Turning us on or putting us off?

Great fun yesterday evening, at the biennial Family Planning Association debate. Two years ago it was on sex education and I bounced up from the floor to make a contribution. This year it was on pornography and I was asked to speak - a really great honour.

The title was "Turning Us On or Putting Us Off". The panel - Mark Limmer the North West Teen Pregnancy Coordinator, Maddy Coy from the Women Abuse Studies Unit and Jamie Maclean of the Erotic Review - was wonderfully facilitated by David Aaronovitch, who seamlessly wove all our statements together then moved it on with substantial audience contributions. I would like to have heard more from "Leanne", a former porn star, and perhaps slightly less from an unamed man in the audience who seemed not to have got the point at all.

Views were wide-ranging - though all agreed on the essential horror of violent porn and the essential wisdom of good sex education. My own approach, though occasionally challenged, hinged on my belief that society is currently in a state of total confusion about many aspects of the porn debate. For a start, what is porn - and what is pleasurable erotica or useful information and knowledge? In my own lifetime I have seen the definition shift - what was reviled thirty years ago is now accepted as natural, normal and helpful.

Above all, though, what I found wonderful was that we were putting issues on the table, talking them through, shining a light on areas that are so often hidden or avoided. Whatever agreements we did or didn't come to, whatever action is or isn't taken, we talked about it sensibly, calmly and usefully.

Hats off - as always - to the Family Planning Association for raising the issue!

The ugh factor

I spent Friday consulting to a pharma company that is trying to gain more acceptance for its vaginal atrophy product.

Its what? Let me explain. The pharma has produced a pessary to help women who, usually because they're postmenopausal, suffer difficulty with... how shall I put this... thinning of the skin... loss of lubrication... discomfort while...

I can almost hear you wincing.

Actually, that was the whole point of the consultancy - to find a way to present the topic in a way that anyone will listen to. Because say the words "vaginal atrophy" and people's first response is incomprehension and their second response is a wrinkled nose and an "ugh" noise. Even women don't want to talk about it, while men simply turn white and start talking football.

But it's a real problem - I know because I get letters about it from my readers. After a certain age, with the shift in hormone levels, many women start to suffer. Itching, dryness, urinary incontinence and yes, pain and in particular pain during intercourse. It's not a trivial issue. "It hurts" say my readers - and they don't just mean the physical discomfort. They mean the horror of having one's most pleasurable and intimate part start to let you down... the strain and stress that puts on your relationship... and the intimation if not of mortality then at least of ageing.

This is not a plug for the pharma product. But help of various kinds is available - and many women don't seek it both because they don't know about it and because if they do, they're embarrassed to even admit they need it.

So it would be great if we started to take this one seriously. If the media gritted their teeth and covered it. If the health profession started asking pertinent and sympathetic questions of menopausal patients. And if ordinary men and women worldwide stopped wincing and started talking...