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Let's get intimate

Dr Dawn Harper
Article written by Dr Dawn Harper

Date published 14 August 2019

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Although we are getting better at discussing intimate issues, there's still a long way to go. Here, Dr Dawn Harper discusses the most common issues that affect men and women and what we can do about them.

Loss of libido

Libido is complicated. It is normal to have days when you are just too exhausted to even think about sex, but if those days become more and more frequent, it can have a negative impact on your relationship.

I see women in surgery from time to time who tell me their husband or partner has sent them because there 'must be something wrong'. If this sounds familiar, ask yourself if you ever masturbate or have sexual thoughts. If the answer is yes, the chances are you are looking at a relationship issue and it is time to start talking. If the answer is no and your lack of libido is at a mismatch with your partner, then you need to see your GP.

Urinary tract infections

Most urinary tract infections can be simply treated with a course of oral antibiotics, but left untreated, the infection can take hold leaving you feeling very unwell.

People often try to restrict their fluid intake in an attempt to pass less urine to avoid the burning pain experienced when urinating with an infection. Sadly, this usually exacerbates the problem, as very concentrated urine irritates the bladder lining, so make sure you drink enough to keep your urine straw coloured and take a sample of urine to your GP. A simple dip test is usually all that is required to make the diagnosis.

Top tip: research studies don't all agree on this, but some of my patients find cranberry juice helps alleviate the symptoms.

Middle age spread

We have become so politically correct over the years that we rarely hear this phrase today but just because we don't talk about it, doesn't mean it isn't a very real phenomenon. As we reach middle age our metabolism slows down, meaning that for most of us if we do nothing differently in terms of diet and activity level, we are likely to gain weight, which is usually deposited around the midriff.

Pound for pound, weight around our middles is linked to a greater risk of developing heart disease and type 2 diabetes, than weight gained on the hips, so should not be ignored. Losing weight in middle age isn't easy but the health benefits of doing so are worth it - if you are a woman with a waist greater than 32 inches or a man with a waist greater than 37 inches (36 if you are of south Asian descent) it's time to think about doing something about it.

Vaginal dryness

If I went out on the street and asked the first 100 people I met to name three symptoms of the menopause, even the men would be able to tell me about hot flushes and mood swings, but few would mention vaginal dryness. It is in fact an extremely common problem around the time of the menopause and is easily treated, so should not be suffered in silence.

Vaginal dryness is a common cause of loss of libido as it can mean painful sex, which of course will put women off. Your pharmacist can advise on long acting lubricants and most pharmacies now have consulting rooms where you can discuss things privately.

There are also oestrogen creams and pessaries available on prescription. These only act locally so even if you don't want to consider HRT, it is worth having a chat with your GP. They really will have heard it all before, probably in the same week so don't let embarrassment stop you.

Erectile dysfunction (ED)

The advent of drugs like Viagra has made it easier to discuss ED but this is one symptom not to be ignored. Every man will have the occasional episode where they are unable to achieve or maintain an erection, but a persistent problem could be a sign of problems elsewhere. So it is important to check your risk factors for cardiovascular disease including body mass index, blood pressure and to have blood tests for diabetes and cholesterol.

Make it easy on yourself

  • Check out minor problems with your pharmacist - most have areas where you can talk about your symptoms in private
  • If you need to see your GP ask to see a male or female doctor - whichever makes you feel the most comfortable
  • If you can't face your GP make an appointment to see your practice nurse. They will be able to advise on whether you need to see the GP and may also be able to diffuse the embarrassment factor;
  • If you really can't face talking about your symptoms write them down and hand them to your doctor or nurse

Remember whoever your appointment is with they will have seen similar problems many times before - and may even have first-hand experience.

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Dr Dawn Harper

About Dr Dawn Harper

Dr Dawn Harper is a GP practising for the NHS in Gloucestershire and privately on Harley Street, specialising in preventative medicine and women's health. Dawn has regular columns in various publications and has appeared in Channel 4's Embarrassing Bodies.