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Published: 11:15 BST, 19 January 2022 | Updated: 11:55 BST, 19 January 2022
A doctor has appeared in court accused of depositing his semen in a cup of tea he gave to a woman.
Dr Nicholas John Chapman, 54, who is currently suspended from his post at the 4,000-patient North Curry Health Centre, in Taunton, denies the allegation.
The details of the case against him were outlined during a 40-minute hearing at Taunton Magistrates’ Court in Somerset.
Dr Chapman, of Kingston St Mary, Somerset, is charged with attempting to cause a woman aged 16 or over to engage in sexual activity (no penetration) without her consent on September 13 last year.
Dr Nicholas John Chapman (pictured), 54, is charged with attempting to cause a woman aged 16 or over to engage in sexual activity (no penetration) without her consent on September 13 last year. Defence lawyer Nigel Yeo said Dr Chapman denies the allegation
Giles Tippett, prosecuting, told the two magistrates overseeing the hearing that the victim discovered a substance at the bottom of her cup when she finished the drink, which she said had been given to her by the defendant.
Mr Tippett said the incident was reported to police three days later.
Nigel Yeo, defending, said his client’s response to the charge is 'a straightforward denial'.
Dr Chapman will face a plea and trial preparation hearing at Taunton Crown Court (pictured) next month after electing to be tried in front of a judge and jury
Dr Chapman was born in South Africa, where he qualified as a doctor at the University of Cape Town in 1993.
He was given the chance to defend himself at a trial in the magistrates’ court but elected to be tried in front of a judge and jury at Taunton Crown Court, where he will face a plea and trial preparation hearing on Monday, February 21.
He was released on conditional bail, including an order not to contact any named witnesses, by chairman of the bench Valerie Castell.
Nigel Yeo, defending, said all of Dr Chapman's 'community ties' are in the UK, where he lives with his partner and part time with a child.
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Published by Associated Newspapers Ltd
Part of the Daily Mail, The Mail on Sunday & Metro Media Group

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... Few studies have been conducted exploring sexual dysfunction (SD) in chronic kidney disease (CKD) despite its high incidence; up to 75% of dialyzing men report erectile dysfunction (ED), while 30-80% of women report sexual symptoms [1]. The impact of SD on quality of life (QOL) is well recognized and is associated with low self-esteem and confidence and higher rates of anxiety and depression [2] . As advances in dialysis therapy decrease mortality in CKD and end-stage renal disease (ESRD), the identification and the management of SD in both men and women remain under significant scrutiny as we seek to achieve as "normal" a life as possible for individuals who receive dialysis. ...
... It has been accepted for some time that the somatic mechanisms described above do not adequately explain the high rate of SD in male and female patients with CKD and/or RRT [1,73,74]. It is now well established that SD is a major determinant of life quality and is associated with anxiety, depression, social withdrawal, and loss of self-confidence and self-esteem [2] . However, compared to men, the clinical research and investigation of SD in women on different RRT modalities is lacking [75,76]. ...
... However, compared to men, the clinical research and investigation of SD in women on different RRT modalities is lacking [75,76]. Furthermore, the lack of clear definition of female SD has resulted in inconsistencies in the literature [2] , and we begin with a brief comment below. ...
Patient survival continues to increase with the growing quality of dialysis and management of chronic kidney disease (CKD). As such, chronic therapy must include considerations of quality of life (QOL), and this includes the disproportionate prevalence of sexual dysfunction (SD) in this patient population. This review aims to describe the pathophysiological and the psychosocial causes of SD with regard to renal replacement therapy, particularly hemo- and peritoneal dialysis. The differences in its manifestation in men and women are compared, including hormonal imbalances—and therefore fertility, libido, and sexual satisfaction—the experience of depression and anxiety, and QOL. The impact of comorbidities and the iatrogenic causes of SD are described. This review also presents validated scales for screening and diagnosis of SD in CKD patients and outlines novel therapies and strategies for the effective management of SD. Increased prevalence of CKD invariably increases the number of patients with SD, and it is crucial for health care professional teams to become familiar with the clinical tools used to manage this sensitive and under-quantified field. As a known predictor of QOL, sexual function should become a point of focus in the pursuit of patient-centered care, particularly as we seek to achieve as “normal” a life as possible for individuals who receive dialysis.
