Byline: GU
Story by GU

Midlife Medic: Should I Worry About Sexual Health?

Sexual health is an important subject for us forty somethings (and beyond!)

This can be a time of our lives when we are enjoying new relationships or just emerging from old relationships with the confidence to try something (or someone!) new.

That being said, there are some draw backs. Please give some consideration to the information below. Be safe and have fun!

2017 data shows an increase in unplanned pregnancies in over 35 + year old women and a massive leap in Syphilis and Gonorrhoea in 35+ year old men.

Both concerns mean one thing: ALWAYS use condoms! Even if you have another form of contraception.

Regarding the latter, there are lots of different types for a ‘belt and braces’ approach: pills, patches, vaginal rings as well as longer acting contraception options such as Injections, implant and coils (copper or progesterone – see website for detailed information).

Sexually transmitted infections

Data from 2017, the latest I could find, shows a strong increase in Gonorrhoea and Syphilis in men in 35-44 age group. (Guys…wrap it before you tap it!) Again, condoms are your friend when used correctly. See website for more information.

Sexually transmitted infections can be silent, in both men and women. Checks for STIs are available through GU clinics which are done anonymously as well as organise contact tracing (thereby avoiding embarrassing ‘phone calls or wattsapp messages). Other places providing these services would be your GP practice, NHS walk in clinics, family planning clinics or your local pharmacy.

Sex and the menopause

Women experiencing the changes of the menopause can very often experience vaginal dryness. This can make for uncomfortable sex and takes them much longer to achieve orgasm. Vaginal dryness can be improved by vaginal lubricants such as Sylk, KY jelly and others, available from pharmacies.

Hormone Replacement Therapy (HRT) and/or vaginal oestrogen can also help. Vaginal oestrogens are very safe and low dose but increase lubrication which can have additional benefits of improving over active bladders and reducing the incidence of urine infections after having sex.

Women uncomfortable with vaginal dryness may want to consider some of these options but can also be anxious about taking the plunge again after an uncomfortable experience. This might be improved with the lady on top who can initiate penetration when she feels ready and at her pace. Do discuss this with your partner, so he can understand your needs and both of you can go on to have a fulfilling sex life.

Erectile dysfunction (ED) is a common sexual problem in men, particularly in the 50+ age bracket. It is really important to take this seriously as not only does it affect your relationship, but it could implications for your health.

The diameter of the penile artery is the same diameter as the coronary artery. If you have ED due to furring of your arteries, then it is worth considering your heart health. Most GP surgeries offer over 40 checks which include blood pressure and blood tests.

The blood test would typically cover cholesterol, kidneys and blood sugar levels. However, there are many causes of furring of the arteries, made worse by high cholesterol, diabetes, sedentary lifestyle and smoking.

Other causes of ED include low testosterone, often characterised by lack of libido. There are other causes and would be best investigated by your GP. Viagra (Sildenafil) and other of the same family can often help with ED, but not in every case. It would be wise to discuss this with a professional, either in General Practice but it can also be obtained from your local community pharmacy.

‘Midlife Medic’ Dr Nicky Townsend qualified from the London Hospital Medical College in 1995, then trained as a GP, qualifying in 2001. She now works as a part time GP in Fleet, Hampshire and is also The Clinical Lead for Prescribing for Surrey Heath CCG.

Her ‘free time’ is spent as 'wallet and taxi service' to her children, tending to her allotment and playing tennis.

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