I do understand, truly I do, exactly why the government has decided not to hand out free smear tests to women in England under the age of 25.

It's absolutely logical. Studies suggest that below that age more women have false positives - which scares them. Subsequent unnecessary treatment may be harmful - and even necessary treatment can occasionally cause damage to the woman and premature birth to her future children. And - though of course this couldn't possibly be a factor in the government's decision - increased smear tests cost money that could be spent on other more urgent causes. You know it makes absolute sense.

And yet, and yet.... If it makes such sense, how come countries like Denmark and Sweden set the test age at 23? How come the advice in many countries is to have the test at 21? And how come the rest of the UK offers smear tests at 20 (why do the words 'postcode' and 'lottery' come inexorably to mind?)

But actually, my main worry here isn't to do with the figures, the statistics or even the logic of the argument (nor am I, as so many press sources are today, citing the Jade argument). No, my main worry is for individual younger women, women who because of their youth are probably less aware of the risks of cervical cancer whilst at the same time being more at risk simply because they are in that life stage of having many partners. The hard fact is that if we lowered the smear test age - lowered it way down to the average age of sexual intercourse at 16, we would save lives. Not many, but a few. And the fact that we aren't doing so horrifies me.

I'm not arguing that cervical smears are a better use of money than other heart-rending health causes - who am I to deny the importance of treatment for leukaemia, infertility, heart disease. and who is anyone to make comparisons and judge who should get the cash?What I'm arguing is that tests would be a better use of money than so many other things that the Government spends on - warfare, thousand-pound-an-hour consultancy, and of course, second homes and dirty videos.

My suggestion? Just cut a fraction back on the expenses and put that money into bringing England into line with the rest of the UK when it comes to the life-saving smear test...

PS: When one writes an academic paper, one need to cite 'vested interests'. This isn't an academic blog, but here is mine. At age 31 I had my own positive smear test, which led to treatment for developing cervical cancer. Yes, even with the age bar held at 25 I would have been spotted and saved. But I still feel a shiver at the thought that any woman, absent the possibility of that test, will have to go through the treatment and the trauma that I suffered.

Let's hear it for the mourners

I get a lot of letters - I mean a lot - from readers and listeners who have just endured the ending of a relationship.

But here's something that may surprise you. The ones that worry me are not those who outline in heart-rending detail their tears and rages, not those who report a deep loss of self esteem and trust in the world.

Yes, such responses are painful and not to be trivialised - but they are totally normal and healthy. Let emotion flow, get support for the agony, and in the end you will likely recover. Of course there are exceptions, those who are crippled by break-up grief for the rest of their lives; but as with a bereavement, typically nature takes its course and you come through. You may suffer, but you will surive.

No, the readers who terrify me are those that think that they won't - shouldn't - suffer. Those who try to carry on regardless and then wonder why they are finding life difficult. Cf poor, sad Katie Price, downing drinks and hitting the Ibiza dancefloor while shouting defiantly at reporters "I'm over Peter!"

I'm not criticising these readers - their hurt is just as strong as the griefstricken or depressed correspondents, and they need just as much support and pity. But who said that suffering isn't an inevitable part of having loved? Who said that one shouldn't mourn when that love dies?

What sort of world do we live in that persuades people that they should 'bounce back' from the ending of - in Katie's case - a five-year relationship that produced two children? What sort of world do we live in where the default option for coping with such an ending is not to lick our wounds and receive the support and comiseration of friends, but to think we have to carry on regardless drowning our sorrows in drink and yet another relationship. Only last week, in my postbag, I received a long letter from a woman worried there was something wrong because she didn't 'feel better' after her long-term partner had walked out on her... barely a fortnight before.

So let's hear it for the relationship mourners, those who have the courage to feel the pain and grieve the loss, to take their time to come back onto the dating scene, and to learn the lessons of the breakup before they emerge into the world again.

Short term they may seem emotionally weaker than those who don't even break step. Longer-term, however, they will be healthier, happier and far more able to love.

Dying of embarrassment

Some worrying research results yesterday highlighted the differences in the way men and women react to the suspicion of cancer - that is, whether they hie themselves off to the GP within hours of spotting the lump/bump/lesion, or whether they instead burrow their heads even more firmly into the sand.

