Explaining sexual problems to your GP

Discussing sexual problems with a doctor or health professional can be embarrassing. However, it is important not to suffer in silence. Sexual problems can badly affect your quality of life and erectile dysfunction (ED) with men, for example, is now thought to be an early marker of heart disease. Doctors will not be judging your sex life but need to have information to be able to come to a diagnosis and recommend treatment. All information you give will be strictly confidential and not given to anyone else, even a spouse or parent without your permission.

Here are a few tips to make it easier to talk about your problem and a guide to what your doctor or health professional needs to know.

Describing the problem

You need to explain exactly what the problem is rather than making your own diagnosis, as this can lead to the doctor coming to the wrong conclusion. You will also need to explain:

  • How long you have had the problem and how it affects you and your relationship
  • Your current partner’s age and sex
  • If you have several partners, whether the problem with a particular one
  • Whether you’ve had problems with previous partners
  • If your partners have a problem
  • The type of intercourse you have– vaginal, oral or anal
  • Whether you have ever been sexually abused or assaulted, as an adult or as a child

Contraception and sexually transmitted infections (STIs)

  • What type of contraception you and your partner use?
  • Whether you use condoms with a new partner, even though you do not need to for contraception
  • If you have concerns about STIs
  • Whether you have had an STI in the past and how you were treated
  • Whether you have attended a genitor-urinary clinic

What do you want to do?

  • Do you want to try drug therapy? If so, think about what preparation would suit you best
  • Do you want to have counselling? If so, think about where you would like to go and what type of therapist you would like to see

The discussion with your doctor or health professional may be over several appointments and should lead to you agreeing to a management plan that suits you.

Where can you get more information?

The Sexual Advice Association is here to help. We cannot give individual medical advice, but we can answer your questions on any sexual problems and put you in touch with local specialist practitioners. We also have a number of factsheets and booklets on sexual problems and related issues for men and women that can be downloaded from our website or requested. Please feel free to email us or phone our Helpline (our contact details are at the bottom of this page).

You can also visit the NHS Choices website at www.nhs.uk for information and advice on many different health and lifestyle topics.

Donate

By donating to the Sexual Advice Association, you will know that you are helping improve the lives of people living with sexual problems. If you are interested in donating, please click here or contact us for more information (details at the bottom of this page).

Thinking About Sex Day: February 14th

Launched by the Sexual Advice Association, Thinking About Sex Day (TASD) is designed to encourage everyone to think about the physical and psychological issues surrounding sexual activity.

The Mediterranean Diet

What is it?

A traditional Mediterranean diet includes large amounts of fruit, vegetables, nuts, whole grains, legumes (beans, peas and lentils) and olive oil. It includes moderate amounts of fish and alcohol (wine with meals), and low amounts of dairy products, meat and sweets.

Why is it important?

Modern lifestyles involving office working, daily stress, reliance on the car and unhealthy diets are bad for our health. Between 1993 and 2013, the number of obese women increased from 16% to 25% and the number of obese men increased from 13% to 24%. In 2012, 19% of men and 26% of women were classed as inactive. And between 2009 and 2012 overall purchases of fruit and vegetables decreased.

An unhealthy lifestyle and obesity can put you at risk of other health problems, including raised cholesterol, high blood pressure, type 2 diabetes, and diseases of the heart and blood vessels (cardiovascular disease (CVD)). And these can increase your risk of sexual problems.

In 2014, CVD was the second biggest cause of death in the UK, causing 27% of all deaths, a total of around 155,000. These were mainly from heart disease (45%) and stroke (25%). Heart disease remains the biggest single cause of death in the UK.

Studies have shown that consistently eating a Mediterranean diet can:

  • Reduce the risk of death from CVD, cancer and other causes
  • Reduce the risk of Parkinson’s disease and Alzheimer’s disease
  • Reduce the risk of type 2 diabetes
  • Increase the likelihood of healthy aging

med-diet

What else should you know?

One important part of the Mediterranean diet is the type and amount of fat you should eat. This diet includes foods that contain healthier, unsaturated fats, such as olive oil, nuts and oily fish. These fats can help reduce the risk of CVD by lowering the bad fats (cholesterol and triglycerides) in the body.

You should eat less saturated fat, because this can increase the risk of CVD. Saturated fats are found mainly in animal products (fatty meats, butter, cream and cheese), biscuits, cakes and pastries, but coconut and palm oils also contain them.

Other risk factors for CVD include eating too much salt and sugar, being overweight, not taking enough physical activity and smoking.

Although the Mediterranean diet includes ‘moderate’ amounts of alcohol, Government guidelines recommend that men and women do not regularly drink more than 14 units of alcohol per week.

So, consistently eating a Mediterranean diet is a scientifically proven and affordable way to improve your health, but it should also be combined with reduced sugar and salt intake, moderate physical activity, and not smoking.

Where can you get more information?

The Sexual Advice Association is here to help. We cannot give individual medical advice, but we can answer your questions on any sexual problems and put you in touch with local specialist practitioners. We also have a number of factsheets and booklets on sexual problems and related issues for men and women that can be downloaded from our website or requested. Please feel free to email us or phone our Helpline (our contact details are at the bottom of this page).

You can also visit the NHS Choices website at www.nhs.uk for information and advice on many different health and lifestyle topics.

What is the Take Home Message?

