What to say at an NHS sexual health clinic

Going to an NHS sexual health clinic (also called a GUM clinic) about a change since starting a medicine? Start by saying you’re there about a side effect, not an infection. Then name the medicine, when you took it, what changed, and whether it carried on after you stopped.

When sexual problems last after stopping, patients have names for it: post-SSRI sexual dysfunction (PSSD) after an SSRI antidepressant such as sertraline, post-finasteride syndrome (PFS) after the hair loss tablet finasteride, and post-Accutane syndrome (PAS) after the acne medicine isotretinoin.

Say it first, or the visit can turn into a routine STI check. And because the visit is confidential, your GP won’t hear about it unless you ask.

Katie was 21 when she was prescribed the antidepressant fluoxetine (Prozac). When she later described the changes, one health professional told her to look into whether she might be asexual, she says.

Play video: Katie on being told she might be asexual (Moral Medicine, extract)

She remembers having sexual feelings before the medicine. “It’s a medical problem,” she says. “It’s not a sexual orientation.”

Not every clinic can help with this, so check first.

Can a sexual health clinic help with side effects?

Sometimes. If erection problems keep happening, the NHS says to see a GP or go to a sexual health clinic, and that clinics can give the same treatment you’d get at your GP surgery.

But clinics are set up mainly for STI tests, contraception and pregnancy tests, and the NHS list of what they offer doesn’t mention erection problems. Sexual Health Hertfordshire, for one, sends people with erection problems to a hospital urology department, the doctors who treat the bladder and penis.

So find a clinic with the NHS clinic finder (for England), then check its website or call before you go. For a low sex drive, the NHS says to see a GP if you think a medicine is affecting it.

If a clinic can’t help, ask where to go next. If you’re thinking about a sex therapist, our page on finding a therapist covers what to ask.

What should I say when I get there?

Four short lines will do.

1

Why you're here

“I'm not here about an infection. I think a medicine has changed things for me sexually.”

2

The medicine and dates

“Finasteride 1 mg, bought online, from March 2023 to January 2024.”

3

What changed, in plain words

“My genitals feel numb, and orgasm has hardly any pleasure.”

4

Before, and since

“I had none of this before. It hasn't gone since I stopped.”

The last line is the one that points to the medicine. It shows the problem began with it and didn’t stop when you did. Without it, as Katie found, people may look for other explanations. Have your leaflet on your phone too: the ones linked near the top all mention problems that carried on after stopping.

None of the three is only about sex. A checklist doctors and researchers proposed in 2022 lists feeling emotionally numb and problems with concentration and memory among the possible signs of PSSD. For finasteride and isotretinoin, it adds that depression can come too, even without any sexual problems.

Mention changes beyond sex, such as feeling emotionally flat or finding it hard to concentrate. Seeing your GP instead? Our guide for when you’re embarrassed to tell your GP covers that conversation.

If the nurse hasn’t heard of PSSD, this short film may help. In it, a specialist from a group for sexual health professionals explains what PSSD is. Treat it as background, nothing more.

Play video: What is post SSRI syndrome and how is it treated?

What will they ask me?

Expect questions about your sex life. The NHS says staff will ask about your medical and sexual history: when you last had sex, whether it was unprotected, and any symptoms. Doctors and nurses are there to help you, it adds, so try not to feel uncomfortable talking about sex or your sexuality.

For erection problems, the NHS says the doctor or nurse may also ask about your lifestyle and relationships, check your blood pressure and examine your genitals.

You can ask for a female or male nurse or doctor, though you might wait longer for one. And you don’t have to give your real name.

Will the clinic tell my GP?

No, not without your permission, the NHS says. The one exception: if staff think someone is at risk of harm, they may need to tell other services, but they’ll talk to you first.

That privacy has a flip side. If the side effect never reaches your GP record, the doctor who prescribed the medicine may never hear about it. The clinic tells your GP about your visit only if you ask, the NHS says. So if you want it on your record, give your real name and GP surgery, and ask the clinic to write to your GP.

If you bought the medicine online or privately, say where it came from. To see which medicines your GP record already shows, use our guide to your prescription history.

Not sure who to see next? We have guides for PSSD, PFS and PAS.

These medicines help many people. If side effects make you think about changing a medicine, that’s a decision for you and your prescriber. Don’t stop an antidepressant suddenly. Our pages on PSSD, PFS and PAS explain each condition.

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US.
• Use the right words. If symptoms continued after stopping, write Post-SSRI sexual dysfunction (MedDRA 10086208) for an antidepressant, or Post 5-alpha-reductase inhibitor syndrome (MedDRA 10082430) for finasteride. PAS has no term yet, so say the symptoms continued after stopping isotretinoin.

Our reporting guide walks you through it

What else do people ask?

Do I need an appointment? Not usually. The NHS says you don’t normally need a GP referral or an appointment, and many clinics take walk-ins.

Can I go if I’m a woman? Yes. Clinics are open to everyone, whatever your gender or sexuality, the NHS says. The isotretinoin leaflet lists vaginal dryness, orgasm difficulties and reduced sensation in the genitals among its sexual side effects. Our page on PSSD in women covers what women describe.

Can the clinic report it for me? You can ask, but you don’t need them to. Anyone can report a problem with a medicine to the Yellow Card scheme, the UK regulator says, and you don’t need a doctor to agree.

