10 Embarrassing Questions
By PHIL VERSTEN
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| Dr. Philip Favia of Alpine Family Physicians in Algonquin |
Some wait to see if the situation will resolve itself. Others buy an over-the-counter remedy, hoping they can cure it themselves. While almost everyone has to psyche themselves up to ask their doctor about it, there should be no hesitation.
“These are all very common things,” says Dr. Philip Favia of Alpine Family Physicians in Algonquin.
“While it may be embarrassing to the patient, it is very likely something the doctor has heard dozens of times before.”
So, what are the 10 questions most people are too embarrassed to ask their doctor? Favia offers them up in order:
Did my partner give me something?
Concerns over sexually transmitted diseases, or STD’s, top the list, according to Favia.
“Women will often get their pap smears and find out they have human papillomavirus, or HPV,” he says.
“This leads to other STD testing such as for hepatitis or gonorrhea. Since they have it, they usually also ask if their partner should get tested.”
With most STDs such as HPV, a common question concerns whether you can catch them from non-sexual contact.
“You cannot get HPV from a toilet seat,” Favia says. “It has to be mucus membrane to mucus membrane.
“Once someone has it, there is no where to eradicate it completely,” he continues.
“Warts can be treated, but that won’t get rid of the HPV itself. A three-shot series of preventive vaccines is available for women, boys and men, ages 9 to 26, approximately.”
Why don’t I ever feel happy anymore?
Depression and anxiety afflict both sexes almost equally, but perhaps women a little more, Favia says.
“Women broaching the topic of anxiety issues with their doctor tend to phrase it as, ‘My family just can’t put up with my mood swings anymore,’” Favia says.
“In cases involving depression, they’ll say something like, ‘My husband can’t put up with my lack of motivation.’
“Sometimes you can actually have both anxiety and depression. The brain interacts with a multitude of chemicals, some of which can become imbalanced, affecting moods,” Favia continues.
“Some of the key ones, such as norepinephrine, dopamine and serotonin, act as neurotransmitters, connecting adjacent cells in the brain. Problems arise when these connections happen too little or there is interference for some reason.
“Generally, a family history predisposes people to this. Science is looking for genetic markers in the genome.”
Why don’t I ever want to have sex?
“Guys tend to phrase it along the lines of, ‘Doc, I think my T-levels are low,’ meaning testosterone,” Favia says.
“Women just say that they have no sex drive.”
“For both sexes, the most common causes are stress and anxiety,” Favia says. “In men, it can also frequently be attributed to low testosterone, other medications or occasionally anatomical problems causing pain.”
The affliction frequently spurs questions about medications such as Viagra which are not for libido but for erectile dysfunction, Favia says.
“Work-ups should include checks of diabetes, thyroid and testosterone levels, and review of tobacco and alcohol use, mostly all done through blood work.”
Why do I pee a little when I sneeze?
Urinary incontinence during a cough, sneeze and so on is more specifically referred to as stress incontinence,” Favia says.
“Urge incontinence is more common in women, especially those who have experienced vaginal labor.”
Favia says women experiencing these symptoms should see their gynecologist. The problem can be treated with medications and apparatus such as a pessary.
Physical therapy and surgery are options that also can help support the bladder.
How do I treat a rash (or an itch) in an interesting place?
In most cases, the doctor isn’t the first option for people suffering from a rash.
“Usually, by the time we see them, they’ve already tried a couple of over-the-counter remedies,” Favia says.
“Sometimes they’re concerned about STD’s, but it’s usually contact dermatitis, or jock itch, which is a yeast.
“Some people need reminders to always shower and then dry off after a workout.”
Why am I so gassy?
“We often hear from patients who have diarrhea that won’t go away, or constipation, or unstable bowel patterns. We talk to people who complain of always passing gas, or cramping or have rectum irritation and pain,” says Favia.
“There are many potential causes for all these issues. What more can be said?”
Why can’t I lose weight?
“They usually say, ‘I can’t lose weight,’ or, ‘I need a diet pill,’” Favia says.
“We take some time to discuss the importance of calorie counting, watching portions and avoiding late night snacking, excessive drinking and lack of exercise.”
Patients have to fully commit to changing their behavior in order to lose weight and keep it off.
“Sometimes they ask for a good diet,” says Favia. “But I tell them it’s a lifestyle change, and to watch carbs, calories and portion sizes.
“Definitely no late-night snacks if you’re trying to lose weight,” Favia continues. “I advise shifting calories to the first part of the day.”
Why does my groin hurt?
This is common for men and women, and the cause can vary, according to Favia.
“Women have more chronic issues with this after child delivery,” says Favia.
“Men experience more acute instances, lasting perhaps a couple of weeks. Frequently it’s a hernia or a pulled muscle. They often try to treat it first with over-the-counter creams, ibuprofen, heat and so on.
“The major cause is strains, but sometimes it is epididymitis, inflammation of the cord in the scrotum that transports sperm out of the testicles. Epididymitis can be caused by E. coli, a hernia or something inflammatory.
“Groin pain in women can sometimes be caused by a shift in the pubic bone during delivery which throws alignment off.”
Why am I losing my hair? or Why am I growing hair in these odd places?
“Women tend to be a little more concerned,” Favia says.
“Men want to know if they have any options, whereas women tend to request with some urgency that something be done about it.
“Causes of hair loss for women can include iron deficiencies, thyroid issues, hormonal changes or menopause and autoimmune issues. Frequently slicking back their hair in bands and tying it with a scrungy can result in a receding hairline over time.”
Typically, Favia does not advise a lab work up for men.
“Male pattern baldness is caused by a breakdown product from testosterone which subsequently causes damage to hair follicles,” Favia says. “Discussions will usually cover treatments such as Rogaine or Propecia.”
Why do I pee so much, and why does it take so long?
“I’ll hear, ‘Doc, I have to get up three times in the middle of the night to urinate,’ or, ‘I can’t sit down to watch a sporting event without having to get up and go to the bathroom every 20 minutes,’” Favia says.
“In most cases, I’ll look for a urinary tract infection first, then we’ll check for prostatitis, which is inflammation of the prostate,” Favia says.
“Over years, it could be benign prostatic hypertrophy, generally referred to as BPH.”
A rectal exam and prostate cancer markers serve as tests for this condition.
“Sometimes there are multiple causes, including drinking before bed,” Favia says.
“Caffeine is a diuretic, worsening the issue.
“Once we’ve ruled all those out, we talk about medication that might help shrink the prostate from its current size,” says Favia.
There is no shortage of embarrassing medical situations, but no one has to go through it alone. It’s important not to wait too long before talking to a doctor when these symptoms appear.
“We try to be non-judgmental,” Favia says. “Don’t let embarrassment cause you to put off treatment. Get it diagnosed.”
