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Prostate exam suggested. Not able to go to the doctor due to anxiety. Need counselling?

I am a 50 year old male who was to have his first prostate exam last week. I could not go through with it due to the anxiety that it caused me for the six months prior that I knew I was to have it. I'm very fond of my Doctor and feel quite comfortable discussing anything. However, I have always had issues disrobing and being touched by any Doctor. The anxiety that it causes me affects the quality of my life so I have chosen to avoid such exams. He was very supportive and comforting and suggest that I needed to get some therapy. I have no issues with disrobing for sex. Can you tell me how to proceed with finding a therapist? Am I looking for a counselor, psychologist, psychiatrist? Should they specialize in anything?
Asked On : Thu, 25 Apr 2013
Answers:  2 Views:  58
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General & Family Physician 's  Response
Hello sir and welcome to HCM.

Thank you for your query.

Do not worry at all. Such anxiety is normal, no normally sane individual likes to unrobe or undress when they are uncomfortable about it. In fact, would you be comfortable undressing during sexual intercourse, while your partner remains completely clothed. Yours is a perfectly natural response. You do appear to exhibit slightly more anxiety than normal, but unless this is not in response to other activities or on a daily basis, I am sure this does not require any attention.

There are many patients who are uncomfortable with such examinations, and a doctor's duty is to either make them feel more comfortable or suggest alternate methods of investigation. In your case, although not cost-effective, but there exists an alternative. An abdominal and pelvic ultrasound usually provides crucial information on the size and shape of the prostate, although the gold-standard would be a digital rectal examination (DRE), we can settle for an ultrasound. You could visit the same doctor and simply insist on an ultrasound. Only if completely necessary, your doctor might request for more investigations. This should only be required if your serum PSA (prostate-specific antigen) levels are abnormal. It is standard procedure to check this in all individuals with an enlarged prostate to rule out tumors/cancers.

Do not worry sir, doctor's are here to serve you, in the most comfortable manner available or possible. I wish you lots of luck with your investigations and accordingly the therapy that follows.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.

Best wishes.
Answered: Thu, 25 Apr 2013
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Psychiatrist Dr. Gourav Monga's  Response
Welcome to health care magic
I can understand your situation. I appreciate your effort to seek online support.

As per your details, you are possibly having underlying anxiety disorder. Consult a psychiatrist for detailed evaluation and management.

Following treatment strategies would be helpful-

1) Antidepressants like SSRIs (escitalopram, sertarline, paroxetine etc)
2) Antianxiety agents like clonazepam, lorazepam, alprazolam etc
3) Psychotherapy/ Counselling sessions
4) Relaxation techniques like yoga, meditation, deep breathing etc

Hope it helps
Good luck
Dr. Gourav Monga
Consultant Psychiatrist
Answered: Thu, 25 Apr 2013
I find this answer helpful
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