Sexual health for women
Maintaining a healthy sex life with scleroderma
Problems with sexual health can be among the most challenging scleroderma symptoms for men, and there is no need to suffer in silence.
Most men with systemic sclerosis have issues with erectile dysfunction, which means they find it difficult to get and maintain an erection. The good news is that a lot can be done to combat the problem.
For a man to achieve an erection satisfactorily for penetration, three important systems have to be working properly. These are the blood supply, and the nervous and psychological systems.
If one of these systems is damaged, it is difficult for a man to attain and maintain an erection:
Blood flow – for an erection to take place, special erectile tissues have to be filled with blood and this requires a good blood supply. Systemic sclerosis can decrease blood flow to the erectile tissues, meaning they do not fill with blood properly.
Tissue changes – erectile tissue relaxation enables the penis to fill with blood during erection. However, the fibrosis (thickening) process that takes place in systemic sclerosis reduces the ability of the erectile tissue to relax, meaning erections do not occur.
Also, signals from the brain to the penis can be interrupted by nerve damage, again meaning erections fail to occur.
Depression and anxiety – being diagnosed with systemic sclerosis can cause great anxiety and can result in some people becoming depressed. This can lead to a lack of stimulation in the area of the brain that causes the arousal required for erection to take place.
Medical conditions such as diabetes, kidney disorders, psychiatric problems, neurological disorders, trauma, and surgery to the pelvis can also cause erectile problems.
If you have a sexual health issue, don't hesitate to seek help either from your GP or urologist. The problem is common and there are things that can be done to combat it.
If possible, try to get support from your partner in seeking help, as this is an issue that concerns both of you.
You will need to consult with a specialist who will talk through your medical history and give you a physical examination, so that they can come up with an individualised treatment plan for you. They may need to run some tests, including taking blood samples for hormone deficiencies and blood sugar levels.
They may suggest psychosexual treatment, to help you better understand the causes of the problem. This treatment may involve cognitive behavioural therapy, or the 'sensate focus approach', which encourages couples to undertake a series of exercises at home to encourage intimacy. It's worth noting that these treatments can be difficult to access on the NHS.
Your specialist may also suggest physical treatments:
All these treatments should only be tried after speaking to a specialist. Changes in lifestyle, such as cutting down on alcohol and stopping smoking, can also go a long way in solving some of the problems.