During a routine physical, your doctor will ask you health questions that might make you squirm. But editing out symptoms, or being tight-lipped about certain lifestyle habits, can have dangerous repercussions. Your doctor needs to know everything that is going on with your health, and if he or she is not bringing up these topics, you should. “People are often afraid to talk about certain things, but the doctor has heard it all before,” says Jonathan Kerr, MD, a family physician in Belleville, Ont., and the president of the Ontario College of Family Physicians. “You might be embarrassed, but the physician isn’t.” Are you ready to start the conversation? Here are five things you might be lying to your doctor about, but shouldn’t.
1. How much alcohol you drink
Many patients underestimate the amount of alcohol they drink. “It’s not uncommon for us to take what the patient says and double it, just to be safe,” says Dr. Kerr. But honesty is the best policy here, because your alcohol intake could be affecting your health. “It’s important for us to know about your drinking habits so that we can counsel appropriately,” says Scott MacLean, MD, an Edmonton-based family physician. If your drinking is excessive, it “can have serious consequences for the liver,” says Dr. Kerr. Cirrhosis of the liver, weight gain, early onset of dementia, and high blood pressure can all result from heavy drinking.
According to the Dietary Guidelines for Americans, moderate drinking is up to one drink per day for women and up to two drinks per day for men. It’s also important to have non-drinking days in the week, in order to avoid developing a habit.
2. The number of sexual partners
“Be open and honest,” says Dr. Kerr. “The number of partners, the gender of your partners, whether you’re having unprotected sex, and whether you are having any symptoms of sexually transmitted diseases [vaginal discharge, pain, irritation] are all very important to mention.” Some sexually transmitted diseases such as chlamydia and genital human papillomavirus (HPV) may exhibit few symptoms at first. You could be infected without even knowing it, and could pass the disease on to an unsuspecting partner. Left untreated, some diseases such as chlamydia and gonorrhea can lead to pelvic inflammatory disease and infertility, or, in the case of herpes, a lifetime of discomfort.
Do not feel embarrassed about this conversation. “It might be the first time you’ve talked about your sexual habits with a doctor, but he or she has been talking about such topics all week with other patients,” Dr. Kerr says. It’s also helpful to know that your discussion with your physician is confidential and non-judgmental. Even if your doctor also looks after your spouse, the content of your discussion will not be shared. “It’s my duty to protect your information,” says Dr. MacLean. “I’m not here to judge or to scold you, but to work with you toward common health goals.”
It is also important for women over age 50 who are post-menopausal to mention any vaginal bleeding. “This could be cancer-related, and should be discussed,” says MacLean.
3. You are having bathroom problems
In some cases, problems with urination (going too little/too much, or visible blood in the urine) can be early warning signs of urinary tract infections or bladder cancer in both men and women, and prostate cancer in men.
As for frequency of bowel movements, what’s normal depends on the person. Some people go a couple of times a day, others go only every few days. Tell your doctor what is normal for you and mention any changes. Abnormal bowel movements (for example, a change in color, size, amount or frequency, or visible blood in the stool) could signal Crohn’s disease, colitis, or cancer of the colon, pancreas or liver.
In many cases, urinary and bowel issues are not serious and can be easily fixed. “A lot of these things are common, and with some investigation we can make sure that it’s nothing significant,” says Dr. MacLean.
4. You take recreational drugs or prescription meds you don’t need
“From my point of view as a doctor, it’s really important for us to ask patients about risk-taking behavior such as drug abuse, and normalize the discussion,” says Dr. MacLean. “For the patient, it’s key to remember that your physician is not a police officer. He or she is not out to put you in jail, and your discussions are going to be confidential.”
Your physician needs to know about your drug use, whether illicit or prescription, in order to properly assess your health status during a regular checkup. Even if you feel fine and you are not experiencing any worrisome symptoms caused by taking these drugs, you should still be honest with your doctor, and disclose your use of them. Together, the two of you can work toward reducing any risks, or specific health concerns such as kidney or liver failure, addiction and possible drug overdose. (If you smoke cigarettes, even occasionally, your doctor needs to know this, too.)
5. You are having workplace, financial or relationship problems
You might think that your bank balance, marital problems and job difficulties are none of your doctor’s business, but these worries can trigger stress, a major cause of insomnia, anxiety, digestive issues, depression and even substance abuse.
“All patients should be open about these concerns because stress can have many effects on the body and the mind,” says Dr. Kerr. Talking with your doctor about these issues might not solve your woes, but it can help lessen the anxiety you might feel, by starting a dialogue about solutions for dealing with stress and its physical symptoms. “If your physician is not aware of what’s going on in your life, he or she can’t do anything to help you,” adds Dr. MacLean. “The physician is there to look after you.”
Still feeling uneasy?
If you have tried to talk about these subjects with your physician but still feel uncomfortable, Dr. Kerr says it’s a great idea to email your doctor in advance of your next appointment to explain your situation, and provide the details of any of your issues as outlined above. Or, if you are too shy to discuss a topic face-to-face, write the information down on paper and bring that with you to the office. As a last resort, looking for a new family doctor might be the next step. A relaxed patient-doctor relationship, teamed with honest communication, truly is the best medicine.