What is sexual medicine?

Sexual medicine is a medical specialty that deals with sexual health.

Sexual health is defined by the World Health Organisation as “a state of physical, emotional, mental and social well-being in relation to sexuality”. This includes not only the absence of disease or sexual dysfunction, but “a positive and respectful approach to sexuality and sexual relationships”. The speciality of sexual medicine is concerned with both of these aspects of sexual heath.

Conditions that can affect sexual health

A specialist in sexual medicine understands the wide range of conditions and injuries can adversely affect the experience of having sex, and how these can be managed.

In women, this can include:

• ovarian, vaginal or cervical cancer
• uterine fibroids
• urinary tract infections
• endometriosis
• nerve damage after pelvic surgery such as hysterectomy

In men, this can include:

• prostate or testicular cancer
• benign prostatic hyperplasia

Both men and women can also be affected by:

• arthritis
• spinal cord injury
• sexual transmitted infections, including gonorrhoea, herpes, genital warts, chlamydia, and syphilis

Finally, conditions such as diabetes and heart disease can affect both men and women in terms of fatigue, mobility, and self-confidence.

Types of sexual dysfunction

Sexual problems include any type of difficulty that affects how much you enjoy or want sexual activity. In addition to the conditions above, sexual dysfunction can be caused by trauma, changes in hormone levels, stress, drug or alcohol use, medications, or mental health problems. In some cases it is not clear what the cause is.

Types of sexual dysfunction experienced by men include:

• erectile dysfunction
• delayed or premature ejaculation
• anejaculation
• retrograde ejaculation
• painful orgasm

Types of sexual dysfunction experienced by women include:

• painful intercourse
• vaginismus
• clitoral pain

Both men and women can be affected by a low sex drive, anorgasmia, sperm allergy, post-orgasmic illness syndrome (POIS), and “post-sex blues”.

What does sexual medicine involve?

Sexual medicine can involve:

• Clinical treatment of specific sexual disorders through medication, physiotherapy or surgery.
• Rehabilitation following an injury or surgery.
• Sex therapy or counselling to address the psychological element of some types of sexual dysfunction.
• Education and advice to promote healthy sexual relationships.