Comment: The national strategy at primary care level
Paul Woolley
pp 4-6
One of the national strategy for sexual health and HIV’s most important aims is to develop sexual health services around patients’ needs. Often the first point of contact is the GP, who will assess their needs and decide whether to treat them in the community or refer them to more specialised services. The strategy outlines three levels of service provision for developing a comprehensive local service. It is anticipated that a level of sexual healthcare should be available in every general practice setting.
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Sexual side-effects of antidepressants
Peter Marshall
pp 7-9
Antidepressants were discovered over 40 years ago and are now widely used. They are indicated for an increasing number of illnesses and symptoms, including anxiety disorders, depression, obsessive-compulsive disorder, bulimia, body dysmorphic disorder and the treatment of pain. Many different types of drugs, both illicit and prescribed, can cause sexual side-effects. Virtually all of the different classes of antidepressants cause sexual side-effects and with some drugs up to 90% of patients will experience them. Both men and women can be affected.
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Effective management of genital warts
Paul Woolley
pp 10-12
The Department of Health and Social Security survey of genitourinary (GUM) clinics was set up in England in 1988 in response to the considerable rise in workloads in GUM clinics throughout the 1980s. This rise was felt to be due to an increase in sexually transmitted infections (STIs) generally within the population, an increased awareness of HIV brought about by national publicity campaigns and the higher expectations and demands of patients.
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Hypnosex therapy – part 2
Talal Al Rubaie
pp 14-18
Part 1 of this article looked at the new concept in hypnosex therapy, and in particular at Pratt et al’s framework of the six levels of hypnosis/intervention in therapy. This second and final part looks at specific techniques used with hypnosis in the treatment of sexual dysfunction. Behaviour therapists have used hypnosis with systematic desensitisation. Pairing hypnotic relaxation with a hierarchy of fear-inducing situations has been used to treat various sexual dysfunctions. The items of such a hierarchy might contain elements of sexual foreplay and involve some scenes of progressive social and physical involvement.
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A compliance clinic in the management of patients with HIV infection
Karen E Rogstad
pp 20-22
This article describes the evolution of a compliance clinic at a large university hospital in the UK outside London. It does not aim to present a review of the research on the effectiveness of such clinics nor the evidence of which interventions work, for which the reader should look elsewhere. Instead it considers the practicalities of initiating and developing such a service, which may be useful for others to consider when dealing with adherence issues for their own patient group, whether HIV-positive or with another chronic disease that requires long-term therapy.
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The sexual health of elderly women with psychiatric disorders
Christopher E Jagus and Susan M Benbow
pp 24-26
Older people are regarded by the general population and many health professionals as ‘asexual’ beings. The idea of sexually active elders offends some people, may be a source of humour to others or may simply be denied. Sexual activity is widely believed to cease with old age. Substantial evidence contradicts these beliefs and supports the notion that many people can continue satisfactory sexual activity and relationships well into later life.
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Adolescent gynaecology – part 1
Adam Balen
pp 27-30
In the management of young women with gynaecological problems we have to consider the full range of conditions that may be seen in adult women and be sensitive to the specific needs of the adolescent who is confronted with issues relating to sexual function and sexual identity, endocrinology and fertility. The first part of this two-part overview considers disorders of puberty and common causes of menstrual disturbance, while in the next issue part two will look particularly at the polycystic ovary syndrome (PCOS) and disorders of intersex.
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A spot of mystery
David Hicks
pp 31-31
Toyah Wilcox (1980s New Romantic pop singer) is reckoned to be the only person to have hosted the television programmes ‘The Good Sex Guide’ and ‘Songs of Praise’. Credentials like this are probably required to answer the question, ‘Does the female G spot exist?’ Dr Ernst Grafenberg postulated its presence in 1950 but the term only came into common usage after 1980. A recent paper has generated some frenzied excitement in the correspondence columns.
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