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Dear Mary: Our GP won't discuss sex. Where can we seek help?

TWO years ago, at the age of 47, my husband began having problems with erectile dysfunction and loss of sexual desire. This was a first for him and worried him greatly. We have a very close, loving relationship and up to this point always enjoyed a very active and satisfying sex life.

We discussed it openly and with my encouragement he decided to consult our long-time GP. Unfortunately, the GP did not seem to want to discuss my husband's problem and just wanted to prescribe some tablets without any further discussion. My husband insisted that he take some blood tests and they were all fine but he was left upset and somewhat embarrassed by his GP's reaction. He has been in the surgery a few times since and the GP has never again referred to the problem.

We are trying our best to deal with this difficulty but both of us find our sex life less satisfying and my husband admits that he feels anxious about maintaining an erection.

He is fit, a non-smoker, a moderate drinker and the only medication he is on is a statin for cholesterol. We have maintained a close, loving relationship with lots of cuddles and kisses and intimacy but would love to get back to the sexual relationship that we always enjoyed up to two years ago.

Please advise us and maybe suggest a specialist clinic where my husband could get some answers and help. We live in the south but travelling to a clinic in Dublin would not be a problem for us.

Mary replies:

YOU both have done everything that you should have done in trying to address this problem. You talked it over between yourselves and then he went to your GP and insisted that blood tests be done. And you are continuing to have a sexual relationship, albeit one that doesn't include intercourse. You seem to be extremely supportive and I'm sure your husband appreciates your part in all of this. So your experience with the GP is where things started to go wrong.

Over the years I have dealt with many GPs both on a one-to-one basis and when attending conferences, and I found them to be a most caring and hard-working group of people.

But human nature being what it is, not every GP is comfortable in dealing with sexual problems and it seems that your GP falls into that category.

This discomfort can sometimes be exacerbated when doctor and patient are part of a small community and are likely to socialise together which may be the case with you.

I must emphasise that it is only a small number who have a difficulty discussing sex. For the most part doctors complain about not having enough time to discuss patients' problems in detail.

So if you are unhappy with your GP then you should change him in the same way that you would change your dentist if you were unhappy with him.

There is evidence to show that there can be a correlation between the statins and erectile dysfunction (ED) and also loss of libido, and it would be interesting to know whether your husband's ED began after he started the medication.

This is something that will have to be discussed in detail with your new doctor because the medical route is always the first to be explored. It is unfortunate that even though you did that you are no nearer a solution.

If, however, the GP rules everything out from his point of view then you will have to look at alternatives. Was there something stressful going on in your lives that may have contributed to the problem, even though you may not associate the two?

Almost every man experiences ED at some point in his life, for whatever reason, and sometimes one or two "bad" experiences are enough to make him anticipate a problem. So then the next time he tries to be sexual he is unable to get an erection because he is thinking too much and not allowing the natural arousal process to take place. The ED then becomes a self-fulfilling prophecy that is very difficult to change. If this is the case then psychosexual therapy can help.

There is no need for you to travel to Dublin. Instead contact the Irish Association for Counselling and Psychotherapy at (01) 272 3427 and they will give you the name of a qualified therapist in your area, or at least fairly near to you.

So whether it is the medical road or the sex therapy channel that you go down it should be possible for you to find a solution to restore what was a very important part of your life together.

Sunday Indo Living