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When illness changes intimacy: Why we need to talk about sex and chronic health
For many people living with illness, the hardest conversations are often the ones that never happen.
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When illness changes intimacy: Why we need to talk about sex and chronic health
For many people living with illness, the hardest conversations are often the ones that never happen.
For many people living with illness, the hardest conversations are often the ones that never happen. While healthcare focuses on symptoms, treatments and recovery, discussions about sex and intimacy are frequently overlooked. Yet these aspects of our lives are deeply connected to our emotional wellbeing, relationships and sense of self.
In this episode of How We Really Feel, Dr Sula Windgassen is joined by two leading UK psychosexual therapists, Kate Moyle and Lorraine Grover, to explore the often-neglected relationship between illness, intimacy and sexual wellbeing.
Kate Moyle, author of The Science of Sex and host of The Sexual Wellness Sessions podcast, brings her expertise in understanding the psychology of sexual health. Alongside her, Lorraine Grover draws on more than 20 years of experience as a nurse and psychosexual therapist, specialising in supporting people living with conditions such as prostate cancer and bladder disorders.
Together, they unpack why anxiety naturally takes priority over arousal, making intimacy particularly challenging when health concerns dominate daily life. They also discuss how cultural expectations about what sex “should” look like can limit our understanding of intimacy and leave many people feeling isolated when illness changes what is physically possible.
The conversation highlights the important distinction between sex and intimacy, explaining why maintaining emotional closeness doesn’t always depend on sexual activity. Listeners will also gain insight into what psychosexual therapy involves, why it’s far less intimidating than many imagine, and practical strategies that can help individuals and couples reconnect.
Whether you’re living with a chronic condition, supporting a partner, or simply interested in understanding the connection between health and relationships, this episode offers compassionate, evidence-based insights. It reminds us that intimacy deserves a place in conversations about healthcare, and that acknowledging it is often the first step towards feeling whole again.
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Lorraine meets Chiara Acquati: Advancing psychosexual care for cancer patients
Lorraine recently had the opportunity to meet Chiara Acquati to discuss psychosexual care for individuals and couples affected by cancer, particularly prostate cancer patients.
Lorraine recently had the opportunity to meet Chiara Acquati, Chair in Clinical Sexual Health at the University of Minnesota Medical School, to discuss psychosexual care for individuals and couples affected by cancer, particularly prostate cancer patients. The conversation explored the challenges, gaps, and opportunities in this often-overlooked area of healthcare.
Chiara explained that sexual health is frequently deprioritised during cancer care. Many healthcare professionals lack training or feel uncomfortable addressing sexual health concerns, and patients are navigating overwhelming decisions about diagnosis, treatment, and side effects. Yet sexual well-being is a critical component of informed treatment decisions, helping patients understand potential impacts on fertility, relationships, and overall quality of life. Early and ongoing conversations with trained specialists can significantly improve patient outcomes.
The discussion highlighted the importance of interdisciplinary, person-centred care. Chiara described her institute’s approach, which brings together psychologists, social workers, family therapists, and physicians to provide comprehensive support. Patients can access tailored programmes addressing relationship and sexual concerns, compulsive sexual behaviour, and gender-related issues. The institute also provides outpatient care, research, training, and community connections, creating a structured system to guide patients through their cancer journey while ensuring trust, safety, and individualised attention.
Lorraine reflected on the UK context, noting that similar specialist support is limited, and emphasised the importance of teamwork to integrate sexual health into cancer care. Both agreed that specialist training and early intervention are crucial, as assumptions about patients’ sexual identity or personal circumstances can prevent meaningful care.
The conversation concluded with a shared perspective: being seen and heard is essential for patients and their partners. By placing sexual health at the centre of cancer care, healthcare providers can help patients make decisions aligned with their values and goals, access appropriate support, and ultimately improve their overall experience. Lorraine left the conversation inspired by Chiara’s expertise and vision, feeling confident that continued collaboration and dialogue in this field can lead to meaningful change.
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We need to be talk more about sexual difficulties!
There are still significant gaps in support for people experiencing sexual difficulties, particularly within medical settings.
Why, even in 2026, is sexual wellbeing still so often absent from conversations around healthcare, treatment, and recovery?
In this episode, I share my perspective as a psychosexual nurse specialist, reflecting on how sexual health extends far beyond physical symptoms. Throughout my career, I’ve seen time and again that sexual difficulties are never purely about the body. These sexual difficulties are deeply connected to a person’s relationships, identity, emotional world, and sense of self.
