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Sexual health advice

Dr James Stevenson answers questions about maintaining sexual health, problems with sexual function, and the difference between the two.

Transcript

Who are you?

So my name's James.

I've been a doctor for 15 years in London.

I've worked a lot within sexual health.

Currently I'm working for Bupa,

and I've been with Bupa for about three and a half years.

What is sexual health?

So sexual health means a lot of different things

to different people, but for doctors, it's a lot

of the diagnosis, management and treatments of infections

and other things that can be psychological

related to sexual health.

What is the difference between sexual health and sexual function?

So sexual health is more about sexual wellbeing

in relation to infections, treatment

that you may want to see a health professional about.

Sexual function is normally talking about

the act of intercourse,

if you're having any issues with getting

or maintaining erections, achieving orgasm,

and those sorts of things relating to the act of sex itself.

How can I look after my sexual health?

Looking after anyone's sexual

health is really, really important.

Getting regularly tested. In big urban areas in the UK,

it is really important that everybody, regardless

of relationship status, gets tested at least annually for

general sexually transmitted infections,

if you do have multiple partners, it's normally recommended

to get tested every three months or so,

and obviously, if anything is picked up to inform any

of your partners and take treatment as directed by a doctor

or healthcare professional.

How can sexual health impact fertility in men?

In men, it is really, really important

to get regularly tested

because untreated sexually transmitted infections can

long-term affect fertility.

What is sexual function?

Sexual function is a phrase used to describe a healthy

and fulfilling sex life.

If you have any issues with this, though,

it can sometimes translate into issues with getting

and maintaining erections and difficulty achieving orgasm

or even premature ejaculation.

What factors can affect sexual health for men?

There are several factors that can affect

sexual health for men.

Unprotected intercourse with multiple partners is one,

and it's really, really important in these cases

to get regularly tested. Other factors, so

using condoms, so that really reduces your risk

for sexually transmitted infections.

So it is really important, again, to use condoms for

any type of sex you are having.

What factors can affect sexual function for men?

So sexual function is really multifactorial.

There are so many aspects of men

and people that can affect sexual function.

One of the commonest things would be smoking, alcohol,

any drugs, they can all affect sexual function.

Again, it's linked to a lot of psychological issues.

So stress, any anxiety, depression,

anything like that can also affect

sexual function quite significantly.

What are some common problems with sexual function?

Some of the commonest problems

with sexual function would be difficulty maintaining

and getting an erection, loss of libido, so that's a loss

of sexual desire, premature ejaculation,

and also difficulty achieving orgasm.

A lot of these problems are really, really common

and they can sometimes be linked

to other underlying disorders.

So it's really, really important

for any man experiencing any of these issues to speak

to a professional about them so they can manage it

or rule out any other issue that might be going on.

What is erectile dysfunction and what causes it?

Erectile dysfunction is an issue

that many men will have over the course of their life about

getting and maintaining an erection.

For us as doctors, thinking about the reasons

behind it is often to do with the blood flow to the penis,

and any reduction in that can cause erectile dysfunction.

So it can often be an early sign

of cardiovascular disease, so it's important

to see a doctor about that, so that could be prevented.

It can sometimes show diabetes, for example.

It is also linked to psychological

and psychosocial factors, so any changes in your mood,

for example, can indicate

or can manifest in erectile dysfunction.

It's often linked to medications you might be on,

or alcohol, smoking, and other lifestyle factors as well.

So it's really, really important to

see a healthcare professional

if you are experiencing any issues

with erectile dysfunction.

What options are available for someone experiencing symptoms of erectile dysfunction?

So there are several options out there

for people experiencing erectile dysfunction.

The first, and something you can do at home is

ensuring you're having a healthy lifestyle.

So eating healthily, cutting back on alcohol,

if you drink alcohol, stopping smoking are the main things.

Otherwise, there are medications

which are often available over the counter.

People have often heard of things like Viagra,

but there are other kind

of similar drugs that do the same thing.

So speak

to a healthcare professional about these

if you are interested.

There are other methods too.

So you can get penile pumps, which are used

before intercourse to help improve the blood flow as well.

And there are even injections

that healthcare professionals can give in special cases.

What is premature ejaculation and what causes it?

Premature ejaculation is one of the commonest issues

that men have with sexual function,

and it is the early ejaculation through stimulation.

Bear in mind however, that most men will last from on

average four to seven minutes of stimulation

before ejaculation.

So a lot

of men do come into clinic thinking they have premature

ejaculation, but actually when they last maybe five minutes,

but actually that can be quite normal as well.

The causes, so increased sensitivity

to the area can cause premature ejaculation, as well

as psychological issues that are similar for a lot

of issues within the umbrella of sexual

function. Reassuringly,

however, there is a treatment available,

which is in tablet form that men can take to

counteract premature ejaculation.

But you would need to speak to your healthcare professional

about this if you were interested.

What is low libido and what causes it?

Low libido is a really, really common issue,

and most men will experience it at some point in their life.

It can be caused by anything that life throws at you.

It could be stress, so it could be work, low mood,

kind of changes in your exercise routine, changes to diet

if you're started on any new medication.

Alcohol is a big one. Smoking and drugs as well.

Is sexual dysfunction linked to age?

