Turns out, doctors are just as skittish as teens about having “the talk.” Physicians spend an average of just 36 seconds discussing sexuality with young patients, according to a new Duke University study. 

And while you may not be 16 anymore, there’s a good chance your sex talks with Doc still only last about as long as you did your first time in the sack. It's time you have the cojones to ask your most burning questions about sex—for you health’s sake. Start with these four.

Should I get the HPV vaccine?

You may consider HPV the common cold of STDs, but the Center for Disease Control and Prevention recently named the virus one of the top five health threats for 2014. “Any guy who is younger than 26 should get vaccinated as soon as possible,” says Daris Paduch, M.D., Ph.D., director of sexual health and medicine at Cornell University. And even though the vaccine isn’t approved for men ages 26 and up, Dr. Paduch still recommends asking for it: “There is no change in the immunological response at the age of 26,” he says.

I’m not having morning erections as often. Should I be worried?

Waning morning wood is one of the most reliable signs of decreasing testosterone production, says Dr. Paduch. If you’re still standing tall in the a.m., but your erections aren’t as hard as they once were, you should loop in your M.D. In a new study of more than 200 men, Dr. Paduch found that 70 percent of guys with some form of erectile trouble had pre-diabetes or diabetes. “Loss of erections or problems with sustained erections are a very important indicator of overall health,” he says.

Sex hasn’t been as satisfying lately. What’s going on?

If you can, offer a little more detail about what’s letting you down. “Satisfaction can be about rigid erections, the volume of ejaculation, or experiencing orgasms,” says Dr. Paduch. Declines in semen volume or sensation can be signs of falling T, although less-satisfying orgasms may also be linked to diabetes or alcohol. Fess up to pot too: “Some studies show that prolonged use of marijuana can affect sex drive, because of the estrogenic effect,” says Dr. Paduch. In order to diagnose, docs need all of the puzzle pieces.

Should I get tested for STDs?

As far as your doctor knows, you’re still sleeping with the same woman you were the last time he saw you. Request an STD screening if you’ve had multiple partners. Be especially honest if you’ve had any drunken hook-ups, says Dr. Paduch, since you may not have used a condom or, if you did, you may not remember if the condom broke.