In Court Over Sex Claims

Some newspapers have carried stories recently about an unchaperoned
male doctor who allegedly and inappropriately touched a female
patient. This made me think of the unique and unchaperoned position of
the sex therapist. We hear extremely intimate details of peoples sex
lives and form strong bonds with patients for the duration of therapy.
Therefore it is absolutely vital that the sex therapist is aware of
their own sexual feelings towards a patient, the sexual feelings
directed towards them by a patient, and the boundaries within which
they practice to produce a safe environment for both patient and
therapist. Cases of such abuse are rare but health professionals need
to be more aware that fancying some patients is a normal human
reaction and can be discussed with peers; it's the hiding of such
feelings that may cause a danger of enactment.

Viagra makes it harder?

Pfizer are claiming their drug provides more rigid erections than
their competitors but this is difficult to assess from patient
reports. What are your impressions of Viagra, Cialis and Levitra? Have
you had to switch between drugs to achieve better rigidity? Have you
had to employ any other techniques to improve the rigidity? It would
also be interesting to hear from real patients on the use of Cialis
and it's duration of action; can it really be over 36 hours?

Ricky S's Premature Ejaculation (4)

Ricky was more taken with the technique of 'stop-start' to gain better
control over when he ejaculated. This technique involves beginning
with self-masturbation, up to when you feel you are coming close to
ejaculating. You then stop masturbating and allow the erection to
subside. I recommend this is done a maximum of three times before
allowing ejaculation. The idea is to gain a better recognition of when
you are about to ejaculate, and confidence that you have better
control. Ricky will practice this at home and we will move on to
further techniques such as using an oiled hand and involving your
partner in future sessions.

Computer Woes!

I only work one day per week in sexual problems and when I arrived today my computer had gone, vanished, apparently because someone else needed it more. Nice to be informed in advance! Annoyingly it's the small things I'll miss, like easy printing of patient leaflets (rather than relying on the treacle-like NHS flow). I'm taking my pens home with me tonight.

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Sex and the NHS

Today I saw a 45 year old man who needed and wanted a drug like Viagra or Cialis, but who didn't qualify for an NHS prescription. Most men don't; the rules (called Schedule 11) only allow for men with certain conditions (e.g. diabetes, prostatectomy) to obtain these drugs on the NHS. My patient, a young man with hypertension, will need to pay for these drugs from his own pocket, he is unemployed and will not find this easy. Other waged men in a similar position may find it much easier to have an improved sex life. Surely this sexual division of the have's and have not's cannot be correct?

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The Male Contraceptive Pill

Okay who would take it? Lads on a night out? Unlikely, stupid to have
unprotected sex. Men in a stable relationship? Probably, to share the burden
of contraception. Can you see yourself taking a pill every day? How about
having a small implant under your arm, like some women do? Maybe you don't
like the idea of your hormones being mucked about with. Hormonal male
contraception doesn't exist yet, although the technology is being tested.
Would you buy it?

Harry B's Penis Injections (4)

We've covered that in some cases of erectile dysfunction (ED) the most
popular drugs, such as Viagra and Cialis, simply aren't effective enough to
produce an erection and patients need to try something stronger. Harry had
plumped for the easy and painless injection of a drug into the side of his
penis. After the initial injection (see previous posts) Harry reported there
hadn't been any side-effects but he hadn't developed an erection either. It
was now his turn to inject the drug and he did it very well. We increased
the dose and again I left Harry to allow the drug time to work. When I
returned the increased dose had developed the best erection Harry had
experienced in many years, certainly good enough for penetration. There were
no side-effects and Harry will now be able to use this drug in the comfort
of his own home.