By Vicki Rackner, M.D.

The realization hit Natalie like a ton of bricks.  Her mother, Joann, may have died as a result of embarrassment. Joann had noticed blood in her stool (poop) almost a year before she was diagnosed with colon cancer. At first she told herself it must have been those beets she ate. Then, she thought it was most likely her hemorrhoids, although she had not had a flare-up since Natalie’s birth 52 years earlier. 

The truth was Joann was too embarrassed to talk with her family or her doctor about her bowel habits.  She didn’t raise the concern with her doctor until she had bloating, cramping, and abdominal pain. By the time she reported her symptoms to the doctor, she was diagnosed with colon cancer. The cancer ultimately took her life. Natalie’s brother-in-law, who was a nurse, wondered whether Joann would still be alive if she had told her doctor about the blood in her stool when she first noticed it. Joann’s embarrassment may have contributed to her death.

Let’s face it; certain topics may be embarrassing to talk about with your doctor.  I call them the 4 P’s. Here they are:

• Peeing
• Pooping
• Paying
• Procreating

…but there are many more topics that certain people find overwhelming or embarrassing.

Although at first blush the challenge of talking with your doctor about so-called embarrassing medical topics seems simple enough, for some people it can cause significant suffering.

Some Examples of "Embarrassing" Medical Topics

Hillary had what’s now called a “shy bladder.” She had not used a public restroom in over 20 years. She was too embarrassed to talk with her doctor about this; instead, she remained a prisoner to her bladder.

Ed was laid off from work and could no longer afford his asthma medications. Instead of talking with his doctor about it, he decided to do without. He wound up in the emergency room with an asthma attack that could have been avoided with regular medication.

Tom had some sexual side effects from his blood pressure medicine. Instead of talking with his doctor and getting a different medicine, he just stopped taking it.  The doctors wonder if this might have contributed to his subsequent heart attack. 

Jerry noticed a loss of appetite and sleeping problems as his caregiver responsibilities for his aging father mounted. He wondered if he might be depressed, but dismissed the thought because he believed “real men” don’t get depressed.

Imagine how each of these stories might have been different if these individuals who suffered in silence could have talked with their health professionals or loved ones.

Here are some tips that can help you talk with your doctor about embarrassing medical topics.

Recognize the embarrassment.  Say to your doctor, “This is a taboo topic in our family, so it’s hard for me to ask. Is it normal to have a funny smell coming from your belly button?”  

Don’t be afraid to use the wrong words. Your doctor speaks a specialized language acquired through years of training. Sometimes patients are embarrassed because they don’t know the “right words”, and therefore have a hard time describing the problem.

Remember that your job is to communicate. You don’t need to know the fancy words to do that. When Joe said, “Dad had an operation on the dingle-ball thing at the back of his throat,” I knew just what he meant. However, Joe seemed relieved when I said, “Oh, you mean the uvula.”

However, the best way to make sure you and your doctor understand each other may be to use anatomically correct words. Get a basic anatomy atlas or read the Medical Glossary on this site.

• Practice saying the words. Sometimes embarrassing words can be hard to get out of your mouth. Gertrude, a 90-year-old patient, said to me, “You youngsters don’t understand how much things have changed. When I got breast cancer in 1962, the words ‘breast’ and ‘cancer’ were not uttered in polite company.” Some words are still embarrassing to say. Practice saying these words out loud when you’re alone! It might make it easier to say them at the doctor’s office.
• Find the right person to ask. You may have an easy rapport with the nurse or physician’s assistant at your doctor’s office. Bring up the sensitive topic with them.  Say, “Trish, could you please help me bring this up to the doctor? I want to know why I should say no to those steroids my buddies at the gym are offering me. I would love to look like they do.”
• Find the right way to ask. Maybe it’s easier for you to drop a note to your doctor rather than ask in person.  Find the style that works best for you. 
• Remember that your doctor, and all your healthcare professionals, are there to help you, not to judge you. Your healthcare professional has heard it all before. I promise! They will not think less of you for asking an embarrassing medical question; in fact, they with think more of you for overcoming your fear and helping take charge of your health.