Monthly Archives: January 2018

Should all patients be asked about their sexual orientation?

Should all patients be asked about their sexual orientation?


In late 2017, NHS England released guidelines recommending that health professionals ask all patients about their sexual orientation in order to improve services for non-heterosexual patients, but should they? Experts debate the issue in The BMJtoday.

After decades of campaigning from lesbian, gay, bisexual and trans (LGBT) charities, sexual orientation is now a protected characteristic that is written into the Equality Act 2010. General practitioner and research fellow Richard Ma, from Imperial College London says all patients should be asked about their sexual orientation.

Ma comments that it would seem like a welcome step for NHS England to include sexual orientation monitoring in  and social care systems.

“Some doctors and patients have expressed concerns about this policy, citing reasons such as intrusion or invasion of privacy, fear of causing offence, doubts about relevance, data security” he says. “Whilst I understand these concerns, they result in inertia; and failure to act undermines hard fought rights of LGBT patients to better healthcare.”

Ma states there are flaws in recognising LGBT health needs. A survey of nearly 7000 gay and bisexual men, commissioned by LGBT charity, Stonewall, shows that smoking, alcohol, and drug use were more prevalent in this group compared to men in general.

“Sexual orientation monitoring is necessary to make the health service for LGBT patients fairer. If we don’t count our LGBT patients, they don’t count.” Ma concludes.

But Michael Dixon, a , says that it should be up to the individual judgement of GPs as to when it’s appropriate or useful to ask such questions about patient sexual .

He says that whilst there are health benefits from knowing a patient’s sexuality, the approach of asking ‘all’ patients is wrong.

“Apparently this is all to stop discrimination under the Equality Act, but surely the best way to avoid discrimination is by not knowing people’s sexuality in the first place” he says.

“In good medical practice, the patient’s own needs, wishes, choices, beliefs, culture, and perspective should come first – not the rules or diktats of any higher body” he concludes.

In a linked patient commentary, Tamás Bereczky, from the European AIDS Treatment Group, says whilst discussing  between doctors and  can be embarrassing, healthcare professionals should be able to talk about all sensitive topics.

“Visibility and honest discussion can also eventually reduce stigma” he concludes.

Provided by: British Medical Journal

Lesbian sexual health neglected by healthcare and education, researchers find

Lesbian sexual health neglected by healthcare and education, researchers find

Due to the AIDS crisis and the HIV epidemic, sexual-health initiatives within LGBT communities have historically been heavily geared toward addressing men who have sex with men (MSM). Meanwhile, sex education in schools has used opposite-sex partners as its primary focus.

Unfortunately, research is revealing that several groups have been neglected in the process.

A new study led by researchers from the University of British Columbia reveals that although lesbian and female-bisexual teens face a higher risk of sexually transmitted infections (STIs) than their heterosexual counterparts, raising awareness of safe sex between women has been overlooked.

In the study, published in the Journal of Adolescent Health on December 28, 160 U.S. girls aged 14 to 18 participated in online focus groups based on whether or not they were sexually experienced.

What the researchers discovered was related to the exclusion of LGBT issues from mainstream sexual-health programs and preconceived ideas about gender.

The researchers identified four main themes as to why participants did not use latex barriers during sex.

A recurring theme was a concern about sexual pleasure or mood being reduced by awkwardness or discomfort. The study’s authors pointed out that sexual-health-promotion interventions have faced challenges in raising awareness of how pleasure can be increased by some STI–prevention methods, such as female condoms that stimulate the clitoris or lubrication on the underside of a dental dam.

Despite these issues, participants did express a willingness to use barriers in the future. Nonetheless, many participants preferred to use STI testing as a safe-sex strategy to determine whether or not they needed to use barriers. For instance, if both partners tested “clean” or “STD-free”, participants didn’t feel they needed to use barriers.

Another reason for avoiding barriers was the idea that sex with another female is low-risk due to the impossibility of impregnation. Several participants also stated that they trusted their female partners more than male partners regarding STIs.