No criticism here. Fear, which must surely be the key motivator, is a powerful paralyser. And if men - for yes they are the ones doing the sand-burrowing - are terrified, then that's utterly understandable.

It is, however, also tragic. The abovementioned research, brought out to coincide with Men's Health Week, suggests that there is no biological reason why men are 60% more likely to develop cancer and 70% more likely to die from it - particularly from the gender-specific, sexually-linked types of cancer such as prostate and testicular. Yes, there are major lifestyle causes. but the high mortality rate is also down to an unwillingness to acknowledge symptoms, take them seriously and then report them.

It comes as no surprise that this unwillingness is higher when it comes to the gender-specific cancers - because the emotional discomfort factor is so much higher there. I know this myself - for every 20 letters I receive from women asking me to advise on sexual problems I get perhaps one from a man. A mixture of anxiety, machismo and shame is holding the guys back.
Men are, literally, dying of embarrassment.

The answer? Professor Alan White of the Men's Health Forum puts his finger on it when he appeals for health services to be more male-appropriate. And that doesn't just mean more available outside working hours - but more encouraging, more motivating, and more aware of y chromosome reluctance.

I am inexorably reminded of that classic self-development question: which do you choose to be, the rabbit or the headlights? Let's hope that by next year's Men's Health Week, men are beginning to choose the latter option...

Back again...

Yes, I confess, it's been a long hiatus. To be precise, six weeks since I last blogged.

I can't claim wild celebrations have kept me from my screen (although admittedly I have had a birthday since I last logged on - don't ask which one but it ended in a '9').

What I can claim is a slew of work. In particular - unusually for me, as my job rarely entails exotic foreign travel - a work-related trip to Istanbul to speak at the DISPAXWorld 09 conference. For those of you not in the know - as I wasn't until the conference organisers contacted me - this is an aviation get-together on the topic of disruptive airline passengers. Some impressive speakers, some fascinating topics, and a wonderful cruise on the Bosphorus, courtesy of our sponsor. In case you're wondering, I was presenting on sexually disruptive behaviour inflight; no, not so much the Mile High Club as sexual attacks, sexual abuse and public indecency. The model I've developed through the work I've done suggests that while there is no excuse for any of these, there are reasons - Air Lust is as induced an altered state as Air Rage and hence needs careful handling.

Other fascinating projects over the past six weeks? Developing a model of why we hate some celebrities and love others... writing about grey sex for the Menopause Matters magazine... preparing a paper on male contraception for the Journal of Family Planning. Also commenting on Posh and Becks's tenth wedding anniversary, giving my views on the importance of 'sharing', and holding forth about the pros and cons of mothers-in-law. It's a fun life.

But perhaps the thing that's most holding my attention right now is my weekly LBC programme. Listener figures are - gratifyingly - up yet again quarter-on-quarter, and Jim Davis and I seem to be building quite a community of supportive fans. The best bits, though, are the calls - about everything, anything, and things you certainly wouldn't mention to an above-mentioned mother-in-law. The caller who was planning to walk out on his family the next morning but hadn't actually broken the news yet. The sobbing girl whose partner had just abandoned her and her two-week-old baby. The gay police officer who was terrified to come out. The thirty-something woman who wanted me to tell her, in detail, on the air, how to masturbate. And these, of course, are the queries it's legal and decent to broadcast... the ones that aren't still get a reply, but by email.

OK, update completed and now I 'm fully back doing my blog, I hope to keep it a little more regular.

And if you need something else to read, check out the musings of Jane Matthews, a friend of mine whose delightful blog charting her self-imposed challenge to be "someone nicer" is something I myself read every day...

Whoopeee!!!!

Yessss. After a six month review, sex and relationships education in England is to become compulsory for all students of 11 and upwards. At last, at last, the Government has acknowledged what we sex educators have always known - that it's a straight choice between caught and taught.

Thankfully they've come down on the side of the teaching, so contraception, STIs and the supporting raft of relationship advice will be available to all late primary and secondary children from 2011 onwards. And that should mean that more resources are funnelled the SRE way - for student materials, teacher training and course support.

Yes, there are parental and faith school opt-outs, with provision for religious establishments to provide the teaching within the context of their own values. And, actually, though many sexual health providers disagree, I concur with this on the basis that democracy should trump mandatory every time.

