Many people experience problems with their sexual health at some point in their lives. For example, problems with erections, ejaculation, sexually transmitted infections, and low sex drive. Sexual health issues can result from a physical or psychological (mental health) problem, or a combination of both. Here, I’ll discuss some of the most common sexual health problems.
What causes lack of erection?
If you can’t get or keep an erection long enough to have sex, you may have erectile dysfunction. This is not an unusual problem. It can happen at any age, but it is more common as you get older. If you experience erectile dysfunction don’t worry. There are things you can do and treatments available to help.
Reasons for erectile dysfunction can be high blood pressure and diabetes. These affect blood flow to the penis. Erection problems may also be the result of hormone disorders.
Erectile dysfunction may occur after surgery or operations on your pelvic area. There can also be psychological reasons for this condition. You might be feeling stressed or have anxiety or depression. Your doctor will check for these problems or conditions and manage them as necessary.
Making changes to your lifestyle may help with erectile dysfunction. This includes stopping smoking, cutting down on alcohol and losing weight if you need to. Your doctor may also prescribe medication or they may refer you for specialist treatment if necessary. Medicines for treating erectile dysfunction include:
- sildenafil (Viagra)
- avanafil (Stendra or Spedra)
- vardenafil (Levitra)
- tadalafil (Cialis)
These are tablets you take before you have sex. You should follow your doctor’s advice on which is best for you.
What is sexual dysfunction?
Sexual dysfunction can include erectile dysfunction as mentioned above. Another type of sexual dysfunction is premature ejaculation. This is when you ejaculate during sex before or shortly after penetration. This can be disappointing for you and your partner.
Premature ejaculation is usually due to psychological reasons such as anxiety. The problem can get worse if you don’t have sex very often.
Treatment such as behavioural therapy can help you learn how to delay ejaculation. There are also creams or condoms that contain anaesthetic. They can help delay ejaculation although this can also reduce sensitivity during sex.
There are prescribed drug treatments for premature ejaculation. These are medicines called selective serotonin reuptake inhibitors (SSRIs). A doctor can give advice about taking these for premature ejaculation.
Another type of sexual dysfunction is low sex drive (decreased libido). This means you have less interest in sex.
Sex drive can decrease with age. Lower sex drive can also be due to depression, anxiety or relationship problems. Low sex drive can also sometimes be due to low hormone levels. A doctor can help you find out what’s wrong and help you to improve your sex life.
What are sexually transmitted infections?
Sexually transmitted infections (STIs) spread during sexual activity. They can be passed on through unprotected vaginal, anal or oral sex. They can also be spread by sharing sex toys.
STIs are caused by bacteria, viruses or parasites. STIs are most common in people under 25, but anyone who’s sexually active can catch one.
The most common STIs in the UK are chlamydia, genital warts, gonorrhoea and genital herpes. Other STIs include hepatitis, HIV and syphilis. Bear in mind there have been increased rates of gonorrhoea and syphilis diagnosed in men who have sex with men.
With some STIs, you might not get any symptoms at all. But if you do, they may include:
- discharge – mucus or pus – from your penis
- pain when you pee
- rashes, lumps, or blisters around your genital area
- pain in your testicles
It’s important to visit a sexual health clinic or your GP if you think you might have an STI. Getting treatment can help your symptoms and stop the infection spreading to others.
Even if you don’t have symptoms, it’s worth getting tested for STIs if you’ve recently changed your sexual partner.
Getting tested yearly is also a sensible thing to do. Go to your GP or a sexual health clinic if you:
- have had new sexual contact without using a condom or barrier contraceptive
- are planning to have unprotected sex
Some STIs, if left untreated, can lead to more serious health problems, including infertility. Practising safe sex using a condom can help protect you.
Sexual dysfunction such can be due to both physical and psychological reasons. By speaking to a GP you can get the help you need to treat these problems. And it’s important to practice safe sex by wearing condoms to prevent yourself from getting STIs.
What should I do if I'm embarrassed to talk to my doctor?
Seeing a doctor when you're embarrassed | Watch in 2:08 minutes
Dr Naveen Puri talks about how to make it easier to see a doctor about a health issue when you are feeling embarrassed.
Hello, I am Dr Naveen Puri, I am one of the GPs within Bupa Health Clinics.
Today I want to speak to you about embarrassing problems you might have and what we can do if you attend one of our clinics.
I want you to know that many people feel embarrassed or concerned about speaking about certain things with their doctors, but I'm here to reassure you these are the kinds of things we deal with every day.
For me, looking at someone's bottom or their breasts or their genitalia is no different to looking at their nose or elbow.
And that's true for all doctors as we train for many years in these parts of the body and are very used to having these conversations with people just like you.
So what I would encourage you to do if you have any concerns from your perspective, be it a change in your bowel habit, be it a lump, a rash, a swelling. Something on your genitalia or a part of your body you're not particularly familiar with or feel uncomfortable discussing.
Please be assured your doctor has done it all before.
Some of the ways we find patients find it easier to speak to a doctor is to either tell the doctor you feel embarrassed up front. That way a doctor can make extra effort to make sure you feel comfortable.
Or some patients come to us with pieces of paper and will write the problem down and hand it to us. That way we can help with whatever is going on for you as well.
You may also find it helpful to ask for a specific doctor, someone you're familiar with in your practice. Or you might want to ask for a doctor of a specific gender, or background to your liking as well.
I'd also say, doctors do this every day so don't be alarmed if we ask you certain questions around your symptoms. It is purely so we can help you get the best outcome for your enquiry.
And then finally, feel free to use language that suits you as well. We don't expect you to know the medical words for things, or a name for your diagnosis. That's our job to find out for you.
So, take your time, see a doctor, and hopefully we can help put your mind at ease.
We offer a range of sexual health services within our Bupa Health Centres. So whether you have symptoms and need to speak to a GP or don't have symptoms but want a check to see if you currently have an STI we have a check to suit you. Any customers who test positive receive a follow up with a GP and support from our 24/7 Nurse HealthLine. Learn more today.
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Sources Sources
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- Overview of Sexual Function and Dysfunction in Men. MSD Manuals. msdmanuals.com, last reviewed March 2022
- Premature Ejaculation. MSD Manuals. msdmanuals.com, last reviewed March 2022
- Premature ejaculation. British National Formularies. bnf.nice.org.uk, accessed October 2023
- Decreased Libido in Men. MSD Manuals. msdmanuals.com, last reviewed March 2022
- A BASHH Guide to Safer Sex. British Association for Sexual Health and HIV (BASHH). bashh.org, accessed October 2023
- Overview of sexually transmitted infections. BMJ Best Practice. bestpractice.bmj.com, last reviewed September 2023
- Sexually Transmitted Infections. Patient. patient.info, last updated April 2022
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- Sexual health and contraception. Oxford Handbook of General Practice (5 ed online). Oxford Academic. academic.oup.com, published June 2020. Doi: 10.1093/med/9780198808183.003.0021
- Getting tested for an STI: Your guide to how it works. UK Health Security Agency. ukhsa.blog.gov.uk, published October 2022
- A healthy sex life. Terrance Higgins Trust. tht.org.uk, last reviewed February 2022
- Chlamydial Genital Infection. Patient. patient.info, last updated March 2022
- Sexually transmitted infections (STIs). World Health Organisation. who.int, published July 2023
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