Remember, large amounts of plant foods, moderate amounts of fish & wine, small amounts of animal products and sweets.

Further reading

Download or request our booklet ‘Sex and the heart’ and/or our factsheet ‘Body Mass Index (BMI)

Donate

By donating to the Sexual Advice Association, you will know that you are helping improve the lives of people living with sexual problems. If you are interested in donating, please click here or contact us for more information (details at the bottom of this page).

Thinking About Sex Day: February 14th

Launched by the Sexual Advice Association, Thinking About Sex Day (TASD) is designed to encourage everyone to think about the physical and psychological issues surrounding sexual activity.

Body Mass Index (BMI)

Background

The number of people who are overweight or obese is increasing rapidly in many parts of the world. In the UK in 2012, 42% of men and 32% of women were overweight and 24% of men and 25% of women were obese.

What is BMI?

Body Mass Index (BMI) uses your weight and height to determine if you are within the normal, healthy range for weight or if you are underweight, overweight or obese.

The standard BMI ranges for weight categories in adults are:

BMI Weight category
Below 18.5 Underweight
18.5-24.9 Normal weight
25.0-29.9 Overweight
30.0 and above Obese

Why is it important?

Having a low BMI and being underweight may be a sign that you are not eating enough or you have an underlying illness such as an overactive thyroid gland.

People with a BMI above the normal (healthy) range are more likely to suffer obesity-related health problems such as diseases of the heart and blood vessels (cardiovascular disease (CVD)), type 2 diabetes and certain cancers. And CVD, type 2 diabetes, and certain types of cancer and their treatment, can all increase your risk of sexual problems.

How accurate is it?
BMI can tell you if you weigh too much, but it cannot tell you if this is due to too much fat. It does not distinguish between excess fat, muscle or bone mass, and it cannot provide information on how fat is distributed within the body. It also does not account for other factors such as age, sex, ethnicity and muscle mass.

For this reason BMI may be less reliable in certain groups of people, such as:

  • Older individuals who lose muscle with aging – they may fall in the normal (healthy) weight range even though they are carrying too much fat
  • Muscular individuals, or highly trained athletes, who have increased muscle mass – they may be classed as overweight or obese even though they have little body fat
  • Pregnant women – they may be classed as overweight or obese because BMI won’t consider the weight of the pregnancy separately

So, BMI is best used as a ‘screening tool’ to identify people who are overweight or obese. Others factors such as how much fat they have, how this is distributed within the body, their genetics and fitness will all provide more information on their risk of disease.

How can you get it measured?
You can have your BMI measured at your doctor’s surgery or you can check it yourself online using the NHS Choices BMI healthy weight calculator. This is available at: www.nhs.uk

Why you should measure your waist?

Measuring your waist circumference is a good way to check if you have central (abdominal) obesity and are carrying excess ‘visceral’ fat. This is a dangerous type of fat that surrounds the internal organs. Having too much of it puts you at increased risk of CVD, type 2 diabetes and cancer. Even If your BMI is in the normal (healthy) range, you can still have excess abdominal fat that increases your risk of these diseases.

How do you do it?

  • Feel where the top of your hips are and the bottom of your ribs are
  • Wrap a tape measure around your waist, in the middle of these two points
  • Breathe out as usual, then take the measurement in centimeters (cm)

What does it tell you?
The following table tells you how large your waist has to be for you to have abdominal obesity.

Country or ethnic group Waist circumference What it means What you should do
Europid Caucasian/white skin), Eastern Mediterranean, Middle-East (Arab), Sub-Saharan 94cm or more and you are a man
or
80cm or more and you are a woman
You have abdominal  obesity Try to lose weight
South Asian, Chinese, Japanese, Ethic South and Central American 90cm or more and you are a man
or
80cm or more and you are a woman
You have abdominal obesity Try to lose weight
Any 102cm or more and you are a man
or
88cm or more and you are a woman
You have significant abdominal obesity and are at very high risk See your GP

How accurate is it?
Waist circumference will be less accurate in certain situations, such as pregnancy and swelling of the tummy due to medical conditions.

What should you do if you are overweight or obese?

Losing weight will reduce your risk of obesity-related diseases. The best way to lose weight is through diet and exercise. Medication may be required in some cases. It is sensible to see your doctor so they can check your general health and advise you on the best way forward.

Where can you get more information?

The Sexual Advice Association is here to help. We cannot give individual medical advice, but we can answer your questions on any sexual problems and put you in touch with local specialist practitioners. We also have a number of factsheets and booklets on sexual problems and related issues for men and women that can be downloaded from our website or requested. Please feel free to email us or phone our Helpline (our contact details are at the bottom of this page).

You can also visit the NHS Choices website at www.nhs.uk for information and advice on many different health and lifestyle topics.

What is the Take Home Message?

Being overweight or obese can put you at risk of serious health problems – it’s never too late to lose weight!

Further reading

Download or request our booklet ‘Sex and diabetes’ and/or our factsheet ‘The Mediterranean Diet

Donate

By donating to the Sexual Advice Association, you will know that you are helping improve the lives of people living with sexual problems. If you are interested in donating, please click here or contact us for more information (details at the bottom of this page).

Thinking About Sex Day: February 14th

Launched by the Sexual Advice Association, Thinking About Sex Day (TASD) is designed to encourage everyone to think about the physical and psychological issues surrounding sexual activity.