If this is your first visit, check out the community guide. You will have to Join us or Sign in before you can post.

Q&A with Gillian - Let's talk about sex

Sam_ScopeSam_Scope Posts: 2,994Administrator admin
Our theme for the next fortnight is Sex and Relationships and as it is Sexual Health Week, we have our resident Sex Expert Gillian answering all your questions and queries.  FPA is a sexual health charity and their theme is Pornography.

So if you have questions about sex, relationships, sexuality, pornography, sexual health, emotions or more, then ask away.

couple holding hands

Please be respectful of the community and eachother and be aware that this post is not appropriate for children and some people.  It contains adult themes of a sexual nature.


  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    Good morning all and happy Sexual Health Week!  I'll be checking back between classes and 1:1 sessions - looking forward to hearing from you :)
  • Sam_ScopeSam_Scope Posts: 2,994Administrator admin
    Ill kick off @PSHEexpert

    I have had a lot of surgeries and sex is never ever discussed when they tell you about recovery, do you think doctors could be better about talking about sex?  It can feel a bit embarrassing to ask questions if even your doctor seems too shy to bring it up! 

    If you were Queen of all doctors, how would you encourage them to talk to patients?
  • CatmanCatman Posts: 31Member Whisperer
    I suffer from Fibromyalgia and this definately affects my performance at times due to the pain and fatigue. My partner and I have been through a rough patch, I've stood by her despite her violence towards me, though at present she's living with her family on the Isle of Sheppey, quite some distance from me. Yesterday we met up again and are spending the week together. Last night was amazing tbh, despite the fatigue and pain from an epic car journey. I just made sure I was dosed up on my pain killers :-).  She's twelve years younger than me and it amazes me that I can satisfy a woman so young and so stunning, fortunately with our chemistry, there's no stopping us, hence today I'm aching in places the Fibromyalgia wouldn't normally affect. With the right person, no matter what your disability, a healthy sex life is most definately possible. 
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    This is SUCH an important question - sexual wellbeing is so key to general wellbeing for so many of us and it's frustrating that it's not just automatically included, really, and I think that's right across the board, for non disabled people too (although there's no question that it's much harder to get a doctor to bring it up if you do have a disability).  

    If I were indeed Queen of the Doctors I think I'd want to sit them down and remind them how important sexual pleasure and connection is for people and that it needs to stop being so stigmatised.  I wonder sometimes whether doctors don't comment on it because unless it's their speciality, it's maybe regarded as being a bit rude to talk about someone's sex life?  Or perhaps they're worried that it might be insensitive to talk about function, maybe, when someone's getting over surgery, or is very ill, or who has a disability that limits them - as if sexual desires and needs switch off unless you're 100% physically fit and able (which we know isn't the case).  I would want to remind them how important intimacy is and that it's comforting and soothing, as well as sexual - and I'd be very keen to include masturbation within that conversation too.  

    Because sex is one of our basic urges, like eating and sleeping, it seems really counterintuitive to miss an opportunity to bring it up.  There's a link between immune function (which surely would affect recovery?) and sexual wellbeing - it's missing a trick!

    SHADA did work on a Sexual Respect Toolkit for doctors, I will go and seek out the link for it - it was specifically about the importance of raising sexuality and sexual expression with patients with disabilities, etc - came out a few years ago.
  • the_velvet_girlthe_velvet_girl Posts: 67Member Whisperer
    What are people's experiences of disclosing a disability when online dating? I never know when to bring it up. I think if I disclose it on the 1st message it either scares people away or they date me out of sympathy. If I wait until we have arranged to meet, I've had people unhappy that I've not informed them of my disability & I've even been stood up as the guy couldn't cope with my disability but didn't know how to tell me before hand. It's a bit of a minefield!
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    I can only chip in my own experience here as I think it's so different depending on the individual and the person they're meeting...but...I have primary lymphedema, which has at times really impaired my mobility, and especially to begin with, I had quite a lot of (what I thought of as disfiguring) marks on my legs and awful swelling after a terrible bout of cellulitis.  Anyway, I came out and disclosed it really upfront because I was very self conscious about it, and had one guy try and convince me into having sex on the first date as "i needed to grab every day before I die" - turns out he thought I had a primary LYMPHOMA and that since I was obviously close to death (!) there was no reason not to just go for it and sleep with the first available man (!!) as clearly that would be a reasonable priority (!!!).  It was, all in all, a very unsuccessful date.  I sort of laughed it off at the time but YIKES - when I think back on it now I find it alarming that he would have been so at ease with trying to exploit a theoretical situation.  So I suppose I would proceed with some caution.  

    I'm about to go and commute/head to a meeting so I will be back much later (possibly tomorrow morning depending how late this runs!).
  • JulieNeytJulieNeyt Posts: 2Member Listener
    How can I have sex with my Boyfriend as I have a incontinence problem?
  • MarkmywordsMarkmywords Posts: 181Member Chatterbox
    The real and perceived extra vulnerabilities of being disabled carry extra risks. :/

    That said, my view is never pass up an opportunity for happiness if it is genuine and a positive step. Don't be so afraid as to never reach out.

