not know if it would be proper to use such words or speak such street language in the presence of a learned doctor. There is no need to worry. Your doctor male or female is used to such a vocabulary and will not think ill about you for using such words. Many teach the proper words to use. This is of help when the partners discuss their sex problems with each other in a dignified manner. It is observed that where local language jargon is found anxiety provoking, substituting by English words makes dialogue much easier.
Because the problem is relating to sex organs, often there is anxiety about being asked to take off clothes for purposes of exanation. One has to realise that often this cannot be avoided. However no. doctor will carry out such an examination unnecessarily. Very rarely is it necessary to examine the female partner. If it is absolutely essential the doctor will explain why it is necessary to do so. In many instances, if possible she may be sent to a lady doctor for examination and opinion if they feel uncomfortable at being examined by a male doctor. Similarly many males feel uncomfortable at being examined by a lady sexologist out of a fear that they may get an embarrassing erection under such a situation. There is no need to worry. These lady specialists are used to such responses.
Some specialists use sexually explicit maerial for purposes of educating their clients or to monitor their responses to such visual stimulation. Such material is also used as a part of therapy along with certain intrapenile injections. Some individuals are averse to being exposed to such material and fear that they will be forced to see things they would rather avoid. There also false stories that the medical practitioner will ask them to perform in his presence. Such stories are just figments of imagination, altd even if some quack indulges in such practice one can always refuse.
Another major fear in the minds of patients is that sexolo2ists char2e verv hi2h fees. It istrue. that a sexologists consultation takes a fairly long time. They may not be able to see as many patients as, say, a skin specialist may see, during a given time slot. However, almost.all ethical practitioners charge the average market rate for specialist consultation in that area. It is however best to ascertain the fees before fixing an appointment.
For those who are worried about what will happen when they pay a visit to a clinic of a sex specialist, they should know that a sex specialist is like any other medical consultant. He will greet you, or both of you and make you comfortable. He will get your personal details. There is no need to worry that he will disclose all this to some one else. Total confidentiality is the watchword in all medical consultations and much more so in this field. One consult,mt has a board in his waiting room which reads 'If you do not wish to give your real name and address you may give any other name and address, but please give the same name when you visit again.' After a few pleasantries he will come to the point. In case you have any investigation papers, he will go through them. He may make some notes on a pad or in his computer. Some times if a couple is visiting him, it may be necessary to talk to both of them together and later on to talk to each one of them individually. In this case also generally what one person says will not be disclosed to the other without permission. After going through this history taking session, a session on sexuality education is often conducted where the couple is explained anatomy, physiology and functioning of sex organs. At the same time various myths and misconceptions relating to the problem are debunked. If needed a complete medical examination is carried out including blood pressure and pulse. They may be asked to get some investigations for other diseases like diabetes be done. In
some cases a reference to a specialist such as a Urologist or a Gynecologist may be required. It is occasionally essential to get a psychological assessment, from a clinical psychologist.
After all this, a diagnosis of the problem is arrived at. Depending on this diagnosis the treatment plan is prepared and explained to the couple or alternative plans are made and choice is left to them.
In many cases simple sex education may solve the problem. In some counseling sessions may be needed and a few may need intensive therapy. Rarely surgery may be required.
Many individuals and couples delay consulting a sexologist because of many of these constraints. Generally we rush for medical assistance if the problem is painful or life threatening. Since majority of problems in this case are neither painful nor life threatening there is a tendency to further delay.
There is no need to fear your consultant, and often as in most medical conditions, the earlier you seek assistance the better will be the results. |
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