Male embarrassment at the GPs

Physical problems

Men are as conscious of their appearance as women, worrying over the same sort of problems but sometimes less able to openly ask for help. Questions such as 'am I normal?' in size, shape or function, worries over lumps and skin diseases in intimate areas can cause ongoing stress, as well as more acute illness involving urinary, bowel or sexual function. Women are generally better at accessing healthcare and more used to the regular intimate examination which may be needed for contraception, maternity or cervical smear checks.

Help your doctor to help you

The hardest part is opening the conversation about your cause of embarrassment. Remember, you’re not alone - your doctor is trained in talking about difficult topics, won’t be embarrassed or laugh, and almost certainly has seen patients with similar problems.

Give your doctor a chance to get you to open up - most doctors are experienced in reading the body language of someone who has difficulty starting the conversation, and will give them several 'openings' to discuss things. This may take several appointments before you have confidence, but that's not unusual.

Doctors recognise the classic behaviour of patients initially consulting about something seemingly trivial and then hesitating, getting up to go and with their hand on the door, saying 'whilst I'm here doctor...' - the doctor will then expect you to sit down and start again.

If you really can’t discuss that embarrassing topic, try writing it down at home and take the note to your doctor- they should be used to this and won't laugh, no matter how silly or personal you may feel it sounds. If you can’t face the doctor, send it as a letter or email and then come in to discuss it.

Alternatively, you may feel more comfotrtable by telling other members of the healthcare team such as the practice nurse to begin with. They can then make a note for your GP.

Physical examination

Men often find being examined rather embarrassing, even in non-intimate areas. Some find it easier to see a female doctor, or to see the nurse first. Others cope better with a man-to-man type dialogue – think about which doctor in your surgery suits you best.

Obvious as it may seem, remember to have a shower beforehand and wear clean, easy to remove clothes – you want to feel good about yourself, reducing the embarrassment you may feel about your body.

Your doctor will be used to doing all kinds of examinations and will not share your embarrassment. They may ask the practice nurse or another doctor to chaperone them during intimate examinations – this is routine so don't feel it has any other implications.

During any examination your doctor will try to be gentle and quick, and whilst slightly uncomfortable for you, genital or rectal examination shouldn't be painful. It will help if you can try to relax – take some slow deep breaths, distract your thoughts by shutting your eyes, focussing on other mundane things such as what else you are going to do that day.

Sexual problems

Embarrassment over erectile problems, sexually transmitted infections (STIs), sexuality, and issues such as sexual practices is common. Your doctor however will not be embarrassed in discussing them with you, being accustomed to talking about sex and related problems. They will treat these issues in the same way as any physical problem and so may need to examine you or refer you to a specialist for further advice.

If you can't face your own doctor, look in the phone book or online for your local open access NHS sexual health clinic where you can refer yourself and information isn’t passed back to your doctor, or if you are under 25 try the Brook Advisory service.

Mental health

Men are generally less at ease talking about their feelings, admitting to not coping, feeling low or to failing in work or relationships. The suicide rate in young men is higher than in women and yet more often men haven't sought help from their doctor, nurse or other support such as counsellors or the Samaritans. This may be because they don't feel anyone can help, but they may feel uncomfortable actually seeking help in the first place.

Doctors are used to discussing all ranges of emotions and feelings. They won't laugh, judge or ridicule your problems, will listen and reflect some of what you say, as well as asking other questions such as asking about:

• Your energy and concentration levels
• Mood
• Sleep
• Appetite
• Libido

Again, if it’s easier, write down your concerns beforehand. It may help to take a friend, partner or family member to support or prompt you.

Don't worry if you don't manage to cover everything in the first consultation. Your doctor will try to give you the time you need but these types of issues often take a long time to sort and the normal eight to ten minute NHS consultation may not be enough. So the doctor may tell you to come back in a few days to continue. Use this time to gather your thoughts and the next consultation should be easier.

If you really don't feel you are getting anywhere with the doctor, you may consider talking to other members of the team.