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Sexual Health

Sexual health is an essential aspect of overall wellbeing, encompassing physical, emotional, and social factors. For many, sexual health concerns can impact quality of life, relationships, and self-esteem.

Common Sexual Health Conditions

Common sexual health conditions include erectile dysfunction, premature ejaculation (PE), low libido, Peyronie’s disease, and sexually transmitted infections (STIs).

In Australia, urologists, general practitioners and sexual health specialists provide personalised care, diagnosis, and treatment options to support patients facing these issues.

With advances in medical treatments and lifestyle interventions, many sexual health concerns can be effectively managed, helping individuals regain confidence and satisfaction in their sexual lives.

Below is an overview of the primary sexual health conditions treated in urology, along with their causes, symptoms, risk factors, and treatment options.

Overview

  • Erectile dysfunction, or ED, is the inability to achieve or maintain an erection firm enough for sexual activity. It’s one of the most common sexual health concerns among men and can significantly impact self-esteem and relationships.

 

Causes
ED can be caused by a combination of physical and psychological factors, including:

  • Cardiovascular disease, high blood pressure, and diabetes
  • Hormonal imbalances, particularly low testosterone
  • Neurological conditions, such as Parkinson’s disease or multiple sclerosis
  • Psychological factors, including anxiety, depression, and stress
  • Lifestyle factors, such as smoking, excessive alcohol consumption, and lack of physical activity

 

Symptoms

  • The main symptom of ED is difficulty achieving or maintaining an erection. Some men may also experience a reduced interest in sex, which could be linked to underlying emotional or physical health issues.

 

Risk Factors

  • Risk factors for ED include age, chronic health conditions, obesity, lifestyle habits (such as smoking and alcohol use), and certain medications. Men with diabetes, heart disease, or those who are overweight may have a higher likelihood of experiencing ED.

 

Treatment Options

  • Medications: Prescription medications such as PDE5 inhibitors (e.g., Viagra, Cialis) can improve blood flow to the penis and are often the first-line treatment.
  • Lifestyle Changes: Improving diet, exercise, and reducing alcohol and tobacco use can enhance erectile function.
  • Counselling: For men experiencing psychological ED, therapy or counselling can help address underlying emotional issues.
  • Vacuum Erection Devices: These devices help draw blood into the penis, creating an erection.
  • Surgical Options: In cases where other treatments are ineffective, penile implants may be considered.

Overview

  • Premature ejaculation is the condition of ejaculating sooner than desired, often within a minute of penetration. It can lead to frustration and distress in sexual relationships.

 

Causes
PE can have both psychological and biological causes, including:

  • Anxiety or performance-related stress
  • Hormonal imbalances
  • Erectile dysfunction, which may cause men to rush intercourse
  • Neurochemical imbalances affecting serotonin levels

 

Symptoms

  • The primary symptom of PE is the inability to delay ejaculation. This can lead to a feeling of loss of control over ejaculation timing, which can impact sexual satisfaction.

 

Risk Factors

  • Risk factors for PE include anxiety, ED, relationship issues, and certain medical conditions. Men who experience high levels of stress or emotional strain may also be more prone to PE.

 

Treatment Options

  • Behavioural Techniques: Practicing methods such as the stop-start technique or the squeeze technique can help delay ejaculation.
  • Counselling and Therapy: Psychological support can help address any underlying mental or emotional issues.
  • Medications: Certain antidepressants are used to delay ejaculation and may be prescribed by a urologist.
  • Topical Anaesthetics: Creams or sprays that desensitise the penis may help delay ejaculation. These can often be purchased discreetly over the counter from a pharmacy.

Overview

  • Low libido, or reduced interest in sexual activity, is a common issue that can stem from physical, psychological, or hormonal causes.

 

Causes

  • Hormonal imbalances, especially low testosterone
  • Psychological conditions, such as depression and anxiety
  • Relationship issues, stress, and lifestyle factors
  • Chronic illnesses, including diabetes and heart disease

 

Symptoms

  • The main symptom is a decreased interest in sexual activity. Men and women may also experience difficulty initiating or enjoying sexual activity.

 

Risk Factors

  • Age, mental health conditions, lifestyle habits, and certain medications can all contribute to reduced libido.

 

Treatment Options

  • Hormone Therapy: Testosterone replacement therapy may be recommended for men with low testosterone levels.
  • Counselling: Therapy can address relationship or psychological issues.
  • Lifestyle Adjustments: Exercise, diet, and stress management can positively impact libido.
  • Medication Review: Some medications can affect libido, and alternatives may be available.

Overview

  • Peyronie’s disease is a condition characterised by the development of fibrous scar tissue inside the penis, leading to curved, often painful erections.

 

Causes

  • Peyronie’s disease is believed to result from minor trauma to the penis, which leads to scar tissue formation. Genetic predisposition and certain health conditions may also increase susceptibility.

 

Symptoms

  • Symptoms include a noticeable bend or curve in the erect penis, pain during erections, and difficulty with sexual intercourse.

 

Risk Factors

  • Risk factors include age, trauma, family history, and certain connective tissue disorders.

 

Treatment Options

  • Medications: Oral medications or injections directly into the scar tissue may help reduce the curvature.
  • Shockwave Therapy: This can reduce plaque formation and improve penile function.
  • Surgery: Surgical options, such as plaque removal or penile implants, may be considered for severe cases.
  • Traction Therapy: A device used to stretch the penis can sometimes reduce curvature.

Overview

  • STIs are infections transmitted through sexual contact. Common STIs include chlamydia, gonorrhoea, syphilis, and human papillomavirus (HPV). In Australia, STI rates have been on the rise, making awareness and regular testing essential.

 

Causes

  • STIs are caused by bacteria, viruses, or parasites that are transmitted through sexual contact, including vaginal, oral, and anal sex.

 

Symptoms
Symptoms vary widely depending on the infection but may include:

  • Painful urination or discharge from the penis or vagina
  • Sores, blisters, or rashes in the genital area
  • Pelvic pain or discomfort
  • Some STIs, like chlamydia, can be asymptomatic

 

Risk Factors

  • Unprotected sex, multiple partners, and a history of STIs can increase the risk. Certain STIs are more common among younger, sexually active individuals.

 

Treatment Options

  • Antibiotics: Bacterial STIs, such as chlamydia and gonorrhoea, can be treated with antibiotics.
  • Antiviral Medications: STIs caused by viruses, such as herpes or HIV, can be managed with antiviral medications.
  • Vaccination: Vaccines are available for some STIs, such as HPV and hepatitis B.
  • Regular Testing: Routine screening and safer sex practices, including condom use, are essential for preventing and managing STIs.

Maintaining Sexual Health

Maintaining sexual health involves a combination of lifestyle choices, open communication with partners, and regular health checks. Here are some recommendations:

  • Routine Health Checks: Regular visits to a urologist or GP for sexual health assessments can help detect and address issues early.
  • Healthy Lifestyle: Eating a balanced diet, exercising, and avoiding excessive alcohol or tobacco can support sexual health.
  • Communication: Open, honest discussions with partners can improve intimacy and understanding, reducing stress and performance concerns.
  • Safe Sexual Practices: Using protection, limiting the number of sexual partners, and undergoing regular STI screenings can help maintain sexual health.

When to Seek Help

If you experience symptoms affecting your sexual health, seeking professional help can provide clarity and treatment options. Many sexual health issues are treatable, and a specialist can work with you to develop a personalised plan that suits your needs.

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