However, the researchers pointed out that the exchange of vaginal fluid by mouth, fingers, or sex toys can transmit STIs; the human papilloma virus (HPV) can be spread by skin-to-skin contact; and genital HPV has been found on fingers, sterilized forceps, and surgical gloves (making transmission via sex toys possible).

The researchers also found that the participants often lacked awareness of safe-sex practices for sexual activity between women and lacked knowledge of the risks involved.

One 18-year-old participant said that when she started having sex, she couldn’t find any online information about safe sex for lesbians. A 15-year-old girl pointed out she had never been taught about STI transfer between female partners. Meanwhile, others were unaware of dental dams (for use during oral sex) or where to obtain them, and still others mentioned that LGBT sex was excluded from heterosexual-based sex education at school.

The researchers noted that the bias toward focusing on men as transmitters of STIs was prevalent within health-care systems, as female-to-female transmission of STIs was only considered once male-to-female transmission was ruled out.

The findings of this study recalls themes of a 2016 UBC–led research paper about transgender youth and sexual activity that pointed out similar gaps due to preconceived notions about which sexual issues are relevant to LGBT people. That study revealed—contrary to assumptions that pregnancy concerns were not relevant to transgender youth—that trans teens and their cisgender counterparts were equally at risk of being involved with pregnancy.

Consequently, such analyses highlight the need to rectify these areas of omission and oversight in both health care and education in order to achieve equality in treatment within health-care systems.

Cycling Won’t Sabotage a Man’s Sex Life: Study

Cycling Won’t Sabotage a Man’s Sex Life: Study

Men who are avid cyclists needn’t worry that hours spent on the bike will translate into problems in the bedroom or bathroom, new research claims.

Reportedly the largest study of its kind involving bikers, swimmers and runners, the findings buck prior reports that cycling could harm sexual or urinary function due to prolonged pressure on the buttocks and the perineum (the area between the scrotum and the anus).

The results provide some reassurance that cycling doesn’t harm the perineum any more than swimming and jogging do, said study author Dr. Benjamin Breyer, a urologic surgeon at the University of California, San Francisco.

“Those athletes [swimmers and runners] also have erectile dysfunction,” he explained. “The truth of the matter is, many men develop erectile dysfunction, but I think if you ride safely the health benefits of cycling are tremendous. The benefits to overall health far outweigh other concerns.”

Cycling, whether done for leisure or transportation, has become increasingly popular, Breyer said. But the activity has received much attention for its potential effects on sexual and urinary health.

“I think a lot of effort goes into cycling from some men to protect their perineum by wearing padded shorts and using different seat types,” he said.

The new research on men surveyed 2,774 cyclists, 539 swimmers and 789 runners. All completed several research-validated questionnaires about sexual health, prostate symptoms, urinary tract infections, genital numbness and saddle sores, among other factors.

Cyclists were also asked about their bike type, saddle (seat) type and angle, frequency of wearing padded shorts, percentage of time spent standing out of the saddle, handlebar type and type of surface on which they usually ride. The cyclists were split into a high-intensity group (cycling more than two years more than three times weekly and averaging more than 25 miles per day) and a low-intensity group.

Notably, high-intensity cyclists logged better erectile function scores than low-intensity cyclists.

Also notably, cyclists did experience more than twice the incidence of scarring or narrowing in the urethra — a condition known as urethral strictures — compared to swimmers or runners. The condition can affect the flow of urine from the body. But cyclists’ sexual and urinary health was comparable overall to the other athletes.

Among cyclists, those standing more than 20 percent of the time while cycling significantly cut their odds of experiencing any genital numbness. Additionally, having handlebar height lower than seat height increased the odds of genital numbness and saddle sores.

Urethral strictures “are such an uncommon event that I wouldn’t keep people from riding,” Breyer said. “I would try to avoid riding habits that result in really significant numbness in the perineum for really long periods.” Instead, he suggested men adopt more of these practices: getting out of the saddle, wearing protective shorts, using a seat that has a cutout, and getting an appropriate bike fitting.