But the fact remains that if we can fulfil this promise, in two years' time every adolescent in the country will be receiving regular, targetted, well-delivered SRE education. And with a bit of luck, a few years' after that, we won't be bottom of the European league tables for teen pregnancy and STIs!

PS: following a suggestion from my staff (truly not from me), I am now officially a nominee for the Our Bodies Ourselves Women's Health Heroes Award. If you'd like to vote for me - or even, if you know my work, post a comment in my support, then go to the Women's Health Heroes page and scroll down to find me. Last date for voting is May 8th.

Well, yet another gap in transmission due to busy-ness at work.

But that doesn't mean to say that nothing's been happening. The past few weeks have been full of sex-relevant media stories. And, happily many of them have carried a hidden upside.

Poor Jade Goody finally lost her battle with cervical cancer - but on the back of that, in some areas of the UK the number of women taking smear tests is up by many per cent. The economic crisis means that men can't afford to keep mistresses any more - and the upside of that is, hopefully, fewer broken marriages and destroyed families. Plus, Jacqui Smith's husband has been caught in flagrante with two porn films - but that in turn has brought the whole issue of porn squarely into the public domain.

It's been that last story that I've been asked to comment most on - including a long interview for The Times - and I have expressed concern. Yes, I was the one who in the recent Family Planning Association Debate on the issue of porn argued that there are no easy answers. And I still think that burying all sexual images and tabooing all sexual information - as was done in Victorian times - is a very bad idea.

Nevertheless, it's becoming clearer and clearer that while the general principle of openness about matters sexual still holds true, it needs to be done well. When linked with inaccurate information (all men have big penises, all women climax immediately upon penetration) and when surrounded by problematic values (a woman is only valid if she is slim and big breasted, a man is only valid if he keeps it up all night) porn is utterly harmful.

And, of course, addictive. I get more and more letters from women in particular who are distressed and disgusted by their partners' use of porn - and the subsequent deceit and betrayal where such partners promise to stop but then secretly. Relate reports a steep increase in marriage breakdown that is fuelled by Internet porn addiction (though whether the breakdown chicken or the addiction egg comes first is still in debate).

No it won't work to ban all erotic images. It won't work to think that our society can magically switch back to pre-sexualisation days.

But what we can do is to encourage a process of emotional maturity in our treatment of sex, so that we don't get stuck at the 'big tits, big cock' stage of adolescent sexuality. What we can do is topoint out that screen portrayals are not real life, and that real life sex is much much better just because it is real.

What we can do, in short, is to constantly remember that good, positive loving sex is much much better than the ersatz porn variety...

Sons and Lovers

As we come up to Mothers' Day, I thought I'd point you in the direction of two contrasting stories that have emerged this week - both about mothers' relationship to their sons, both causing a bit of a stir in the press.

Julie Myerson has hit the headlines on the back of her latest book, a reworking of the real life conflicts which resulted in her barring son Jake from the house. Should she have put all this in the public domain? The general concensus is no.

Meanwhile, Lucy Baxter is going public with a completely different problem. Her son Otto, 21, has Down's Syndrome, and as a result is finding it difficult to have the normal sexual experiences that a lad of his age wants and expects.

Now, I'm not a mother, so my insights will be limited here - but I'm far more moved, and far less outraged by the the second story than the first. It feels to me absolutely commendable - and very farseeing - that Lucy should be fighting publicly for her son's right to a happy, healthy sex life; his mother is not only doing him a good turn, but doing good for all the other physically and mentally handicapped youngsters (and oldsters) who aren't seen as sexual beings, and who are therefore denied an outlet for their passionate feelings.

The slight nose-twitching that has been going on in response to her speaking out seems to me to be utterly unwarranted. Why should Otto be penalised simply because he has a medical condition? Why should we not support him simply because he does not tally with our view of 'fit'. Why should we not see him as a sexual adult who needs and deserves the pleasure and comfort of an intimate relationship. As Lucy Baxter says, "it's society who has a learning disability" in this respect.

As for Julie Myerson? Yes, her child's drug habit is heartbreaking and everyone sympathises. But perhaps she could learn a lot from Lucy Baxter's support of her son as he tries to make that difficult transition to individuated adulthood.

And perhaps both Julie and her son should thank heaven they don't have the challenges that the Baxter family faces, day in and day out...