![\"Sex](\"http:\/\/i.dailymail.co.uk\/i\/pix\/2016\/06\/07\/00\/34F8877D00000578-0-image-a-16_1465254580936.jpg\")
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Sex is not the taboo subject it once was but\u00a0failure of healthcare professionals to talk about sex places the onus on the patient<\/p>\n
Sex is far from the taboo subject it once was \u2014 except for people living with a serious illness.\u00a0<\/p>\n
Their sexuality is often ignored, with few healthcare professionals willing or able to discuss how an illness or treatment might affect their sex life and relationship.<\/p>\n
Indeed, doctors in most specialties, from orthopaedics to oncology and even gynaecology, very rarely approach the subject directly with patients, according to a major review of studies entitled Why Don\u2019t Healthcare Professionals Talk About Sex?<\/p>\n
The reasons included \u2018fear of opening up a can of worms\u2019 to worries about causing offence.<\/p>\n
Only 6 per cent of GPs initiated discussions about patients\u2019 sex lives because they didn\u2019t want to appear nosy. Some admitted the subject made them feel uncomfortable.<\/p>\n
\u2018If you have a life-threatening disease, the focus is on treatment to keep you alive,\u2019 explains Jo Coker, from the College of Sexual and Relationship Therapists.<\/p>\n
\u2018Yet you might have all kinds of anxieties about whether your partner still finds you attractive and if your libido will return.\u2019<\/p>\n
Furthermore, a healthy sex life has wider implications. Ms Coker says: \u2018We know that if people are happy and supported in their relationship, and that includes having some kind of physical intimacy, their physical health is likely to improve as well.\u2019<\/p>\n
The failure of healthcare professionals to talk about sex places the onus on the patient \u2014 yet most people find it very difficult to discuss worries about sex during routine medical appointments, Ms Coker adds.<\/p>\n
\u2018They worry that the doctor might disapprove, or they feel de-sexed by illness and somehow not entitled to a sex life.<\/p>\n
\u2018Women whose partners experience erectile dysfunction after surgery for prostate cancer rarely complain about their sex lives. They may feel there\u2019s something slightly distasteful about admitting to wanting sex.\u2019<\/p>\n The failure to consider the effect of treatment on patients\u2019 sex lives is illustrated by the experiences of Alex Cowan. She was diagnosed with the degenerative neurological disease MS when she was 25.<\/p>\n By the time she was 39 she was unable to stand or walk. When she developed incontinence, her consultant suggested having a catheter implanted from her bladder to an external bag which could then be emptied.<\/p>\n \u2018The outcome of the procedure was totally liberating because I knew I wouldn\u2019t have to worry,\u2019 says Alex, now 51, from London.<\/p>\n But there was also a downside: the surgeon had placed the catheter tube low over the pubic bone \u2014 he had assumed Alex would want it below her bikini line \u2014 and it made her feel self-conscious and uncomfortable about her sex life.<\/p>\n \u2018I was a young married woman of 39, yet at no point did anyone discuss with me how the catheter would impact on my sex life or my body image,\u2019 she says.<\/p>\n It was four years before Alex found the courage to broach the subject with her surgeon: \u2018Partly out of embarrassment, partly because I knew it would involve more surgery to have it moved higher up.<\/p>\n Experts suggest people should not suffer in silence and must talk about any issues they have regarding sex\u00a0<\/p>\n \u2018I finally said: \u201cFunnily enough, I prefer sex to sunbathing.\u201d And the surgeon apologised and re-sited it.<\/p>\n \u2018That was a very big deal for me because it took months to get over the first op and I dreaded feeling so exhausted and ill again.\u2019<\/p>\n Prompted by her experiences, Alex wrote a book, The Sexual Respect Toolkit, with psychologist Susan Quilliam, to help GPs and other health professionals bring up the issues of sex and sexuality with patients.<\/p>\n \u2018People with disabling diseases aren\u2019t considered by the medical profession as viable, covetable sexual partners and that has the devastating effect of making you feel sexually undesirable when you\u2019re at your most vulnerable,\u2019 says Alex.\u00a0<\/p>\n \u2018Your sexuality is an intrinsic part of being a human being, and when it\u2019s ignored you feel somehow less human.\u2019<\/p>\n Sex and illness may be a taboo subject but it is one that affects countless lives.