Sexual Function: The Practical To-Do List
Sexual Function: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
Difficulties with desire, arousal, pain or orgasm, in any gender. These are common, frequently have a physical or medication cause, and are rarely raised in appointments.
Key takeaways
- Common contributors: medication, depression, relationship factors, hormonal change
- Antidepressants: a very common and often reversible cause
- Most useful single change: Raise it with your doctor; it is a common concern and they will have heard it.
- Commonest mistake: Buying sexual enhancement products online; FDA has found many contain hidden drugs.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Raise it with your doctor; it is a common concern and they will have heard it
- Review medications, which are a frequent and fixable cause
- Ask about a referral to a sex therapist or counselor
- Address sleep, alcohol, smoking and activity, all of which are relevant
Do not
- Buying sexual enhancement products online; FDA has found many contain hidden drugs
- Stopping antidepressants abruptly because of sexual side effects
- Assuming painful sex is normal or psychological
The numbers behind the list
The reasoning behind both lists, in numbers.
| Measure | Figure |
|---|---|
| Common contributors | medication, depression, relationship factors, hormonal change |
| Antidepressants | a very common and often reversible cause |
| Erectile dysfunction | can be an early sign of heart disease or diabetes |
| Painful sex | always warrants assessment; it is not something to tolerate |
If you change one thing
Raise it with your doctor; it is a common concern and they will have heard it. That is the opening item above. Doing only that is still doing something.
Related topics
- Erectile Dysfunction: Sorting the Evidence From the Noise (Men's Health)
- Pelvic Floor: What the Evidence Actually Says (Women's Health)
- The Evidence on Stress, Without the Hype (Mental Health)
- What the Guidance Really Says About Mental Health and Long-Term Illness (Long-Term Conditions)
Where to go next
- A Q and A on Sexual Function
- The Short Guide to Sexual Function
- Sexual Function — the reference entry
- Sexual Health: The Complete Guide
- Sexual Health Services: What Published Guidance Supports
- Menstrual Cycle Tracking: What Published Guidance Supports
When to speak to a doctor
See your doctor for painful sex, which always warrants assessment, or for new erectile dysfunction, which can be an early sign of heart disease or diabetes. Never take PDE5 inhibitors such as sildenafil with nitrate medicines. Go to the emergency room for an erection lasting more than four hours, and call 911 for chest pain during or after sex.
Where this comes from
- National Institute of Diabetes and Digestive and Kidney Diseases — Erectile Dysfunction (ED)
- FDA — Tainted Sexual Enhancement Products
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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