Physical concerns around intimacy are common and very often treatable, yet many people never mention them to a doctor. These guides explain likely causes and what a clinician can do.
4 in-depth guides in this topic.
Pain during or after sex is common and is usually caused by something that can be treated, such as vaginal dryness, an infection, a skin condition, involuntary muscle tightening (vaginismus) or a condition like endometriosis. It is not something you should push through: a GP, gynaecologist or sexual health clinic can help find the cause.
7 min read
Erectile dysfunction (ED) means having trouble getting or keeping an erection. It is common, especially with age, and is often linked to stress, tiredness, alcohol, smoking or conditions such as diabetes, heart disease and high blood pressure. Because it can be an early sign of heart or blood vessel problems, it is worth seeing a doctor, and effective treatment is available.
7 min read
Falling hormone levels around perimenopause and menopause can cause vaginal dryness, discomfort during sex, lower desire, poor sleep and mood changes. These effects are common and treatable: options include lubricants, vaginal moisturisers, local vaginal oestrogen and hormone replacement therapy (HRT). Contraception is still needed for a time after periods stop.
7 min read
The pelvic floor is a group of muscles that supports the bladder, bowel and, in women, the womb. Everyone has one. Pregnancy, childbirth, ageing, prostate surgery and long-term straining can weaken it, leading to leakage or prolapse symptoms. Regular pelvic floor exercises help many people, and a GP or pelvic health physiotherapist can assess problems that do not improve.
6 min read
For couples or individuals noticing changes in desire or comfort: understand common causes and when to get support.
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A GP or family doctor is a good starting point, and a sexual health clinic can check for infections. Depending on the cause, you may be referred to a gynaecologist, a urologist, a pelvic health physiotherapist or a psychosexual therapist. You can ask to see a clinician of a particular gender if that would help you feel more comfortable.
Yes. Anxiety can reduce arousal and natural lubrication and make the pelvic muscles tense, both of which can lead to pain. Pain then often increases anxiety about the next time, creating a cycle. A clinician will still check for physical causes first, and treatment often addresses both the body and the worry together.
Yes. Most people with a penis have difficulty with erections at some point, and ongoing problems become more common with age. Being common does not mean you have to live with it: in most cases a cause can be found and treatment helps. A doctor will not be surprised or judgemental when you raise it.
Yes. Stress, anxiety and worry about performance are common causes, particularly in younger people. A clue is when erections happen normally at some times, such as on waking, but not in other situations. A doctor may still check for physical causes, and counselling or psychosexual therapy can help with the psychological side.
Often it does not. Unlike hot flushes, which tend to ease over time, vaginal dryness linked to lower oestrogen can continue or gradually worsen. The good news is that treatments such as vaginal moisturisers and local vaginal oestrogen work well for many people, and they can usually be used long term under a clinician's guidance.
Not quite. Local vaginal oestrogen is applied directly to the vagina in a low dose and acts mainly on the tissues there, with very little reaching the rest of the body. HRT works throughout the body and treats a wider range of symptoms. Some people use one, some use both. A clinician can explain which is suitable for you.
They can benefit. Men have pelvic floor muscles too, and strengthening them can help with leakage after prostate surgery, dribbling after passing urine and some bowel control problems. A doctor or physiotherapist can show you how to find the right muscles and how often to practise. Anyone with new urinary symptoms should also see a GP.
Most people need to practise regularly for around three months before they notice a clear difference. Results depend on doing the exercises correctly and consistently. If you see no improvement after this time, or are unsure whether you are using the right muscles, a pelvic health physiotherapist can assess you and adjust your programme.