Eight ’embarrassing’ health issues you must always discuss with your GP

A visit to the GP is rarely pleasant. Summoning the courage to discuss something you’d rather not think about can be stressful, as can physical examinations. You may have waited days or weeks for an appointment, only to feel rushed once you enter the room, or be fearful your concerns won’t be taken seriously. In short, it’s something most people want to limit as much as possible. Despite this, there are several times in your life when consulting with a medical professional is absolutely necessary. And when the issue is an intimate or “embarrassing” one, the reluctance to engage can be amplified five-fold. It is on such occasions, however, that it is vital you connect with the experts. The gap between what’s treatable and what people are too embarrassed to say out loud is, according to Dr Karan Rajan, “one of the most frustrating problems in medicine”. Shorts The NHS surgeon tells The i Paper: “Early in my career, I treated a patient who arrived in A&E vomiting, in severe pain, having not opened their bowels for 32 days. The cause, once we got to it, had nothing to do with their anatomy. They lived in a flat with a shared toilet and had been too embarrassed to use it. Something a pharmacist could have sorted, snowballed into something that needed a general anaesthetic and a surgeon.” Here, Dr Rajan lists eight things that might be embarrassing to raise with your GP, but which are vital to talk about. Irregular poo “Almost half of UK adults can’t identify what a healthy stool looks like, and bowel cancer is the second biggest cancer killer in this country, so it’s worth taking seriously. “Going less often, straining more, suddenly going far more than you used to or seeing blood in your poo are all signifiers worth checking out with your GP. It could just be piles or an off day – it usually is – but ‘usually’ is not always. “Most of us consume nowhere near the 30g of fibre a day we should be getting, and the fix is variety rather than one worthy cereal – if you’ve upped that and nothing has improved, stop experimenting and get seen.” You don’t have to accept painful periods (Photo: Burak Karademir/Getty) Painful periods “This is pain that stops you working or having sex, bleeding between periods or after sex. None of that is the price of having a uterus – whatever generations of women have been told. “Some cycles are naturally irregular, so you may want to track it for two or three cycles to give you data and a pattern to discuss with your doctor. What’s ‘normal’ for you may not be normal at all. And if you feel you’re being sent away without an explanation, ask what else it could be, and ask for that question to go in your notes. “Common, expected and ‘normal’ are not the same thing.” Exhaustion “Low libido, persistent fatigue, poor concentration, losing strength in the gym… if this is you, you’ll know that there’s already an entire industry ready to sell you the solution (yes – your algorithm is listening to you). “Maybe you’re just 42 and knackered, but if you’re suffering from hypogonadism, there are medical treatments available to you. Before you buy anything from a website, check: are you not getting enough daylight, ingesting too much alcohol or cannabis, dealing with chronic stress and bad sleep? “If the answer’s yes, ask your GP for a morning blood test, because that’s when levels peak and it’s the best way to know what you’re dealing with.” Stubborn weight “A lot of people want to ask about GLP-1s but don’t, because discussing your weight feels like inviting judgement and there’s quite a bit of taboo surrounding these trending therapies. Ask anyway. These drugs are game-changers in that they work, they’re licensed, and they’re prescription-only for good reason – so buying them from an unregulated website is not the judgement-free shortcut it looks like. “Of course, there are other ways, like upping your soluble fibre, which slows how quickly food moves through you and prompts your gut to release more of your own GLP-1 – the same hormone these drugs imitate – but what fibre won’t do is match the drugs. Your own GLP-1 lasts seconds to minutes, the injected version lasts days.” Get a cough checked out by a doctor (Photo: adamkaz/Getty) Unexplained coughing “In my third year of medical school, I heard one aphorism several times: ‘If you hear hoof beats, think horses, not zebras’ – essentially, it’s usually whatever’s common. “A chronic cough is likely to be a lung condition like asthma or COPD, not a rare tropical disease. The problem with checking your symptoms online is that Dr Google and Dr TikTok can’t examine you, can’t order a chest X-ray and can’t prescribe you anything. “What they can do is convince you that you’re either dying or absolutely fine – and both of those conclusions get people into trouble.” It’s nothing “A quarter of the UK population will experience a mental health problem in any given year, but there’s still lots of stigma that stops people from seeking help. Not only can doctors help with the physical symptoms of conditions like anxiety (such as a racing heart, breathlessness, nausea, an acne flare-up, or the frequent need to urinate), but they can also work alongside therapists and cognitive specialists to treat the cause.” Failure to launch “There might come a time when your rubber dinghy begins to nosedive, but fear not, it’s nothingto be embarrassed about, and nor is it uncommon – up to 50 per cent of men over 40 are affected by erectile dysfunction. “You can make dietary changes such as eating foods rich in nitrates and antioxidants to give you a boost, but if you do find yourself needing additional support – you guessed it – go get it checked out. “Asking for the little blue pill is nothing to be ashamed of – and wouldn’t you rather get it sorted than live a sexless life of bravado-fuelled denial?” Do you know what a healthy digestive system looks like? (Photo: TadejZupancic/Getty) The big C “I think this one is more out of fear than embarrassment, but it needs to be said. If you notice a change in your health and it persists, get it checked. “Most of the time they’re small things, like a mouth ulcer or a cough – not ‘urgent enough’ to bother anyone with. But these things, if left will grow. The American Cancer Society has an acronym that is worth committing to memory: CAUTION. Change in bowel or bladder habits A sore that won’t heal Unusual bleeding or discharge Thickening or a lump anywhere Indigestion or difficulty swallowing Obvious change in a mole or mark Nagging cough or a change in your voice “The bottom line is nobody enjoys these conversations. But believe me when I say that by the time your doctor has graduated medical school, they’ll have seen and heard of enough cases that this isn’t new to them. As doctors, we want to help – so let us, before it gets worse.” Dr Karan Rajan is the author of the No.1 Sunday Times bestseller This Book May Save Your Life and This is Vital Information. He provides evidence-based, actionable information on social media, where he has more than 12 million followers, @drkaranrajan