My work has evolved from a traditional medical model into something much more holistic, grounded in the lived experiences of the people I support. Whether I’m supporting someone experiencing sexual difficulties (whether that’s navigating erectile dysfunction, adjusting after cancer treatment, or coping with body image and intimacy concerns), I’m not simply treating a symptom.
I’m listening to their story, understanding their context, and helping them make sense of what these changes mean in their lives, including the impact of sexual difficulties.
Looking back, my journey in this field has been shaped by a wide range of experiences, from assisting in early clinical trials for treatments like Viagra in the 1990s, to my work in prostate cancer care. These experiences have reinforced my belief that effective care must go beyond prescribing medication. It requires curiosity, compassion, and a willingness to explore the broader picture of a person’s wellbeing.
I also discuss the current medical treatments available for erectile dysfunction and other sexual challenges. But just as importantly, I talk about how I work collaboratively with patients to explore different options, encouraging them to reconnect with their bodies, question assumptions, and redefine what sex and intimacy mean for them personally.
There are still significant gaps in support for people experiencing sexual difficulties, particularly within medical settings. Too much remains unspoken. I believe it’s essential that we continue to challenge this silence and bring sexual wellbeing into the heart of healthcare conversations, where it has always belonged.
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Lorraine meets Professor Zaza: Advancing penile implant care
Lorraine speaks with Professor Zaza about the playful ‘PIMP’ acronym, standing for Penile Implant Interoperative Measurements Planning Chart.
Lorraine meets and discusses her work in the world of sexual health. During a coffee meeting, she had the opportunity to reconnect with Professor Zaza, whom they first met a few years ago during penile implant discussion. This meeting provided the perfect chance to talk about a poster he brought, and Lorraine believes you’ll recognise the name: PIMP Chart.
The term “pimp” here is playful, meaning “to improve,” and PIMP is actually an acronym for Penile Implant Interoperative Measurements Planning Chart. Lorraine highlights how remarkable penile implants are for patients, and Professor Zaza explains the importance of precise measurements both before and after surgery.
He notes that without pre-operative measurements, it’s impossible to objectively address patient concerns, such as complaints about reduced penile length post-operation. By providing a structured table of measurements, the PIMP Chart guides both surgical planning and post-operative assessment. It helps ensure that the implants are tailored accurately, and patients can clearly see their progress. Lorraine emphasises how the chart even allows clinicians to “pimp” the patient’s results, ensuring a robust and satisfying sexual experience.
Professor Zaza shares that the chart has been in use and it has improved communication between surgeons and patients, provided crucial data, and demonstrated why certain implant techniques are superior. He also explains the role of partners during consultations, highlighting the importance of reassuring them that sexual function remains natural and pleasurable.
Lorraine notes the discussion about the cavernosal tissue, explaining to audiences unfamiliar with the anatomy that these two cylinders in the penis are critical for erection and are preserved whenever possible during implant procedures.
Lorraine concludes by expressing her gratitude for the chance to meet with Professor Zaza again, appreciating the inspiring discussion about sexual health.
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Lorraine meets Maurice, they discuss how he underwent a Prostate Cancer clinical trial
Maurice shares that he took part in a clinical trial that involved two years of hormone therapy alongside radiotherapy.
At Mac Live 2026 in Birmingham, Lorraine meets Maurice for the first time and is immediately drawn to his knitting, which Maurice explains has become part of how he copes with the physical and emotional effects of prostate cancer treatment. Maurice shares that he took part in a clinical trial that involved two years of hormone therapy alongside radiotherapy. As part of this, he received painful three-monthly injections into his stomach, delivering hormone-suppressing pellets. Despite the discomfort, he describes the trial as a positive experience, feeling it offered more personalised and closely monitored care.
Maurice explains that he was initially diagnosed with a PSA level of 11.5 and a Gleason score of 3+3, which placed him on active surveillance for 12 months. During this period, regular PSA tests monitored his condition. When his PSA rose and further biopsies revealed more aggressive cancer, his Gleason score increased to 4+4, placing him in a higher-risk category. At that point, his treatment options were limited to surgery or radiotherapy. Due to his age and fitness, he was eligible for a clinical trial involving whole-node radiotherapy, brachytherapy with radioactive pellets, extended radiotherapy sessions, and long-term hormone treatment.
While Maurice found the physical cancer treatments manageable, he describes hormone therapy as the hardest part of his journey. By suppressing testosterone, the treatment caused loss of libido, weight gain, breast growth, hot flushes, and significant emotional challenges. Maurice likens the experience to having his “male side” temporarily switched off, which had a profound psychological impact and raised uncertainty about whether normality would fully return.