... The prevalence of sexual dysfunction in women with ESKD is high and caused by different factors as loss of libido, failure of vaginal lubrification, and orgasmic impairment [34] . A review on sexual dysfunction in ESKD women identified a significant sexual dysfunction in 306 subjects [4]. ...
... Too few studies have been made to allow their safe use in pregnancy [34, 97]. There is a need to obtain further evidence. ...
Sexual life and fertility are compromised in end stage kidney disease both in men and in women. Successful renal transplantation may rapidly recover fertility in the vast majority of patients. Pregnancy modifies anatomical and functional aspects in the kidney and represents a risk of sensitization that may cause acute rejection. Independently from the risks for the graft, pregnancy in kidney transplant may cause preeclampsia, gestational diabetes, preterm delivery, and low birth weight. The nephrologist has a fundamental role in correct counseling, in a correct evaluation of the mother conditions, and in establishing a correct time lapse between transplantation and conception. Additionally, careful attention must be given to the antirejection therapy, avoiding drugs that could be dangerous to the newborn. Due to the possibility of medical complications during pregnancy, a correct follow-up should be exerted. Even if pregnancy in transplant is considered a high risk one, several data and studies document that in the majority of patients, the long-term follow-up and outcomes for the graft may be similar to that of non-pregnant women.
... Some of the negative effects of sexual dysfunction on quality of life include: anxiety, low self-esteem and self-confidence, depression, and social issues. Lack of awareness of sexual dysfunction among women with chronic renal failure, and feelings of shame they experience when talking about it are seen as important negative factors affecting quality of life (Holley & Schmidt, 2010) . Patient sexual health and psychological wellbeing are important topics to address in nursing practice. ...
... Sexual problems in women with hemodialysis negatively affect quality of life (Peng et al., 2005). Lack of awareness of sexual dysfunction among women with chronic renal failure, and the shame they experience when talking about sexual dysfunction are seen as important negative factors affecting quality of life (Holley & Schmidt, 2010) . The mean age of the studied women was 34.3 (± 5.9) years with a range of 28-45 years. ...
... Some forms of negative impact of sexual dysfunction on the different quality of life domains are the presence of anxiety, low self-esteem and self-confidence, depression and social problems [7] . ...
... Female patients with hemodialysis can't live normal life which is meaning life free from physical and psychological disorders [10]. Lack of awareness and shame to talk about sexual dysfunction among women with chronic renal failure are considered as important factors leading to negative effects on their quality of life [7] . ...
... Sexual functioning also worsened with increasing comorbid conditions, with female patients indicating less impairment than men. Unfortunately, sexual dysfunction is still an under-recognized burden in CKD patients and clinical trials of treatment options are scarce [38, 39]. ...
Given the increasing prevalence of chronic kidney disease (CKD) and its impact on health care, it is important to better understand the multiple factors influencing health-related quality of life (HRQOL), particularly since they have been shown to affect CKD outcomes. Determinants of HRQOL as measured by the validated Kidney Disease Quality of Life questionnaire (KDQOL) and the Patient Health Questionnaire depression screener (PHQ-9) were assessed in a routine CKD patient sample, the Greifswald Approach to Individualized Medicine (GANI_MED) renal cohort (N = 160), including a wide range of self-reported data, sociodemographic and laboratory measures. Compared to the general population, CKD patients had lower HRQOL indices. Dialysis was associated with (1) low levels of physical functioning, (2) increased impairments by symptoms and problems, and (3) more effects and burden of kidney disease. HRQOL is seriously affected in CKD patients. However, impairments were found irrespective of eGFR decline and albuminuria. Rather, the comorbid conditions of depression and diabetes predicted a lower HRQOL (physical component score). Further studies should address whether recognizing and treating depression may not only improve HRQOL but also promote survival and lower hospitalization rates of CKD patients.
... Sexual dysfunction in females is defined as loss of libido, vaginal lubrication, ability to orgasm, as well as vaginismus, dyspareunia, and infertility. 74 In the United States, almost 30% of highschool students reported being sexually active, 75,76 with nearly 50% of young females reporting sexual dysfunction. 77 The prevalence of sexual dysfunction in the adolescent CKD population is unknown. ...
