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 consultations.
Key takeaways
- Common contributors: medication, depression, relationship factors, hormonal change
- Antidepressants: a very common and reversible cause
- Most useful single change: Raise it with a GP; it is a common consultation and they will have heard it.
- Commonest mistake: Buying treatments from unregulated websites.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Raise it with a GP; it is a common consultation and they will have heard it
- Review medications, which are a frequent and fixable cause
- Ask about psychosexual therapy, which is available on the NHS in some areas
- Address sleep, alcohol, smoking and activity, all of which are relevant
Do not
- Buying treatments from unregulated websites
- 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 reversible cause |
| Erectile dysfunction | can be an early cardiovascular marker |
| Painful sex | always warrants assessment; it is not something to tolerate |
If you change one thing
Raise it with a GP; it is a common consultation and they will have heard it. That is the opening item above. Doing only that is still doing something.
Where to go next
- A Q and A on Sexual Function
- The Short Guide to Sexual Function
- Sexual Function — the reference entry
- Sexual Health Services: What Published Guidance Supports
- Menstrual Cycle Tracking: What Published Guidance Supports
When to speak to a doctor
See a GP for painful sex, which always warrants assessment, or for new erectile dysfunction, which can be an early marker of cardiovascular disease or diabetes. Never take PDE5 inhibitors such as sildenafil with nitrate medicines. Seek urgent help for an erection lasting more than four hours.
Where this comes from
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, summarised or generalised 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 a GP, 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 999.
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