Katie had to explain that the change was a medical problem. Put your four lines in your phone before you go. Then you can say it first.

Sources

1. NHS, Find a sexual health clinic, page last reviewed 31 July 2024, next review due 31 July 2027 (England). “Sexual health clinics are free and available to everyone, no matter your age, gender, ethnicity or sexuality.” “They may be called genitourinary medicine (GUM), or sexual and reproductive health clinics”. Services listed: STI tests and treatment, contraception, pregnancy testing, abortion advice, PrEP and PEP, hepatitis and HPV vaccinations, help after rape or sexual assault. “Staff at a sexual health clinic will not tell anyone what you discuss without your permission. This includes your GP.” If staff think someone is at risk of harm “they may need to tell other healthcare services. But they will not do this without talking to you first.” A female or male nurse or doctor; a friend, family member or other member of staff in the room during tests or examinations.
2. NHS, Visiting a sexual health clinic, page last reviewed 22 February 2023, next review due 22 February 2026, still not re-reviewed when we read it on 28 October 2026 (England). Used only where the newer pages above and below don’t cover the point. Staff “will ask you about your medical and sexual history”: when you last had sex, whether you’ve had unprotected sex, whether you have any symptoms. “You don’t have to give your real name if you don’t want to.” A female or male doctor or nurse “but you might have to wait longer than usual”.
3. NHS, Sexually transmitted infections (STIs), page last reviewed 13 May 2024, next review due 13 May 2027 (England). The doctor or nurse “will ask you about your sex life”. Doctors and healthcare professionals “are there to help you, so try not to feel uncomfortable about sharing information about your sexual activities or sexuality”. “You do not usually need a GP referral or an appointment for a sexual health clinic, but contact the clinic first to check”. On the GP: “No information about your visit to the clinic will be shared with the GP or anyone else outside the clinic unless you ask for it to be”.
4. NHS, Erectile dysfunction (impotence), page last reviewed 28 July 2023, next review due 28 July 2026, still not re-reviewed when we read it on 28 October 2026 (England). “See a GP or go to a sexual health clinic if: erection problems keep happening.” Clinics “can provide the same treatment you would get at your GP surgery”; “Many sexual health clinics offer a walk-in service”. At the appointment the doctor or nurse may ask about lifestyle and relationships, do basic checks such as blood pressure, and examine the genitals.
5. NHS, Low sex drive (loss of libido), page last reviewed 26 May 2026 (England). “See a GP if: you’re taking a medicine or using hormonal contraception and you think it may be affecting your sex drive.”
6. Sexual Health Hertfordshire (Central London Community Healthcare NHS Trust), Psychosexual support, undated page, read 28 October 2026. “Erectile dysfunction clinics are not a specialist service provided by Sexual Health Hertfordshire. For medical assessment and treatment of erectile dysfunction including complex or unresponsive cases, refer to your local Urology department.” One service, cited as an example of how services differ.
7. Lustral (sertraline) 50 mg and 100 mg film-coated tablets, patient leaflet, Electronic Medicines Compendium, last revised December 2025. Section 2, “Sexual problems”: “In some cases, these symptoms have continued after stopping treatment.”
8. Propecia (finasteride) 1 mg film-coated tablets, patient leaflet, Electronic Medicines Compendium, last revised May 2026. Section 4, frequency not known: “persistent difficulty having an erection after discontinuation of treatment”, “persistent decrease in sex drive after discontinuation of treatment”.
9. Roaccutane (isotretinoin) 10 mg and 20 mg soft capsules, patient leaflet, Electronic Medicines Compendium, last revised April 2026. Section 2: sexual problems include “problems getting or maintaining an erection, lower libido, vaginal dryness, orgasm difficulties and reduced sensation in the genitals. There have been reports of long-lasting sexual problems where the symptoms have continued despite stopping treatment with isotretinoin.”
10. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Proposed criteria. PSSD: ancillary non-sexual symptoms “may include: emotional numbing”, “depersonalization”, “other sensory problems” and “cognitive impairment”. Finasteride and isotretinoin: effects “that can occur independently of any sexual difficulties” include cognitive impairment and depression.
11. Medicines and Healthcare products Regulatory Agency, Yellow Card scheme: “Anyone can report an issue with a medicine”. MHRA, The Yellow Card scheme: guidance for healthcare professionals, patients and the public, last updated 24 July 2025: “only a suspicion is needed”. MedDRA terms as in apps/web/src/data/meddra.ts.
12. Moral Medicine, I Lost My Sexual Identity After Prozac, interview with Katie, May 2026. Prescribed fluoxetine at 21 (0:40 to 0:45). Extract 5:46 to 6:23: “one health professional even told me to look into asexuality and consider that I might be asexual” (5:49 to 5:54); “it’s a medical problem. Um it’s not a sexual orientation” (6:18 to 6:23). Quotes from YouTube’s automatic captions, with “um” removed.
13. ISSM International Society for Sexual Medicine, What is post SSRI syndrome and how is it treated?, video, 5 May 2023. Cobi Reisman, urologist and sexologist in the Netherlands, lists the signs of PSSD from 0:37. Embedded to stop at 1:34. ISSM says the speakers give their own views. Used as background, not as evidence for any point in this article.

Sources checked on 28 October 2026. AI-assisted writing and review, not clinical review.