I am proud to be associated with Cliterati as there are many stories and other contents on this website which, if used correctly, can help people improve a healthy sexual life. I am often asked why after training as a Consultant in General Medicine and Pharmacology I made my clinical life mainly in the sexual arena. The answer is simple.
I learnt very early on in my medical career that this was an area where people needed help, were embarrassed to ask for it, and needed non-judgemental, caring people to help them.
I was lucky enough through my early training to be involved in a NHS sexual health clinic and was pleasantly surprised to see that when treating sexually transmitted diseases and infections that you could actually make people better. This contrasted to a lot of my general medical practise where you were trying to help people with the symptoms of their health problems, but were not able to offer a cure.
My sexual health practise comprises three distinct areas.
The first is the screening, testing and treating for sexually transmitted diseases, the second is to help people with their sexual performance, and the third is to help people improve their sex life.
All three involve a mixture of an understanding of the medical and psychological aspects of the patients, and treatments for all three usually involve medicines and some form of psychotherapy. I am lucky that my patients have been my best teachers.
People often ask me what is the difference between normal, abnormal, kinky, or bizarre sexual practise. I think similarly to all those involved with Cliterati my bar is set at a very simple position. Provided the sexual practise is safe, legal, consensual, and age-appropriate, very little is prohibited.
The most important aspect is that both the partners within a relationship are happy and comfortable with whatever goes on and neither are coerced or blackmailed into any practise with which they are uncomfortable.
In the field of sexual practise, it is often upsetting for me when treating couples that both partners in the relationship would like to try something different but are unable to ask their partner to try because they think the partner will be ‘disgusted’ and they themselves will be embarrassed. This is a real shame because on the path to sexual contentment and happiness, top of the agenda has to be open communication between both.
I make no difference between male/female, male/male or female/female relationships. The same principals apply.
One of the first patients to convince me I could help people unable to have an enjoyable sex life make changes which would be beneficial, happened not within a sexual health clinic, but within the high blood pressure clinic I started at the London Hospital. Drugs that treat high blood pressure are notorious for having adverse effects on all aspects of sexual health.
This has three components to it. The first is desire and libido, the second is physiological performance of erection in the males and lubrication and dilatation in females, and the third is orgasm.
All three can be altered by many medicines and illegal drugs, not only those for high blood pressure, but commonly those used for mental health and pain, as well as many others.
A very friendly and pleasant 40 year old gentleman came into the clinic complaining of an unfulfilled sex life because of inhibition of all three elements of libido, practise and performance. He was sure the drugs were to blame. Over a period of three months I changed his drugs many times to many different combinations, giving very low doses, however, nothing improved. He appeared to be getting depressed, which is often a consequence of an unhappy sexual partnership. One day I decided to grab the bull by the horns and asked him whether he minded if I made some suggestions that may help him and his wife. I suggested what has become my top three (among many) areas of trying something different.
I call these the ‘3 Fs for a good F***’. These include Fantasies, Films, Flimsies. I will write more about these later. But briefly, it is often helpful that both sides share their fantasies with each other to increase intimacy and to help excitement. They do not have to be the same fantasises, it is just the sharing of them.
Films show how old I am because this initially involves pornographic films and this is my shorthand for getting people to understand that pornography may be helpful. It is now readily available on both DVDs and over the internet. People have to be careful that they don’t drift into connecting with illegal video sites involving children or severe sadomasochism. People also have to be careful not to be addicted to using pornography alone. These are both real dangers that people have to be aware of.
The third ‘F’ stands for ‘Flimsies’ and is a way of telling people it is okay if their partners dress in erotic clothing or anything that either feels increases excitation. It may involve leather, or other materials such as PVC, or it may mean them dressing up in other manners. Many heterosexual men get excited by wearing women’s underwear and clothing without any sense of homosexuality.
I went through these three simple additions to my patient’s sexual armamentarium and he went ballistic. He told me his wife is not that kind of woman and he would never do anything as disgusting or suggest she did as well. He threatened to report me to the hospital governors and administrators and told me my medical life was over. I made my apologies and he stormed out the room. I made myself a note in the records of what had happened and a mental note never to mention this again. I told the Professor of Medicine what I had done and he tried to be reassuring, but I could see disapproval in his eyes.
Three months later the patient retuned for his next visit and this was held in a semi icy atmosphere, with me feeling completely inhibited. After the consultation he left the room and I gave a sigh of relief that his aggression had not returned. As he left the room he looked at me, smiled and winked and said “thank you very much doc”.
Once having left the room he re-opened the door, popped his head round, gave an even bigger smile and three winks and said ‘by the way my wife says thank you very much as well.’
God knows what they were up to, but whatever it was seemed to have done the trick and he was looking like an a young man with a new toy.
We were able to give him any medication we wanted to lower his blood pressure and the so-called side effect never returned, so please remember the first step to a fulfilling sex life may be to embrace the use of fantasies, films and flimsies.
Dr Malcolm VandenBurg BSc MBBS FISMA FCP FFPM FRCP