Throughout his journey, Maurice remained open and honest with his family, particularly his four children. He believes keeping children informed at every stage is crucial and advises others not to shield them from the truth. Through humour, openness, and storytelling, particularly via the Real Talk platform, Maurice uses his experience to support others. He believes that sharing his journey helps reduce stigma, makes conversations about masculinity and sexuality easier, and ensures his diagnosis serves a meaningful purpose by helping others navigate their own cancer journeys.
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Lorraine meets with Henderson, Mental Health First Aider
In this conversation, Lorraine speaks with Henderson about his role as a Mental Health First Aider, a title she finds both unfamiliar and enlightening.
In this conversation, Lorraine speaks with Henderson about his role as a Mental Health First Aider, a title she finds both unfamiliar and enlightening. Drawing on her own background in physical first aid through the Red Cross, Lorraine reflects on how those skills stayed with her for life, and Henderson explains that Mental Health First Aid works in a very similar way. Rather than treating physical injuries, it focuses on recognising signs of emotional or psychological distress and offering timely, appropriate support.
Henderson explains that Mental Health First Aid is about noticing when someone’s behaviour seems out of character or “out of sync” and creating a safe, non-threatening space to talk. The role is not about diagnosing or fixing problems, but about listening, understanding, and signposting people to professional or community-based support when they may be experiencing issues such as anxiety, depression, or crisis. A key part of the role is knowing how to respond calmly and compassionately, without judgement.
He introduces the Mental Health First Aid acronym “ALGEE,” which provides a structured approach. “A” stands for approach, assess, and assist in a crisis. “L” means listen and communicate non-judgementally. “G” refers to giving reassurance, support, and relevant information. The first “E” encourages the person to seek appropriate professional help, while the final “E” focuses on encouraging other forms of support, recognising that practical barriers such as cost, location, or accessibility may exist. Having multiple support options is therefore important.
The discussion also explores how people become Mental Health First Aiders and how others can identify them. Henderson explains that training is available through Mental Health UK and delivered by accredited practitioners over several days. Many organisations formally designate Mental Health First Aiders, similar to safeguarding officers, making them visible points of contact within workplaces or colleges.
As a freelance consultant who delivers workshops, Henderson incorporates his Mental Health First Aid training naturally into his work. Rather than announcing the role, he uses the skills to recognise concerns and initiate supportive conversations when needed, adding an important layer of care, awareness, and responsibility to his professional practice.
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Lorraine meets 2 brothers, both diagnosed with prostate cancer
This conversation takes place at Macmillan Live 2026 as part of the Real Talk storytelling series, where Paul and Wayne, two brothers, share their powerful lived experiences of prostate cancer.
This conversation takes place at Macmillan Live 2026 as part of the Real Talk storytelling series, where Paul and Wayne, two brothers, share their powerful lived experiences of prostate cancer. Paul explains that both he and Wayne were diagnosed in 2019, a moment that profoundly changed their lives and led them into advocacy work. Paul is now Chief Executive of Cancer Black Care, a charity dedicated to supporting Black people and people of colour through cancer, with the aim of improving outcomes, experiences, and trust in healthcare systems.
The brothers use humour to tell their story, which they describe as cathartic and a way of connecting honestly with audiences. Wayne shares that, unlike Paul, he initially chose not to follow conventional medical advice. Influenced by online information and holistic approaches, he delayed treatment for three years due to fear, uncertainty, cultural beliefs, and a lack of trust in the healthcare system. He explains that it was difficult to believe in a process where he could not see himself reflected, culturally or socially, in the messaging or professionals delivering care. Eventually, Wayne underwent surgery and was fortunate that his cancer had not spread, recognising how easily the outcome could have been very different.
Their story is shaped by wider family trauma. In the same period, their sister was diagnosed with breast cancer, and in 2021 their father died from prostate cancer. The brothers highlight how the absence of symptoms made diagnosis hard to accept and fuelled distrust, especially given historical and ongoing inequalities faced by Black communities within healthcare.
Paul explains that his own cancer was detected only because he challenged his GP and insisted on testing after seeing an NHS advert. This experience motivated his advocacy work. Both brothers stress the importance of regular check-ups, PSA testing, and early detection, particularly for Black men, who face higher prostate cancer risk. They end by urging men to seek medical advice even without symptoms and to believe that life, health, and joy are possible after cancer.
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From early viagra trials to oncology care: Why communication matters
A candid discussion on communication, patient honesty, and unexpected clinical moments shaping compassionate oncology care.