<\/p>\n The cancer charity Macmillan\u2019s report Cured But At What Cost?, published in 2013, found that while about half of those people diagnosed with cancer today will live for 10 years after diagnosis, a quarter (some 500,000 people) live with distressing problems such as urinary or bowel incontinence, crippling fatigue and sexual difficulties for years after their treatment has finished.<\/p>\n \u2018The sense of your body as a private, sensual, intact and functioning object is damaged by being investigated and treated by strangers,\u2019 says Dr Frances Goodhart, author of The Cancer Survivor\u2019s Companion.<\/p>\n \u2018Regaining yourself as a sexual being can be very challenging.\u2019<\/p>\n Changes in weight and muscle tone and function (such as erectile dysfunction in men), and scars, can all affect the physical act, but also have a huge impact on the patient\u2019s perception of themselves as a desirable sexual partner.<\/p>\n Millions of people live with chronic conditions that are not life-threatening but nonetheless have an impact on their confidence and their sex life<\/p>\n \u2018Chronic illness also changes how you see each other,\u2019 adds Dr Goodhart. \u2018The partner who has to help you on the loo may not easily change roles back into a loving sexual partner. Awkwardness about talking then leads to avoidance and a downward spiral.\u2019<\/p>\n Alex Cowan describes a recent period of depression when she realised how much her body shape was changing.<\/p>\n \u2018My body is different to how it was when I took movement for granted and I had this crisis over whether I was still attractive.\u2019<\/p>\n So what helped? \u2018I had to look at my sex life in a totally different way,\u2019 she says.<\/p>\n \u2018Spontaneity before I had MS might have been three minutes. It\u2019s now more like three days.\u2019 She adds: \u2018It\u2019s really important to move on and find different ways of feeling satisfied.\u2019<\/p>\n Alex feels communication with her husband is probably the key part of their sex life now. \u2018It has been hugely enriching,\u2019 she says. \u2018But there\u2019s a lot of fear involved: you\u2019re worried your partner will be disgusted by how you look.\u2019<\/p>\n People in long-term relationships, where sex has become routine, can find it hardest of all to talk to their partner.<\/p>\n \u2018During the acute phase of diagnosis and treatment, people often manage by suppressing their feelings, and for some there is a reluctance to go back to having sex because it involves extreme vulnerability,\u2019 says Dr Catherine Hood, a psychosexual specialist based in London.<\/p>\n \u2018Picking your sex life up again with scars or disfigurements means you have to mourn the loss of your former carefree self, and that takes time.\u2019<\/p>\n And, she adds, millions of people live with chronic conditions that are not life-threatening but nonetheless have an impact on their confidence and their sex life.<\/p>\n \u2018With conditions such as irritable bowel syndrome, people habitually avoid intimacy because they feel bloated and uncomfortable, or are terrified of breaking wind. The main thing is to lower distress by opening up communication and helping people adapt.\u2019<\/p>\n Most therapists will suggest using sex aids, including special cushions and lubricants.<\/p>\n Samantha Evans, a former nurse, founded the website Jo Divine after realising that patients found it difficult to talk to healthcare professionals. \u2018Many find it easier to talk to us on the phone about their sexual problems,\u2019 she says.<\/p>\n All experts agree that the most important thing is not to suffer in silence.\u00a0<\/p>\n \u2018Please don\u2019t struggle on alone,\u2019 says Dr Goodhart. \u2018A referral to a qualified psychosexual therapist can save relationships.\u2019<\/p>\n \u00a0<\/p>\n","protected":false},"excerpt":{"rendered":" Sex is not the taboo subject it once was but\u00a0failure of healthcare professionals to talk about sex places the onus on the patient Sex is far from the taboo subject it once was \u2014 except for people living with a serious illness.\u00a0 Their sexuality is often ignored, with few healthcare professionals willing or able to Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-81129","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/81129","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/comments?post=81129"}],"version-history":[{"count":0,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/81129\/revisions"}],"wp:attachment":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/media?parent=81129"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/categories?post=81129"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/tags?post=81129"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"http:\/\/i.dailymail.co.uk\/i\/pix\/2016\/06\/06\/22\/34FCBEE100000578-0-image-a-11_1465247977884.jpg\")
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