    Sadly I'm too damaged for any of this to be relevant to me now but I'm so glad the conversation is being had.
    I've found that doctors are often unable to maintain their objectivity and feel too uncomfortable to discuss such things. This applies even to GP's.

    Thanks for being brave enough to talk about the elephant in the room, especially if it's wearing stockings and suspenders ;)
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    @JulieNeyt - this is a great question and a very sensitive issue.  I have only worked with a few sexually active clients who experience incontinence, and it affects them in different ways (it has certainly been an eye opener for me as it is an area that I need to learn more about).  I l found a lot of useful information on this page at the Bladder & Bowel Community: https://www.bladderandbowel.org/help-information/sexual-relationships/  
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    @MarkMyWords - I think your comment about perceived vulnerabilities is really important, and I wonder whether that contributes to the reluctance from doctors to engage in conversations about sex.  It's so hard to get the conversations rolling, and it really shouldn't be - why should it be up to the patient to have to initiate having their needs met?  

  • MarkmywordsMarkmywords Posts: 181Member Chatterbox
    It could be @PSHEexpert .

    Also I think specialists have even more trouble than GP's as they never learn the social skills. Consultants are even worse; there are still a great many "Sir Lancelot Spratt" figures in medicine sadly.

    It goes further than sexual health too. I'm still meeting people in Haematology who are severely mentally scarred by what chemo, radio and a bone marrow transplant has done to their body and spirit. On top of that is becoming a social pariah and, as in my case, being dumped by a partner so they could get away from it.

    No counselling is available to help cope with the results of what their treatments have done.

    There are people worse off than me though and I don't want to steer the thread off course. It's difficult to stop looking inwards when every day is a battle. :/
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    It is really shocking that there's not more counselling done routinely after traumatic treatments - unfortunately I just don't think there's any money left over to prioritise the issue of mental and emotional wellbeing (which I'm not saying is okay, btw - that wasn't me excusing the situation as I think it's horrendous).   

    It sounds like you've had a terrible time, I am so sorry to hear it.  That's awful, and it's only natural to look inwards as you say - we have to focus on our own stuff first and foremost and it's miserable that there is so little support available.  Services need to be targeted for when people are at their least resilient so that access isn't yet another barrier that needs to be overcome before any help can be had.
  • Sam_ScopeSam_Scope Posts: 2,994Administrator admin
    @JulieNeyt I was reading up on the NHS website about urinary incontinence and sex and they say this:

    Enjoy good sex despite incontinence
    Worries about embarrassing leaks during sex can mean you avoid intimate contact. This puts strain on relationships and damages your self-esteem and self-confidence.
    There's no reason why anyone with bladder or bowel weakness can't enjoy intimate relationships.
    If you empty your bladder and bowel and don't drink too much fluid before having sex, any leak probably won't be serious. Sex involves all sorts of bodily fluids, so a small leak probably won't even be noticed.
    It can give you peace of mind to protect the bed. Bed pads, which absorb moisture and have a stay-dry cover, may be the most comfortable choice.  

    I think communication is key, if you can talk to your partner openly and honestly, the experience will be better in the long run.  I always think that the sex you see in films and tv is so far away from real life sex! Sex can be messy, sex can be funny and noisy!  

  • ClydeBuiltClydeBuilt Posts: 22Member Listener
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
  • ClydeBuiltClydeBuilt Posts: 22Member Listener
    I was being flippant but relevant. :(
    My wife called a halt on those proceedings some twelve years ago now and had to deal with it. There is no dealing with it, its kust over I suppose!
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    Sorry! I'm used to that being asked as a genuine question (and I do think Bish has some great videos).

    That's a really tough situation, and I'm sorry to hear that it's so.  I realise you've probably been asked all this before, but has there ever been the opportunity to talk to anyone about it (ie do you think there's potential to resolve things or move forwards)? My sincere apologies if that's my asking a silly question; it isn't intended to be. It's terribly hard when sexual intimacy is withdrawn if that's not what you want. 
  • ClydeBuiltClydeBuilt Posts: 22Member Listener
    No...there hasnt, Im rather old fashioned about these things so you can imagine how questions about toilet arrangements and self care from ATOS/SOLUS go down. My GP says Im a stoic, I imagine he means I put up with things rather than deal with them. He's right to a point, so it makes the whole q&a mind games harder to deal with too.

    There are one or two other issies going on at home as well.
  • CockneyRebelCockneyRebel Posts: 647Member, Community champion Chatterbox
    This is SUCH an important question - sexual wellbeing is so key to general wellbeing for so many of us and it's frustrating that it's not just automatically included, really, and I think that's right across the board, for non disabled people too (although there's no question that it's much harder to get a doctor to bring it up if you do have a disability).  

