When I talk about sex, I mean whatever that means to you as a couple

So, it’s about talking to people about date night and scheduling it as a priority and making sure you have a babysitter and making sure there’s private time for intimacy. And you know, I always normalize it. I’m not talking about penetrative sex. When I’m talking about my patients, I’m talking about intimacy, I’m talking about whatever that means to you.

I have a lot of men who have impotence because of their arthritis or because of their medications. I have a lot of women who can no longer tolerate vaginal penetration. I have a lot of women that can’t tolerate orgasm or haven’t been able to achieve orgasm because of neuropathy. And it’s kind of re-establishing that communication.

Rebecca Gillett: Well, you mentioned some medications. Are there specific medications that can hinder sex drive or motivation to even participate? Is there specific medications out there that might be an issue?

And how to maintain that healthy emotional relationship with your partner

Iris Zink, NP: Yeah. There’s an appendix in the book. I think probably the most common offender that I see is gabapentin, believe it or not, which is an anti-seizure medication. I check hormone levels on my new patient visit. Cortisol rushes will make your hormones low, too, just from the stress of the diagnosis. Your prednisone is affecting your adrenal axis.

How do you start that conversation, Iris, when it comes to your partner, without hurting their feelings and saying, you know, whether it’s a man or a woman, saying, “I love you, but I’m not in the mood

Pete Scalia: Vicky, you said off the bat that you had a patient who actually mentioned the mechanics of it to you. How do you get that conversation started though? Since somebody might feel physically and mechanically like, well, gee, I guess that’s just something I can’t do anymore.

Victoria Ruffing, RN-BC: I think, for the most part, this is not an area that physicians really have any training or background in, you know? Nurses are nurses. And so, we are educators, we are counselors. And most people will feel comfortable with their nurse. And a simple question: How are things going? And are you having any intimacy issues? They can say yes, no, or they can say, “Now that you brought that up, I was thinking blah blah blah.” I find that just opening the door a little bit, maybe they don’t bite that first time. But they will come back, and they would say, “You remember the last time we were together? And I was thinking, could I just run this past you? Or do you have any suggestions?”

It’s not hard to bring it up. It’s less hard than you think. It’s just a conversation. I think one thing that we should probably talk a little bit about is communication between the partners. I think that’s where things get tough. That’s where I think people still have some, I hate to use the word, hang-ups. But some barriers there, to be able to be open and honest with their partner about what their needs are, what they like, what they don’t like, what they find uncomfortable or don’t find uncomfortable. It’s something that I think we need to encourage: to make sure that that communication is there. And that there’s no judgment on either side.

Pete Scalia: I know my wife and I have had conversations in hindsight, looking back to those times, especially when you’re doing something where if you’re trying to get pregnant or you’re talking about, Namoro braande like, timing and that sort of thing. But then at the same time, with the medications, you might not be in the mood. It might diminish mood. ” Or trying to explain what’s happening with your body.