Wednesday, September 12, 2007

Sex and the pill (no, not the one you think I mean)

Yesterday I took part in Radio 4's Case Notes, a half-hour's digest presented by the thinking girl's doc, Mark Porter. This week's programme was all about sex problems (part of the Radio 4 The Sex Lives of Us season) and Mark, sexual physician John Dean and I batted about several topics including erectile dysfunction (for him), anorgasmia (for her) and loss of desire (for both).

Despite the fact that I was the only non-medic present, Mark gave me a deal of leeway to argue against medication for sexual problems - and he and John happily agreed with my stance. Yes, medication is a wonderful way forward for some problems; you only have to look at the eye-watering alternative treatments for ED (pumps, injections, surgery) to acknowledge that sometimes medication is by far the best option. But I am still wary.

For a start, pill-popping may hide an underlying physical issue. During a recent pilot scheme to dole out the little blue pill through Boots the Chemist, 9 out of every ten men who turned up tested positive for diabetes or heart disease and needed to be referred to a consultant rather than simply prescribed the pill.

Secondly, however, many sexual problems are not physically caused. The woman with low sexual desire may be tempted by the upcoming range of testosterone patches - whilst ignoring the fact that she's exhausted, depressed, in an abusive relationship, and with two under-fives to look after. Sort that lot out and she not only would be less likely to need the patches, but more likely to live a fulfilled and happy life.

John Bancroft, head of the famed Kinsey Institute, once famously said that the traditional role of the penis has been to tell its owner the truth... whether or not he wants to hear it. And whilst I don't wish to underplay the role of physical issues, I suspect many sexual problems serve the same function for both men and women.

So let's not medicalise or medicate where inappropriate. Instead, let's regard any sexual disorder as carrying a message that both its sufferer and their physician needs to hear...


Andrew P. said...

Very much enjoyed the Case Notes program. Good to hear sexual problems spoken about frankly with sensible attitudes, and in the middle of the afternoon, too!

One question: You mentioned that recent research points to a "four year itch" syndrome in sexual relationships, rather than the classic seven-year variety.

I would be interested to know more about these findings. Where can I get details?

Susan Quilliam said...

Andrew, thanks so much for your positive comments - and for taking the time to listen to Case Notes. I totally agree about the programme's approach, and also the timing; it first goes out late night but is then, very helpfully, repeated for the commuter market.

The "four year itch" research I referred to is the work of Prof Helen Fisher of Rutgers, who has done a great deal of work on "lurve". You can find the original paper on or for comments and crits, Google some combination of "four year itch Fishers love".

Hope this helps - and do keep in touch.