Other urologists praised the study design, saying the comparison between cyclists and other athletes added strength to the findings.

“In my experience with bicyclists, this really reflects what I see,” said Dr. Brian Miles, a urologist at Houston Methodist Hospital in Texas. “Erectile dysfunction, of course, happens to men as they age for various reasons, but with cyclists, their rate seems to be no different in my experience.”

Dr. Aaron Katz is chairman of urology at NYU Winthrop Hospital in Mineola, N.Y. He said the findings were a little surprising, “because as a urologist who’s been in the field for many years, we’ve had this notion that prolonged cycling can have an effect on sexual function.

“But those studies were older and didn’t use a [similar] cross-sectional analysis,” Katz added. “I was really happy to see this study. I think it will allow men who are cycling to continue and not be so worried about it.”

The study is published in the March issue of The Journal of Urology.

More information

The American Sexual Health Association offers more on men’s sexual health.

6 Things That Can Cause Penis Allergies After Sex

6 Things That Can Cause Penis Allergies After Sex


Pains on the surface of the penis, redness or itchiness are some common symptoms of a penis allergy and it can have a huge impact on a couple’s sex life.

All couples seek a healthy relationship with a satisfying sexual life. But no matter how sexually compatible they are, there are always chances that allergies or side-effects of the products used while sex, come in the way of happy couple who are having great sex. One such condition is men having penis allergies immediately after having intercourse. Pains on the surface of the penis, redness or itchiness are some common symptoms of a penis allergy and it can have a huge impact on a couple’s sex life.

While an expert medical attention is required to treat the condition, there are some steps that men can take in order to prevent having such allergies.

Here are some common triggers of penis allergies:

1. Diabetes

Rashes and red spots can develop on the skin because of high blood sugar level. An unusual sign of diabetes, this causes burning sensation and redness on the skin. Antibiotics or anti-allergens too seem to show no results. It is a clear symptom of balanitis and patient must get their blood sugar levels checked if this happens.

2. Latex condoms

Many men are allergic to condoms and may develop itchiness or redness on being exposed to condoms. People who work in the healthcare industry are most prone to such allergies as they wear latex gloves all day long. The spermicides that are present on the lining of the condoms and the dyes that are used to colour these products can cause allergic reactions in some men. There are latex-free condoms available in the market, which are slightly more expensive. But these are an effective rash-free solution.

3. Allergies

In some rare cases, some allergic reactions cause burning sensations, pain and itchiness on the penis. These allergies can be aggravated by pubic hair, female secretions or pubic lice.

4. Infections

Sexually transmitted diseases (STDs) are another possible reason for penis allergies after sexual intercourse. These include trichomonalis vaginalis (red spots on the penis), syphilis (boils on the penis after a few days of sexual intercourse with a person suffering from syphilis) and herpes (red spots on the genital area).

5. Products used by women

Many men are under the misconception that vaginal secretions are to be blamed for their penis allergies. But it is actually some of the products that women use which may be triggering these allergies. These products include creams, lotions, lubricants, perfumes, powders and soaps to name a few.

During sexual intercourse, the delicate skin of the penis might come in contact with these irritants, thus leading to rash or redness of the skin. To get the condition properly treated, medical attention is required. But if an emergency situation rises in the odd hours of the night, you can opt for hypoallergenic products or products which mention they are free of allergens and perfumes.

6. Lack of Lubrication

When couples indulge in sex in a hurry, it often leads to lack of lubrication in women. This causes red spots and abrasion of the skin on penis. However, this kind of sexual intercourse is more painful for women than men.

Ways to deal with penis allergies

Wearing breathable fabrics can go a long way in terms of preventing penis allergies. Also, prevent using lotions or creams as they can cause an adverse allergic reaction. You can penis health creams that are available in the market.

However, we do suggest taking medical assistance for treating penis allergies as a long-term method to prevent them.