In this episode of Rad Chat, I join the team from Oncology Professional Care for an open and engaging discussion about communication, confidence and the very human realities of cancer care. We start light-heartedly, touching on holidays, Disney magic and my ever-growing “box of tricks” (something I believe every clinic should have) before moving into much deeper territory.
Drawing on my nursing background as a former casualty sister, I reflect on how crucial honest, compassionate conversations are with patients, particularly around topics that are often avoided or minimised. I share my unique experience of being involved in the early clinical trials of what later became known as Viagra, long before it was a household name. What began as a blue tablet with a complex compound name quickly became a catalyst for patients opening up about sexual health, intimacy and the impact of treatment on their lives.
This conversation highlights how unexpected moments in clinical practice can shape a career, and how listening properly to patients can change the way we care for them. It’s a candid, warm and informative discussion that underlines why communication matters just as much as clinical expertise, and why creating safe spaces for difficult conversations is essential in oncology care.
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Lorraine meets Anderson the barber at Macmillan Live
The conversation takes place at a Macmillan event in Birmingham, where Lorraine interviews Anderson, a barber whose work has become deeply connected to men’s health and wellbeing.
The conversation takes place at a Macmillan Live event in Birmingham in 2026, where Lorraine interviews Anderson, a barber whose work has become deeply connected to men’s health and wellbeing. Lorraine explains that meeting Anderson feels like a “dream come true” for her, as she has long believed in the power of barber shops as safe spaces for men to talk openly. Anderson confirms that barbering has been part of his life for over 20 years and that his work has evolved far beyond haircuts.
Initially, Anderson and his team focused on helping clients feel good through grooming, then expanded into training and education by delivering apprenticeships, NVQs, and study programmes in barbering. However, the area where they believe they have made the greatest impact is in encouraging men to talk openly about health, particularly issues often surrounded by stigma. Anderson explains that when the environment, energy, and relationships are right, men feel relaxed and comfortable in the barber shop and often open up naturally.
Recognising this, Anderson saw the barber shop as an ideal place to start conversations about healthcare. This insight led to a partnership with Macmillan, which has lasted for five or six years. Together, they work to break down taboos around cancer and other health issues, helping normalise conversations that men may otherwise avoid with healthcare professionals.
The discussion highlights how men often feel barriers when speaking to doctors or specialists, particularly about emotional wellbeing, masculinity, finances, family pressures, or sexual health. In contrast, the trusted relationship between barber and client removes many of these barriers. Lorraine relates this to her own experience in healthcare, noting how men often open up more in confidential, informal settings.
They also discuss the symbolism of uniforms, with Anderson arguing that barbers hold an important, respected position in the community and should present themselves accordingly. The conversation ends with mutual appreciation, celebrating the value both bring to communities by creating safe spaces, building trust, and adding “droplets of value” through meaningful human connection.
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Open conversation about sex: Orgasm facts and misconceptions
Lorraine Grover clarifies sexual health misconceptions, explains orgasm types, and encourages open, informed conversations about intimacy.
In a lighthearted yet insightful moment on The Hot Hits Podcast, we were discussing some of the misconceptions and curiosities around sexual health, and I found myself clarifying a common mix-up in terminology. Someone had been using the word “ejaculated” incorrectly when referring to something being “ejected,” and I couldn’t help but laugh at how easily these terms get confused. It’s a small thing, but language matters, especially when talking about sex, intimacy, and the body: topics that people are often embarrassed to explore.
We also touched on the concept of orgasm, and I shared an interesting fact: a man can experience six different types of orgasm, each triggered in slightly different ways. I emphasised that not everyone will achieve every type, and that’s entirely normal. My goal as a psychosexual therapist and nurse specialist is always to normalise these conversations and provide clarity.
Moments like these, mixing humour with education, highlight why open discussions about sexual health are so important. Correct language, accurate information, and gentle guidance can empower people to understand their bodies better, explore intimacy safely, and remove the shame often surrounding sexual experiences.
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When pain changes everything: Listening to your body and speaking up about your health
I reflect on a meaningful reunion with my close friend Anna, a physiotherapist I first met in November 2022 following major spinal surgery.
I reflect on a meaningful reunion with my close friend Anna, a physiotherapist I first met in November 2022 following major spinal surgery. Our connection began during a deeply vulnerable time, just days after I had a spinal meningioma removed, leaving me flat in bed, attached to drips and a catheter, and coming to terms with how quickly independence can be taken away. Despite us both being healthcare professionals, I describe how being a patient strips you of confidence and certainty, replacing knowledge with vulnerability and self-doubt.
