Why Doctors Need Better Sex Education

By Matty Silver, Sex Therapist on October 20, 2016 in Other

Over the years I have seen many clients experiencing problems relating to sexual issues or suffering from some sort of sexual dysfunction. Many turn to their GPs, but while going to the doctor is straightforward if you have stomach pains, seeking help with sexual problems can be embarrassing.

It’s disappointing to hear that many of my clients feel their doctor was either not helpful or found it difficult to talk about sexual issues. Some issues my male clients deal with include premature ejaculation, losing their erection or having difficulties ejaculating. Menopause is a big problem for older women. The onset of menopause is something most women dread because, as well as the physical symptoms, their sex lives can also be affected.

Years ago every woman was routinely prescribed hormone replacement therapy (HRT) as soon as she reached menopause. This changed in 2002 when a study in the US was stopped because researchers found that HRT increased women’s risk of breast cancer.

A decade later, medical professionals agreed these findings were flawed and HRT was not as risky as believed, but there is still anxiety and confusion among women and the medical professionals. I have spoken to many women who are too frightened to take HRT, but suffer from symptoms affecting their libido and their relationships with their partners.

Over two million women in Australia are going through menopause, but only eight per cent use conventional HRT. It’s therefore important that GPs do not talk women out of taking HRT, but rather explain the risks and benefits, and provide an informed choice.

If you are a GP and a young man comes to see you complaining about often losing his erection, the first question you should ask is whether or not it also happen when he self-stimulates. If the answer is no, he may have acquired performance anxiety. Loss of erection only has to happen a few times for a man to feel doubt, leading to anxiety the next time. When he starts anticipating problems about his performance, it becomes a self-fulfilling fear. Prescribing young men Viagra is not helpful – only men over 50 may need it.

To keep an erection a man must be sexually aroused. When his anxiety takes over, it inhibits the blood flow to his penis, which can result in erection difficulties. The same effect happens when a man has difficulty ejaculating or is not able to ejaculate at all – he concentrates so much on reaching orgasm that he is not sexually aroused anymore.

Premature ejaculation (coming too quickly), affects about 30 per cent of the male population. It’s quite common these days for GPs to prescribe healthy young men a class of antidepressants (SSRIs) because it’s known they can delay ejaculation. But what about the side effects of taking daily anti-depressants when the patient may only have a psychological problem that can be treated easily and effectively without them?

I’m sure it’s difficult to diagnose patients with sexual issues properly with the short appointment times doctors have these days. Referring them on to a sex therapist may actually lead to a better outcome.