    If this is the case, should sex be available on the NHS for people that have no access to a partner ?
    Be all you can be, make  every day count. Namaste
  • MarkmywordsMarkmywords Posts: 181Member Chatterbox
    It was privatised as "the oldest profession" @CockneyRebel ; :D
  • Sam_ScopeSam_Scope Posts: 2,994Administrator admin
    @PSHEexpert can you recommend any good books about sex and relationships for teenagers or young people with some learning difficulties?
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    @CockneyRebel that's a really good point and opens up a lot of important ethical questions.  Everyone has the right to sexual expression, but not to sex per se, as of course it involves consent from both parties, so you could never really accurately say "we have the right to sex" - we have the right to HAVE sex, but only in specific circumstances.  

    Would our NHS ever consider such a move?  I am not sure but I suspect not, because of the potential for a legal minefield (around consent, for a start), and because arguably there's not enough resources and capacity for some of the lifesaving stuff.  I suspect it'd be an "attitude lottery" too around who was 'allowed' to access such services.  However, if it's a question of should there be more adequate support for people to access services around sexual wellbeing - yes absolutely.  Even a conversation would be a start.
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    @Sam_Scope There are some that I really like by Kate Reynolds, about Tom and Ellie.  There are two sets of three books: 'What's Happening To [Tom or Ellie]", "Tom [or Ellie] Needs To Go", and "Things Tom [or Ellie] Likes".  They're about body changes and growing up, using public toilets safely, and masturbation respectively.  Other resources I use frequently are the "Talking Together About..." books, published by the FPA - there's a set, about growing up, contraception, and sex and relationships.  They're aimed more at parents and staff working with young people with LD, but they're very accessible and useful.

    Generally speaking though this does highlight a more widespread problem which is a shortage of information and resources aimed directly at young people with LD.  This is an issue - it means there's not a lot of opportunity for learning independently, which is very important not only for retention of information but also for dignity and privacy...

  • lavenderlavender Posts: 16Member Listener
    Sex..; Is there differnce desires/needs between men and women,regarding age,health and lust?
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    I think it's different day to day, individual to individual, situation to situation!  :) 

    of course health and age can affect interest in sex and might also affect enjoyment/function, but there aren't really any hard and fast rules (no pun intended)...
  • TopkittenTopkitten Posts: 80Member Whisperer
    I lost my partner in 2005 and for 8 years had no contact with women beyond friendship. Then I was basically preyed upon by a healthy lady with purely MH issues. I put a stop to it fairly quickly but it hurt. Since then though the interest has returned but, because my condition is progressive, my dating attempts were half-hearted at best. I ALWAYS disclosed my problems up front which simply put ladies off. It seems no one likes complete honesty. When I can afford it I pay for sex just to keep things simple but even in this there are those that try to take advantage of me. It's very disheartening.

    Despite being severely disabled with invisible issues I look much younger than my actual age often being thought as 15-20 years younger. However, as my condition causes nerve damage the lower half of my body is being affected (not just my legs) so physical activities in the bedroom will, at some point, be virtually impossible due to loss of bladder and bowel control. I am NOT looking forward to that.

    Paying for sex with much younger women (it's an industry mostly populated by the young) is a stop gap to make me feel better. However, funds are limited most of the time as I haven't been in work for over a decade. It's only my deceased mothers estate that allows me to go this route for now. I don't even do it for my own release as I actually want to prove I can still GIVE pleasure, which I happen to be quite good at.

    At some point I will become just another sad old man, crippled, miserable and alone. Life is tough enough without something else to lose.

  • TopkittenTopkitten Posts: 80Member Whisperer
    Apologies. The initial statement implies she died. She didn't. She left because she was much younger than me and couldn't cope with the pain she was causing me.

  • Sam_ScopeSam_Scope Posts: 2,994Administrator admin
    @Felix_Grieve86 I thought you may be interested in this thread :)
  • BikernutBikernut Posts: 1Member Listener
    After suffering from Sarcoidosis in my brain which also affected my pituitary gland, I always found that it was difficult to get aroused, with the resultant erectile dysfunction. Although I have seen specialists regarding this, they seem to pay little regard to the cause of the problem and just prescribe the standard treatments of pills, Viagra, Calaise etc. I also have testoserone injection every week. Would it not be possible to investigate and treat the cause of the problem, rather than the symptom?
  • MarkmywordsMarkmywords Posts: 181Member Chatterbox
    The way I look at it is doctors are like car mechanics. If it's in the "manual" then they can fix it. If not, then it's "nah mate better scrap it."
  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    @Bikernut that's really interesting - and I would have thought that'd make sense, too.  Did the specialists who treated the sarcoidosis acknowledge that this could be a resultant issue, or was it just never addressed?

  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    @Markmywords I think it's very symptomatic of how stretched things are, it's really challenging.

  • PSHEexpertPSHEexpert Posts: 67Member, Community advisor Talkative
    @Topkitten Thank you for sharing your story and some of the realities of progression of condition - it's really highlighted (more than ever) how isolating it is to have this swept under the carpet.  It is so very important to, really, a majority of people - a core part of how we see ourselves and our self esteem.  

  • Sam_ScopeSam_Scope Posts: 2,994Administrator admin
    Thank you so much @PSHEexpert for your help with this Q&A! 

    If anyone has further questions about sex, relationships and disability then head over to the Ask a PSHE expert category now.
This discussion has been closed.