DYS FUNCTION
What to do if you can’t get it up, in,
or make it happen quite like you want to Jack Summerside’s
common sense look at sexual dysfunction
Illustration C(Aitch)
Sometimes
your body just doesn’t co-operate with your head. And I’m not
talking about what happens after a few vodkas. This month we’re looking
at sexual dysfunction; medical-speak for when your body or mind stops you
getting on with a healthy sex life.
Getting or keeping an erection is an obvious form of sexual dysfunction affecting
men but it’s not the only kind. There are many others affecting men
and women and relating to penises, vaginas, anuses or other body parts you
may use regularly or occasionally when you have sex. But let’s start
with the obvious one.
Failure to launch
The trouble with men, whether we admit it or not, is most of us tend to think
the world revolves around our penis. And, when it doesn’t work properly,
the world comes to a grinding halt on its axis. Of course it doesn’t
really, it just feels like it.
Old red-eye is back
Jamie struggled for years with trouble getting an erection.
“It was one reason I couldn’t be bothered with condoms, so it’s
kind of connected with how I got HIV. I’ve tried Viagra and similar
things, but it dries out my sinuses and my eyes go red. So I get an erection,
I keep an erection, but I end up all bunged up, looking like the bride of
Frankenstein.”
For many of us, drugs like Viagra or Cialis have been a boon in enabling us
to get an erection, when previously it was hit and miss. Sometimes keeping
an erection while you get through the ‘holding pattern’ of getting
a condom out, unwrapping it and getting it on the right way round can be more
of a challenge than getting the damn thing stiff in the first place. But there
are drawbacks to these drugs, not least their effect on blood pressure. Being
red in the face with a raging hard-on can be a bit off-putting to a partner,
as can a trip to A&E if you use amyl (poppers) at the same time.
A common form of sexual dysfunction affecting women is vaginismus. This is
involuntary tightening of vaginal and pelvic muscles that makes penetration
difficult, if not impossible. It can be very uncomfortable, and even painful.
No
entry
Marie has genital warts around her vagina.
“I get regular check-ups and have to get the warts removed with laser
treatment. But it means sex can get uncomfortable. When my husband’s
inside me I have to brace myself against the pain. I tend to get dry. That
makes me more anxious, so it makes me tighten up.”
A similar condition called anismus again involves involuntary contraction
and tightening of the muscles, but this time around the anus, and can affect
men and women. Medical literature tends to focus on this as a cause of constipation,
unsurprisingly ignoring the bottom as a sexual organ. But the basis of the
problem, and the consequences for sex and penetration, making it uncomfortable,
are much the same.
Get to the bottom of it
• Find out if the problems have a physical cause
• Get yourself checked and treated for things like genital warts, or
herpes that cause discomfort or pain when you have sex
• Once physical causes are eliminated, consider psychological cause
• Don’t grin and bear it. Talk to your partner
• Talk to your doctor who can refer you to a specialist for more help.
Not
tonight Josephine
Napoleon is famous for two things, three if you count trying to take over
much of Europe. The first was for turning down Josephine’s sexual advances
and the second for having his hand tucked inside his jacket holding his tummy.
And the two were connected. He suffered from terrible pain from stomach ulcers,
he held his hand over his stomach to soothe the pain, and it was because of
the pain he didn’t feel like having sex. Physical ailments stop you
feeling sexy.
Walter said: “I was diagnosed with peripheral neuropathy with constant
pain in my hands and feet. The pain was too distracting for me to feel like
sex. It made my body, back and shoulders tighten up. Sex isn’t a high
priority when you’re not very agile and in pain”
For many of us living with HIV it can be common to have something niggling
away in the background that gets in the way of sex. Physical pain, as well
as stress and anxiety can mess up your sleep patterns. And being tired and
irritable as a result can make you feel anything but sexual. Lack of sleep
and irritability can make you substantially less appealing to a partner too,
so it becomes a vicious circle.
And that’s assuming you already have a partner. If you don’t;
you may not feel much like making an overture to someone if you lack energy.
“Come over to my place, but don’t touch me because it hurts and
don’t expect sex ‘cause I don’t feel very sexual. Oh and
I don’t sleep well so I’ll be up and down all night and tossing
and turning.” Mmm. Doesn’t rank as the world’s best chat-up
line. Let’s just say it wouldn’t have worked on Cleopatra.
Pain in your hands can be problematic, as a good lover needs to be able to
use them as part of making love. If gripping, stroking and (if you like that
sort of thing) slapping and tickling is uncomfortable and sets off your neuropathy
it makes it hard to let yourself go. Even sex with yourself can be a less
satisfying experience than perhaps it was before.
There are all kinds of physical issues people don’t generally recognise
as affecting person’s ability to be sexual and to have trouble-free
sex. But many of them are treatable. It’s worth mentioning to your doctor
that symptoms to do with treatments (such as diarrhoea) or with long-term
effect of HIV (fatigue, pain) are having that kind of impact on your personal
life. It doesn’t mean they’ll be able to solve the problem, but
it might help them think outside the box about how your quality of life is
affected.
Turned
off
Getting diagnosed with HIV can have a profound impact on how you feel about
yourself as a sexual being. It’s not uncommon for people to be turned
off by the very thought of sex. You can have feelings of guilt that your sexuality
got you into a mess, so you suppress your desires. You might have worries
about infecting someone else, and the psychological impact can be made worse
by the recent crop of court cases. Or the feelings of anxiety about your health
and future, regrets about the past and general pre-occupation with living
with HIV can all play a part in diminishing the sexual dimension of your personality.
“I just felt like a leper,” says Robin “I didn’t feel
like anyone would accept me as a person, let alone have sex with me. It made
me depressed and took away my sex drive. It just vanished. And because I felt
I didn’t deserve a sex life because I’d got HIV, I didn’t
talk about it or get help.”
You most important sexual organ is not below the waist, it’s above your
neck. I’m not talking about oral sex here, I mean your brain. Sex has
famously been described as one per cent friction and 99 per cent imagination,
and that’s pretty much true. The root of many a sexual problem is not
the physical state of your body, but your feelings about yourself, about sex
and sexuality, and about your partner.
Living with HIV doesn’t mean you should sit at home doing a jigsaw or
sewing an interesting cushion cover. Sex can and should be a dimension of
your life that you can take part in and enjoy. It will never be an HIV prevention
success if people with HIV feel it’s necessary to withdraw from such
an important part of human life. This just isn’t an option any of us
should consider feasible or practical, though sometimes it does seem easier.
Next month, The Sex Pages look at a very different form of sexual dysfunction;
when sex is altogether too important in your life.
If you have tips or advice about anything to do with making sex and relationships
work better for positive people we would like to hear them. But please remember,
this isn’t an agony column and we can’t give individual advice.
• You can write to Positive Nation at the usual address, or email thesexpages@positivenation.co.uk