Yes, a lot of sexual dysfunction is linked to age, so

if you're more advanced in life, then you are more likely

to experience erectile dysfunction, a loss of libido,

and there's lots of causes for this.

Many older men might experience issues with prostate,

which is also linked to sexual dysfunction.

However, this really doesn't mean that if you were younger,

you will not experience sexual dysfunction.

So premature ejaculation and erectile issues

and libido are really common as well in younger age groups.

So it is really important whatever age you are,

if you are experiencing any issues with your sex life

or sexual function, to speak

to a healthcare professional about it.

How can men's mental health impact their sexual function?

Sexual function and mental health are significantly

interlinked. It's really, really important

that if you are having any issues with your mental health,

you do see a healthcare professional

because any major life change, so like moving house, going

through a relationship change, anything else that can cause

depression, low mood, burnout, anxiety,

they're all linked very strongly

to changes in sexual function.

So that can often be linked in the way we

diagnose depression is often a question we would ask is,

have you had loss of libido?

Are your energy levels down

and do you have any sexual function issues?

So it's really important if you do experience any of them

to speak to a healthcare professional

and we can often signpost you to talking therapies

and other support networks as well.

I'd also say that it's really important to try

and improve lifestyle.

So exercise is really good at preventing mental health

issues and speaking to your friends

and your mates down the pub

or playing a sport or something like that.

And opening up often can lift those burdens

of day-to-day life, which then will have a knock on effect

of improving your sexual function.

My sexual function may be having an impact on my mental health. Should I seek help?

So personally and as a doctor, I would say that as soon

as you start worrying

that your sexual function is infecting your mental

health, speak to someone.

And that could be a friend, it could be a colleague,

but it could also be a professional.

So that could be someone from talking therapies

or a doctor such as myself.

And that really is just to try

and reduce the impact of this on your day-to-day life.

I would certainly say if it's been going on for

certainly a good few weeks

or months, then I would definitely speak

to someone about it in a professional status.

I struggle to reach out for support with my sexual function. What can I do?

So I'm speaking to you as a doctor and as a man really,

and it's really difficult to reach out

and take that very, very first step. Speak to a friend,

a colleague, or even I know some people have spoken

to their pets, so their dog

or another animal as that first step just to kind

of get over that barrier of saying those first words

that you might be struggling or having an issue.

And it's just that first step

that can be the most difficult.

If you're not comfortable speaking to someone you know,

then really remember that any conversation you have

with a healthcare professional will be treated

as confidential and won't go any further.

So do make an appointment with your GP

or other healthcare professional to take

that very first step.

What kind of support is out there for a man and his sexual function?

So any healthcare professional is there

to listen and support.

So if you do want to reach out to a healthcare professional,

then you will have the time to feel supported, listened to,

and we may come up with a management plan about how

to move forward with things, which hopefully you would leave

that appointment assessment

feeling a little bit lighter on your shoulders,

and that there is a light at that end of the tunnel.

How do I maintain good sexual health?

It's really important to maintain good sexual health

and wellbeing, and it's something

that is available across the whole of the UK,

and that's in both the public and the private sector.

So regardless of where you live and accessibility really,

and it's really to make sure you test regularly.

So everyone who lives in a kind

of large urban area would be recommended to have a

sexual health test at least annually,

even if you're in a long-term relationship.

And that would be more frequently if you have symptoms

or if you have more than one sexual partner. Condoms,

or barrier contraception, as we often call it as doctors are

also integral in maintaining good sexual health.

How do I get help for problems with sexual function?

So sexual function such as erectile dysfunction, loss

of libido, premature ejaculation,

difficulty achieving orgasm, can be sought

by speaking to a healthcare professional, such as your GP.

So just make an appointment to speak to them today.

What are some of the common treatments for problems with sexual function?

There are lots of treatments available for issues

with sexual function, and it really depends on the cause.

The first treatment, and it probably covers most issues

with sexual function, is lifestyle.

So reduce your alcohol intake, don't smoke or vape,

and don't take illicit drugs as well.

And improving all of those as well as regular exercise

and a healthy diet will improve sexual function.

If you go see a doctor or another healthcare professional,

they may prescribe medications,

so there's different medications available

for different aspects of issues with sexual function,

and then there's psychological therapy.

So talking therapies

and psychosexual therapy can also help massively

with issues with sexual function.

How can I ask for help or speak to a GP about a problem if I feel embarrassed?

Now all of us feel embarrassed at some point in our lives.

I've certainly been to see a doctor

and worried about an examination

that may or may not happen.

Just remember that you are in control.

If you don't want to be examined, tell your doctor

and they may explore the reasons behind that.

And there may be some topics you are feeling really

embarrassed about talking about.

But remember with doctors

and other healthcare professionals,

everything is confidential.

It won't leave that room.

So just make that small step.

If you don't want to say it out loud,

write it down on a piece of paper or on your phone

and show it to them sort of thing, which

may break down a few

of those worrisome barriers that you might have.

But above all, if you are worried about something,

it's really important to speak to someone.

So do take that step to go to the doctor.

And even if you leave that consultation,

you haven't actually said the embarrassing

thing, you've made that step.

And maybe make an appointment

for a week's time when you're feeling a bit more ready.

But do just make that appointment

with a healthcare professional so you can speak

to someone about the issue you're experiencing.

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