When Illness Changes Your Sex Life, But Your Clinician Won't Talk About it

Here's something that comes up again and again in this episode: sexual dysfunction and chronic illness travel together constantly. Through cancer diagnoses, pelvic conditions, hormonal changes, prostate treatment, recurrent infections and more. And yet in most clinical settings, the subject never comes up at all.

Not once. Not even as a footnote.

The Silence That Does Its Own Damage

Lorraine Grover, nurse and psychosexual therapist with over 20 years of experience, knows this from both sides of the consultation room. Following her own spinal surgery in 2022, she found herself as the patient. Despite the known risk of sexual dysfunction having been flagged pre-operatively, nothing was mentioned afterwards. Not on the ward round. Not at discharge. Not at all.

"The word sexual dysfunction had been mentioned once, nothing post. And this was in 2022." ~ Lorraine Grover

That silence isn't neutral. For patients, the absence of a conversation sends its own message: that this isn't something worth bringing up, that others aren't dealing with it, that it's probably just them.

"If it hasn't been brought up by a healthcare professional, it doesn't give the patient permission to bring it up at any point." ~ Kate Moyle

Why People Don't Ask

Sexual dysfunction and chronic illness can intersect physically, emotionally, and relationally. People who have been through serious illness often describe feeling that surviving should be enough. Asking about sex on top of everything else can feel greedy, trivial, or simply too much to put on the table.

The mind-body-sexuality connection makes this even more layered. Illness doesn't just affect the body, it changes how safe the body feels, how trustworthy it seems, and how easy it is to access pleasure when the nervous system has been in a prolonged state of threat. The anxiety-arousal conflict is real, and illness tips that balance in ways that can persist long after treatment ends.

The Partner Nobody Asks About

One of the most striking observations in this episode comes from Lorraine's clinical practice. When she asks the partners of patients about their own experience, they often look surprised…Nobody had thought to ask them before. The patient's partner may be managing their own health challenges, their own grief about the relationship changes, their own confusion, meanwhile the medical model has rendered them completely invisible.

"They usually look at me in surprise because they're in a medical model, the doctors ask about the patient only." ~ Lorraine Grover

What Healthcare Professionals Can Do

Psychosexual therapy can't be offered by every clinician, and nobody is suggesting it should be. But asking one question (for example, does anything feel different in this area of your life?) opens a door that patients often can't open themselves. A single signpost to a relevant resource can be enough. The barrier isn't always time or training. Sometimes it's just the assumption that someone else will bring it up, even though unfortunately, no one does.

Listen to the full conversation with Kate Moyle and Lorraine Grover to understand what better support looks like  and what becomes possible when healthcare professionals decide this conversation is worth having.

Resources and research discussed here