A key part of our conversation centres on how easily symptoms, such as numbness, back pain, or changes in sensation, can be dismissed, especially by women. I share how I doubted myself, questioning whether my symptoms were “serious enough” to seek help. This delay is something many women recognise, often fearing they won’t be listened to. Anna highlights important red flags, such as progressive loss of sensation, reinforcing the need to trust our instincts and act early.
We also touch on an often-ignored topic: sexual wellbeing after spinal surgery. I speak candidly about how pain, neurological changes, and fear can affect interest in sex, and how little this is discussed in clinical settings. Being told vaguely that “sexual difficulties may occur” is not the same as having open, supportive conversations. Pain, discomfort, and altered sensation can profoundly affect desire, confidence, and intimacy, yet patients are rarely given space to talk about this.
Together, we emphasise the importance of listening to our bodies, believing our experiences, and not being afraid to speak openly with healthcare professionals. Our ongoing friendship is rooted in shared passion for patient care, advocacy, and ensuring that people, especially women, feel heard, informed, and supported in every aspect of their health.
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How can men with prostate cancer be supported in their sexual identity and relationships?
An honest discussion on sexuality, identity and relationships after prostate cancer, offering expert insight and compassionate support for men and partners.
In this episode of On Focus, I join Clare Delmar to talk openly about one of the most overlooked consequences of prostate cancer: the impact it can have on sexuality, sexual identity and relationships. Prostate cancer is now the most commonly diagnosed cancer in the UK, yet conversations about intimacy, confidence and connection are still too often avoided.
Drawing on my 25 years’ experience as a psychosexual nurse specialist, I share how sexual difficulties following prostate cancer treatment can arise from both physical and psychological causes. These changes don’t just affect sexual function; they can influence how men see themselves, how they relate to their partners, and how confident they feel in their relationships.
We explore why sexual wellbeing should be considered a core part of cancer care, not an optional extra, and why involving partners wherever possible can be so important. I also discuss the importance of moving beyond a purely medical model, helping men find ways to redefine intimacy and maintain meaningful connections after treatment.
This conversation is about normalising difficult discussions, challenging stigma, and offering reassurance that support is available. My hope is that this episode encourages men, partners and professionals to open up conversations that can make a real difference to quality of life after prostate cancer.
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Sexual health in the context of cancer
In this episode of the Simply Oncology podcast, hosts Mike and John tackle an important but often avoided subject: sexual health in the context of cancer.
In this episode of the Simply Oncology podcast, hosts Mike and John tackle an important but often avoided subject: sexual health in the context of cancer. They open with humour and honesty, acknowledging how uncomfortable many clinicians feel when discussing sex, despite it being a natural and significant part of patients’ lives. They admit that although sexual wellbeing is frequently affected by cancer and its treatments, it’s a topic rarely brought up in clinic.
I join them as their guest, a psychosexual nurse specialist based in London, to help open up this conversation and break down the barriers that so many healthcare professionals face. Mike admits openly that he struggles to raise sexual concerns with patients, and I reassure him that he’s not alone. I share that when I first started in this field, I too felt embarrassed, awkward and unsure. Those feelings are normal, but they shouldn’t stop clinicians from offering support.
Together, we highlight the importance of discussing sexual health early and compassionately, giving patients permission to talk about something that deeply affects their quality of life. The episode encourages clinicians to feel more confident, informed and proactive, reminding them that even small conversations can make a profound difference.
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Eating a Danish with a very special Dane
Life after cancer surgery affects intimacy, bowel health and confidence. Surgeon Soren shares honest insights on sexual well-being and personalised patient support.
In this candid Travel Talk episode, I sit down over coffee and a Danish with Professor Soren Laurberg, an experienced Danish cancer surgeon, at the European Colorectal Congress in St. Gallen, Switzerland.
Soren brings decades of expertise in colorectal and pelvic cancer surgery, and together we explore the often-overlooked topic of life after cancer treatment, particularly how surgery affects intimacy, sexual function, and everyday confidence.
He reflects on how far cancer care has come: once focused solely on survival, modern practice now centres on long-term quality of life. Soren explains how his former hospital transformed follow-up care by replacing routine consultant appointments with highly trained specialist nurses who patients can call directly. Their system achieves an impressive 90% response rate to follow-up questionnaires, helping teams identify everything from chronic pain and bladder or bowel issues to the deeply personal topic of sexual well-being.
We also tackle taboos around faecal incontinence, urgency, and the isolation many patients experience. Soren highlights the power of patient advocates who share their stories publicly, helping others feel less alone.
This conversation shines a light on why clinicians must initiate sensitive discussions, and why personalised support matters.
Join us for an honest, compassionate talk that every healthcare professional should hear.
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