Questions about sex and health

Reader questions about sex, relationships, and health answered by experts: case analyses, anatomy, potency, contraception.

A few months have passed since giving birth, and I have no desire for sex at all. Is this normal or should I see a doctor?

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According to the data, this is a very common situation: in a study of postpartum women, 56% of participants reported a decrease in desire. At the same time, age, mode of delivery, and number of children did not influence this—but there was a connection with low self-esteem, arousal problems, and overall deterioration in sexual function. So it's not that you are 'broken,' and it's not just fatigue as the sole cause. Since this is only a snapshot from a small study, it does not prove causality, b...

I'm fat, gay, trans, and possibly autistic — how do I even meet anyone if I don't fit the ideals of the gay scene?

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You're not alone in this: narrow standards of appearance and identity are indeed often imposed in queer spaces, and the feeling of not fitting into that grid is familiar to many. If a person takes the initiative and keeps showing up, they're most likely genuinely interested — you can take the risk and ask them out somewhere, keeping in mind that regretting what you didn't try hurts more than enduring awkwardness. Try body-positive events: there you can see that the world is full of different bo...

I have a friend who considers himself an LGBTQ+ ally, but he tells others about my orientation without asking, flirts even though I find it unpleasant, and sends explicit queer content. How do I know when it's time to set boundaries, and what should I do if talking doesn't help?

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It seems you've found yourself in the role of a "token friend": when your identity becomes a way for someone else to assert themselves, rather than part of your personality. The warning signs are that he ignores your boundaries, makes inappropriate remarks, and behaves as if you were his personal trophy. The most honest approach is a direct conversation: tell him that you find it unpleasant when he oversteps, and ask him not to tell others about your orientation or send explicit videos. If your...

I am constantly dissatisfied with my body, even when I look athletic, and because of this, problems in bed have appeared. Is this somehow related?

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According to research, there is indeed a connection: the stronger the symptoms of muscle dysmorphia, the more often men complain of sexual difficulties—reduced desire, problems with arousal and erection, anxiety during sex, and even pain. Moreover, the strongest correlation was specifically with 'appearance intolerance'—when a person literally cannot accept their body, rather than the fanaticism in the gym itself. This does not mean that bodybuilding 'kills' libido: the study shows only a corre...

My husband had prostate cancer, and our intimacy has almost disappeared. I feel guilty that I miss it. Tell me, is it normal to worry about sex when the main thing is that he survived?

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The fact that you are worried about the lack of intimacy is normal and very common. According to a study, wives of men who had prostate cancer reported the absence of an intimate life almost twice as often, and dissatisfaction 1.8 times more often, than women without such experience, while their own needs were almost no different. The men themselves after the diagnosis were twice as likely to report that they did not have sexual intercourse at all, and almost six times more likely to experience...

I grew up in a strict religious family, where sex is only for children and "marital duty". After giving birth, sex is painful for me, and I feel guilty if I refuse my husband. How can I stop seeing this as a punishment, and is it even possible to change anything?

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Based on your description, you are experiencing several things at once that researchers call key points for revising beliefs: a changed body, pain during sex, and a conversation with your husband. In such research, women reported that pain was often perceived as retribution or something that "must be endured for the husband's sake," but when they managed to talk to a doctor and get an explanation—for example, about lack of lubrication or hormonal changes—their attitude toward sex changed. This ...

I have restless legs syndrome, and lately my erections have gotten worse. Could this be related somehow or just a coincidence?

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According to a review involving more than 33,000 people, men with restless legs syndrome have erectile dysfunction about 70% more often than those without the syndrome. Moreover, the association is seen primarily with severe forms: they occurred several times more often, while mild and moderate problems were distributed about equally in both groups. This is still a statistical association, not proof that restless legs directly worsen erections: there may be common causes — vascular problems, ir...

After experiencing violence, I am afraid of any gynecological procedures — how can I make myself go and what should I ask the doctor?

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You are not obligated to conform to anyone's ideas about how to "properly" cope with trauma: some people go to a psychologist, others choose a medical procedure — all these paths are about reclaiming control. If you decide to go through with the procedure, look for a doctor who works with people with traumatic experiences, and ask in advance whether the procedure can be stopped, what pain relief options are available, and whether they are ready to maintain an ongoing dialogue about consent. As ...

Erection pills don't work for me — should I try a gel without a prescription?

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The gel may indeed be an option if pills don't work, cause side effects, or if taking them is uncomfortable — it's also worth considering for those who want to avoid systemic effects on the body. It is applied topically to the skin, absorbs quickly, helps achieve an erection naturally, and is also convenient for spontaneous situations when you don't want to plan taking it in advance. However, experts emphasize: it is still unclear how effective the gel is in different groups of men (young, elde...

I have an enlarged prostate, surgery is coming soon — is it realistic to preserve erection and normal orgasm, and not get 'dry'? What is this blue laser that people talk about?

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The blue laser with a wavelength of 450 nm is a technique in which prostate tissue is evaporated point by point, with minimal impact on the nerves and vessels responsible for erection and ejaculation. In a Chinese study of 105 sexually active men with an average age of 63, one year after this surgery, erection scores on the IIEF-5 scale did not change (18 and 18 points), no one faced new problems with erection or incontinence. The ability to ejaculate was preserved in 97%, although semen volume...