Talking to your doctor about bedroom problems

A lack of libido or physical health issues is not only frustrating - it also can affect your relationship. A serious talk with your doctor might be all you need to alleviate issues that can crop up in the bedroom. Here are suggestions for your next visit.

• If your sleep is frequently interrupted by trips to the bathroom, ask your doctor whether your prostate could be causing the problem.
• If your prostate is enlarged, it could be squeezing the urethra, the tube that urine passes through on its way out of the body.
• The result of that squeezing is that you feel as if you need to urinate more often.

• Impotence is sometimes an issue for men with diabetes.
• A wide range of factors — for instance, the nerve damage and blood flow problems that are common in people with diabetes — can contribute to erection problems, as can some blood pressure medications, taken by many patients with diabetes.
• In fact, some 50 to 60 per cent of all men who have diabetes and are over age 50 have erection problems.
• Your doctor won't be surprised to hear about your condition.
• Erectile dysfunction problems can be either physical or emotional. Here's an easy way to tell the difference.
• Before bedtime, wrap a small strip of paper around your penis and tape the ends together to form a band (don't put tape all the way around the penis). If the paper is broken in the morning, you probably had an erection.
• If a man is having erection problems during sex because of emotional issues, he will probably still have erections while he sleeps.
• The more scientific way to detect nocturnal erections is to have yourself monitored during sleep, either in a sleep lab or with a monitor you use in your own bed.
• If you are not having erections during sleep, your problems are likely physical.

• Some doctors are quick to write a prescription without taking a medical history and looking for underlying medical problems.
• Don't settle for a libido-enhancing pill as your first and only solution. By identifying the cause, the best fix can be found for you.

• High blood sugar compromises the body's ability to fend off bacterial invasion.
• If you feel pain during sex (especially for women) or have urine that's clouded or bloody, a burning sensation when you urinate or constantly feel the need to urinate, talk to your doctor.
• You may have a urinary tract infection. Refrain from sex until the problem is resolved.

Some types, namely monophasic contraceptives, which contain fixed amounts of estrogen and progestin, appear to keep blood sugar more stable than triphasic pills or progestin-only pills.

• First: Does your reduced sexual desire apply to all situations at all times? If so, review with your doctor the possible medical sources of your diminished sex drive.
• Medications you're taking or hormone problems could be the culprit.
• If the answer to the first question is "no," ask yourself; does the strength of my sex drive depend on the situation?
• Perhaps you have little desire for sex with your partner, but you find other people attractive and get satisfaction from masturbation. If so, marital or psychological counselling could help.