The magical mystery land of community health

I don't make this stuff up!…but I do change identifying information.

Is it my business? March 2, 2010

Filed under: Uncategorized — lesbonurse @ 4:21 am

Is it my business to counsel patients on what is clearly poor sexual technique?  Here’s the situation: A young male patient came in with a request for std testing.  He reported that a condom had broken during sex last week, and he was worried.  In these situations, I always inquire into the circumstances of the breakage.  Improper use of the condom?  Lack of lubrication?  Oil-based lubrication?  It turns out that this patient’s condom had broken at some point during 90 minutes of sexual intercourse.  I pointed out that condoms can get very dry during extended sexual intercourse, and inquired about whether or not he had used any lubricant.  “No,” he said, “But I think you’re probably right.  She kept saying ‘I”m so dry, I’m so dry.'”  Ok then, we have identified the problem.  I pointed out that using lubricant can prevent dryness and therefore prevent condom breakage, especially during long sexual encounters.  The patient seemed receptive.  I was close to pointing out that his lady friend would have no doubt been happier and more comfortable with some extra lubrication.  I was also close to asking him if he usually has a problem reaching orgasm.  Neither of these things were exactly relevant to the std testing situation, and neither of them are strictly medical (although the orgasm question can be a medical issue).  I settled for reinforcing the proper use of condoms and lubricant, as well as reviewing the different types of std’s and screening.  I decided against dispensing any more sex advice, but I couldn’t shake the feeling that I had passed up an opportunity to help this young man become a better partner.  But really, is that my job?  I don’t want to be inappropriate as a provider, but I also don’t want to encourage what sounded like a relatively unpleasant sexual encounter for his partner.

I’ll be seeing him again for his lab results, so if I can think of a professional-but-rapport-building approach to this issue, I’ll get another stab at it.  No pun intended.  ha.