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"Let's talk about men's sexual health all year round"

26 Nov 2021

This Movember, we speak to Lorraine about her work with patients, how taboo is preventing people from having better sexual experiences, and what we can do about it.

Lorraine Grover

About Mrs Lorraine Grover

Lorraine helps men and women overcome difficulties with sex. A big speciality is erectile dysfunction, discussing treatments and providing psychosexual help optimises the best outcome.

November, often coined Movember, is a month dedicated to talking about men’s health.

Whether sporting awareness-raising moustaches (hence “Mo-vember”) or not, together people highlight diseases impacting men, like prostate and testicular cancer, as well as issues including mental health and suicide prevention.

Each year, Lorraine Grover, a Psychosexual Nurse Specialist at The London Clinic, joins millions of people in recognising Movember, from sharing advice on social media and speaking at events on men’s issues, to little gestures like proudly sporting blue nail varnish, the month’s official colour.

Lorraine has specialised in sexual health and well-being for nearly three decades, including supporting the first Viagra trials in the nineties and running an erectile dysfunction clinic before joining The London Clinic in 2000.

As a woman in a “man’s world” – 99% of the patients she sees are men – Lorraine is passionate about supporting all people with regards to sex and intimacy.

What does a psychosexual nurse specialist do?

The term Psychosexual Nurse Specialist is a useful phrase to bring together the various areas that I’m qualified in. I am a Psychosexual (Sex) Therapist, a Clinical Nurse Specialist (or a senior nurse) and I specialise in managing conditions and disorders relating to sex.

Broadly speaking, I help patients who have identified a sexual problem to manage it both physically and psychologically. It’s unusual to bring these two elements together in my specialty, and I enjoy it immensely.

I see patients for all sorts of reasons, including erectile dysfunction, low desire, vaginismus, painful sex, premature ejaculation and anorgasmia, which is where people find it difficult to reach orgasm.

Sexual problems can arise as a result of medical treatment, such as for cancer, or they can pre-exist before ill health is diagnosed. The brain is a powerful sex organ and can influence how sexual difficulties affect us. It’s my job to help people to lead more satisfying sex lives, whatever that might look like for each individual.

How did you come to specialise in this area? 

I was an Accident and Emergency Sister in the NHS at Barts Hospital specialising in trauma for a number of years before I was introduced to urology.

I returned to clinical practice after maternity leave and was connected to Consultant Urologist Professor Roger Kirby by a mutual friend.

I worked as part of Professor Kirby’s NHS team at Barts and then St George’s Hospital, initially as one of the Clinical Research Sisters. I managed Viagra trials and developed a totally nurse-led Erectile Dysfunction Clinic.

I saw patients referred from primary care as well as from different specialities within the hospital. We then worked in combination at The London Clinic where Professor Kirby was already established as a very highly-regarded Urologist.

Our main focus was prostate cancer. Professor Kirby performed the surgery and I saw patients before and after as the Clinical Nurse Specialist, helping patients with the physical and psychological management of the sexual difficulties that occurred as a consequence of the disease.

This was in the early 90s, when sex was hardly ever talked about, let alone erectile dysfunction, which is often what the focus was on treating. Back then, it was very much about fixing things physically and moving on.

But it’s not just an “erectile problem”, there is a person and sometimes a relationship attached.

My practice was and still is in treating people as individuals, rather than a disease or a problem, and helping them holistically through diagnosis and treatment.

Today, I have my own practice and patients can self-refer or are sometimes referred to me. I am a multi-disciplinary team (MDT) member in Urology and Colorectal at The London Clinic.  

I’m also Treasurer and Trustee for the Sexual Advice Association and a specialist advisor to Prostate Cancer UK and Macmillan.

Ultimately, I want to help people understand the importance of managing their sexual health and well-being. Our psychological well-being is as important as our physical, and ill health can affect both. Each patient has their own specific needs.

How do you work with patients?

The vast majority of patients I see are men – so Movember is the perfect time to talk about my experiences of working with them!

While the pandemic changed accessibility somewhat, video calls have actually been quite beneficial to my work. I need to be visible to patients (rather than on a phone call) in order to build an environment of trust.

People tend to feel more relaxed in their own space, so Zoom has been a great way to connect with patients.

Then, it’s about getting to understand the individual, what they feel the problem is, when did it start, and working out some solutions together.

For men, often just the act of talking, also known as sex therapy, can be hugely transformational. Then there are sexual “treatments” like sex toys, lubricants and other aids.

There are myriad options. I try to get patients as comfortable as possible so we can get to the root of how they’re feeling.

We then create a forward plan, usually a combination of further appointments and treatment options.

Why is sex such a difficult subject for many people? 

Where do you start?

Sex is so well documented, particularly in western culture, through TV, films, pornography, but most of what we see and hear around us isn’t the real deal.

Sex is a very personal experience, and often one of the main problems people struggle with is whether or not the sex they are having is “normal”. Are you performing as you should? Are you young or beautiful enough?

In actuality, there’s no such thing as normal – and the glamorisation of sex just creates ridiculously unattainable expectations from the outset.

This coincides with the fact that across many cultures people are taught not to talk about sex.

So, you have this friction between heightened pressure but not feeling comfortable to talk about your own experiences. It creates a very tense environment for many people.

For men, I have found that sex is a particularly difficult topic, not least because of the pressure on performance, sexual prowess and penis size.

Women are more often brought up to at least talk about periods and contraception, perhaps even menopause, so genitalia encompass more than just the act of sex.

Events like Movember would be a fantastic platform to open up meaningful conversation around sex for men – but then it’s about taking it a step further to talk about it all year round.

What problems does this sense of taboo cause? 

If someone feels unable, or even wrong, to talk about sex, they’re stifling one of the most important parts of sex: communication. It means they can’t be true to themselves or to their partners. It will also prevent people from exploring and expanding their sexual desires.

A good way to think about sexuality is as a spectrum. It changes throughout your life. For instance, after ill health a person’s body might have changed.

There are certain disease areas that have a greater impact on sex, such as diabetes, cancer. If people can’t talk about that, how can they come to terms with and respond to the change?

Interestingly, this extends to clinicians – not all of them are comfortable talking about sex with patients.

This is why it’s important to create access to someone skilled who can have honest, open conversations with patients, giving them permission to talk where they might not have felt it otherwise.

How can we start to move the dial in talking about sex? 

Education is critical, at a much earlier age. I believe children in primary schools should be taught about sex at a level that is appropriate to them. We should be talking about it biologically, physically and psychologically.

Simultaneously, the healthcare experts need to bring sex into day-to-day discussions. For instance, if a patient has surgery on their prostate gland, it is likely to impact their erection and ejaculation.

For anything that is related to the reproductive system or is likely to have an impact on a patient’s sex life, either physically or mentally, then addressing sexual issues needs to be on their care programme.

When should people seek help from a professional? 

If a person feels that there is a problem, it’s worth reaching out to your GP for starters. There can be underlying ill health, especially with erectile dysfunction.

But it’s also that putting things off will mean the problem is likely to get bigger in your mind. It may start impacting your relationships, your work, your mental health. There really is no time like the present.

There are also safe, secure online advice portals, such as the NHS and Sexual Advice Association. It can be unsettling to go down the Google wormhole, so look for authentic information sources that can point you in the right direction.

Any final words?

Everyone deserves to have satisfying experiences – and slowly but surely society is starting to see a shift in how we talk about sex and intimacy. Life and ill health can get in the way, but if it does there is help available.

Disclaimer

Any views expressed in this article are those of the featured specialist(s) and should not be considered to be the views or official policy of The London Clinic.

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