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Sexual health: what you need to know

There’s no need to put up with problems in your love life. Find out how to deal with the most common issues that can affect your sexual health

Written by Charlotte Haigh on March 18, 2019 Reviewed by Dr Rob Hicks on March 28, 2019

From troubles with arousal to sexually transmitted infections, plenty of things can go wrong with your sexual health. It’s important you don’t ignore your concerns, as sex is an important part of life. Follow our guide for tips on how to support your sexual health.

Sexually transmitted infections (STI)

An STI is an infection passed on through unprotected sex or genital contact.1 And while they are more common in under-25s,2 incidence has risen by a third among those aged between 50 and 70, who may be dating new partners3 and not receiving safe sex messages. The most common STI in the UK is chlamydia. Others include genital herpes, genital warts and gonorrhoea.4 You can have a STI without any symptoms. However, common symptoms include:5
  • pain on urinating
  • discharge from the penis, vagina or anus
  • rash and/or itching around your genitals
  • lumps, blisters or sores around your genitals or anus
  • unusual vaginal bleeding in women

Managing an STI

Get tested at your GP or sexual health clinic – especially if you know you’ve had unprotected sex with someone with an STI. Some infections may lead to other health complications, for example chlamydia is linked to infertility. Your doctor can prescribe medication to help manage your condition.6

Pain during sex

Pain during sex, called dyspareunia, affects both men and women. A 2017 study by the London School of Hygiene reported that it’s experienced by 7.5% of women aged between 16 and 74 years.7 In women, causes of pain during sex include:8
  • vaginismus – a condition in which the vaginal muscles shut tightly
  • an STI
  • thrush
  • lack of arousal - leading to vaginal dryness
  • vaginal dryness, caused by menopausal hormone changes
  • a health condition, like constipation, irritable bowel syndrome or endometriosis
In men, causes include:9
  • foreskin issues, like tightness or tears
  • an STI
  • thrush
  • inflammation of the prostate gland (prostatitis)

Managing pain during sex

See your doctor or visit a sexual health clinic for tests to identify the underlying cause – whether that’s physical or psychological – and receive treatment.10

Vaginal dryness

Dryness in your vagina can cause pain during sex, and vaginal itching, too. It affects 17% of women aged 18-50, rising to more than half of all women between 51-60 due to changes in oestrogen levels after the menopause.11 Triggers include:12
  • lack of arousal during sex
  • hormonal changes, including menopause and breast-feeding – a drop in oestrogen can lead to vaginal dryness
  • certain medication, for example antihistamines
  • an underlying medical condition, like diabetes

Managing vaginal dryness

Use a water-based lubricant and spend plenty of time on foreplay before having sex. See your doctor too, to talk about hormonal replacement therapy (HRT) or changing your usual medication.13

Erectile dysfunction

Also known as impotence, the failure to get or keep an erection affects half of men aged between 40 and 70 to some degree.14 If it happens occasionally, it’s likely nothing to worry about – stress, tiredness or too much alcohol can all cause temporary problems with erections. For more frequent occurrences, common causes include:15
  • cardiovascular problems – high cholesterol and high blood pressure can affect blood flow to the penis
  • low testosterone levels
  • certain medication, such as antidepressants

Managing erectile dysfunction

See your GP for treatment. You could also discuss with them whether taking the herb Korean red ginseng might help – a 2008 review in British Journal of Clinical Pharmacology found it can improve blood flow during an erection, although more research is needed.16 Try making some lifestyle changes, too. Losing weight, tackling your stress levels, eating a healthy diet, regular exercise and reducing the amount you drink can all help.17

Premature ejaculation

This is when a man can’t delay ejaculation for more than a minute after penetration.18 The average time to ejaculation during sex is around 5.5 minutes,19 but as many as one in three men will experience premature ejaculation at some time. It’s absolutely nothing to worry about if it only happens occasionally, but if it happens during most of your sexual encounters – and you’re finding it distressing or avoiding sex as a result – take action.20 Causes of premature ejaculation can include:21
  • thyroid problems
  • anxiety about premature ejaculation
  • depression
  • relationship issues
  • stress

Managing premature ejaculation

Try the following tips:22
  • masturbate 1-2 hours before sex
  • use a thick condom to reduce sensations
  • distract yourself with boring thoughts during sex

If this makes no difference, see your doctor or a sex therapist – they can look for underlying causes and may prescribe medication to help.

Loss of sex drive

Experts say one in three women and one in five men in the UK experience a loss of libido at some point in their lives.23,24 Common causes include:25
  • relationship difficulties
  • stress, anxiety and depression
  • fatigue
  • menopause – the fall in oestrogen can affect libido
  • drinking too much alcohol
  • thyroid problems
  • certain contraception
  • obesity
  • long-term health conditions, like diabetes and heart disease

Managing loss of sex drive

Boost your libido naturally by increasing your activity levels, reducing stress and setting aside some proper time for intimacy with your partner.26 Counselling may also help relationship problems, and consider taking the herb maca – a 2008 US study found it may improve libido.27 It’s also a good idea to see your doctor to rule out underlying medical causes and to test for hormonal imbalances.

Supporting your sexual health

Whatever your concern, a counsellor can help with any relationship issues that are causing sexual difficulties. And always see your GP if you’re worried about any aspect of your sexual health.

Advice is for information only and should not replace medical care. Please check with your GP before trying any remedies.

Sources

1. NHS Inform. Sexually transmitted infections 2. FPA. Sexually transmitted infections factsheet 3. Katie Forster. The Independent. More elderly people being diagnosed with STIs such as chlamydia and genital warts

4. As Source 2

5. NHS. Sexually transmitted infections (STIs) 6. NHS. Chlamydia 7. Mitchell KR, et al. Painful sex (dyspareunia) in women: prevalence and associated factors in a British population probability survey 8. NHS. Why does sex hurt?

9. As above
10. As Source 8

11. Women’s Health Concern. Vaginal dryness 12. Shannon Brosek. Medical News Today. What are the possible causes of vaginal dryness?

13. As Source 11

14. Sexual Advice Association. Erectile dysfunction 15. NHS. Erectile dysfunction 16. Jang D-J, et al. Red ginseng for treating erectile dysfunction: a systematic review

17. As Source 15

18. Mayo Clinic. Premature ejaculation 19. NHS. Ejaculation problems

20. As above
21. As Source 18
22. As Source 19

23. Charlotte England. The Independent. Women suffering from loss of sexual desire should be offered testosterone on the NHS, says doctor 24. NHS Inform. Loss of libido 25. Mayo Clinic. Low sex drive in women: Diagnosis

26. As above

27. Dording CM, et al. A double-blind, randomized, pilot dose-finding study of maca root (L.meyenii) for the management of SSRI-induced sexual dysfunction

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