A survey released today by the American Sexual Health Association, Men’s Health Network, HealthyWomen, and Pfizer looks at a curious disconnect: people believe that sexual health is important but are so shy about the topic they often avoid discussing it altogether.

The survey—conducted by Kelton—was done with over 3,000 men and women in long-term relationships where at least one of the partners has a sexual health issue. 64% of participants said sexual health impacts their overall well-being, but only 13% of those unhappy with their sex lives are open and honest with their partner about their concerns. The bedroom isn’t the only place where they clam up: about 1 in 4 say they don’t feel comfortable discussing sexual health issues with their healthcare providers either.

We talk with our partners about where to set the thermostat, which vacation destination we’d prefer, and money issues. In the medical office we chat about everything from our cholesterol check-up to our blood pressure. Why—both at home and in the clinic—is sexual health such a challenge?

Some of it can be explained simply enough; 26% of our respondents said plain old embarrassment with the subject kept them from asking their healthcare provider about sexual health. You know, it is S-E-X, after all.

It may also be because we just don’t know how to have these conversations, either with our sweetie or our doctors and nurses. That works both ways: medical professionals are given scant sexual health training and aren’t much better (or more comfortable) than patients in bringing up the topic. We don’t grow up having these conversations, or listening to others have them, so no surprise we fumble around a bit.

But not to worry! ASHA has developed tools to jump-start effective sexual health talks with your partner, your doctor, even your kids. Go here for detailed survey results and links to ASHA’s resources on talking the talk (including our popular 10 Things to Ask Your Healthcare Provider).