Chronic kidney disease (CKD) increasingly affects younger people, including adolescents and young adults. CKD among females is accompanied by unique reproductive and gynecologic health concerns, though to date, this area has not been well studied. Hormonal disruptions attributed to CKD may underlie the high prevalence of abnormal uterine bleeding and influence the age of menarche in adolescents. Period poverty as a socioeconomic barrier further exacerbates the female-specific burdens of CKD. Reduced fertility in CKD is likely multifactorial and may be related to a reduction in ovarian reserve, reproductive hormone disturbances, and gonadotoxic medication use in addition to low sexual function and activity. Fertility, sexual function and activity, and risk of sexually transmitted infections increase with transplantation. Pregnancy is possible at any stage of CKD, although often accompanied by high risks of maternal and fetal complications. Contraception is thus an important consideration in CKD, but use is low and the risks and benefits of different forms in the setting of CKD are not well characterized. Though patients with CKD report reproductive health as an important element of care, many nephrologists report lack of confidence and training in this area, highlighting the need for targeted research and education. The unique reproductive health care needs of the growing transgender youth population warrant attention in nephrology training with multidisciplinary input. This review will discuss female reproductive health and gynecologic considerations in adolescents and young adults with CKD while proposing clinical and research strategies to improve this understudied yet important aspect of kidney care.
... (vi) Female Sexual Distress Scale-Revised (FSDS-R): 13 questions, self-administered, assesses distress associated with female SD [19,21,22,26, 30] . Table 2: What the guidelines say you should do: treatment of sexual dysfunction in women and the opportunity for psychosexual and/or couples counseling. ...
Few studies address alteration of sexual function in women with diabetes and chronic kidney disease (CKD). Quality of life surveys suggest that discussion of sexual function and other reproductive issues are of psychosocial assessment and that education on sexual function in the setting of chronic diseases such as diabetes and CKD is widely needed. Pharmacologic therapy with estrogen/progesterone and androgens along with glycemic control, correction of anemia, ensuring adequate dialysis delivery, and treatment of underlying depression are important. Changes in lifestyle such as smoking cessation, strength training, and aerobic exercises may decrease depression, enhance body image, and have positive impacts on sexuality. Many hormonal abnormalities which occur in women with diabetes and CKD who suffer from chronic anovulation and lack of progesterone secretion may be treated with oral progesterone at the end of each menstrual cycle to restore menstrual cycles. Hypoactive sexual desire disorder (HSDD) is the most common sexual problem reported by women with diabetes and CKD. Sexual function can be assessed in women, using the 9-item Female Sexual Function Index, questionnaire, or 19 items. It is important for nephrologists and physicians to incorporate assessment of sexual function into the routine evaluation protocols.
In both women and men, chronic kidney disease (CKD) is associated with decreased fertility. Though a multitude of factors contribute to the reduction in fertility in this population, progressively impaired function of the hypothalamic–pituitary–gonadal axis appears to play a key role in the pathophysiology. There is limited research on strategies to manage infertility in the CKD population, but intensive hemodialysis, kidney transplantation, medication management and assisted reproductive technologies (ART) have all been proposed. Though fertility and reproductive care are reported as important elements of care by CKD patients themselves, few nephrology clinicians routinely address fertility and reproductive care in clinical interactions. Globally, the average age of parenthood is increasing, with concurrent growth and expansion in the use of ART. Coupled with an increasing prevalence of CKD in women and men of reproductive age, the importance of understanding fertility and reproductive technologies in this population is highlighted. This review endeavors to explore the female and male factors that affect fertility in the CKD population, as well as the evidence supporting strategies for reproductive care.
Chronic kidney disease (CKD) is a growing health problem worldwide affecting approximately 15 % of the adult population. The risk of dying is severalfolds higher than the risk of starting with renal replacement therapy (RRT), CVDs being the main cause of death. Among various risk factors and mechanisms, nitric oxide (NO) deficiency is particularly interesting. Currently with advances in medical care, the survival of CKD patients has been prolonged, and physical functioning and quality of life (QoL) became more important. CKD patients are likely to reveal various sexual dysfunctions prior to dialysis. Symptoms of this disturbing disability are reported with increasing frequency as renal function declines. Approximately 75 % of men undergoing dialysis have erectile dysfunction (ED) which is much higher than in other chronic diseases. ED is the main sexual problem associated with mental QoL in CKD men. The causes of such high prevalence are multifactorial and include physiological, psychological and iatrogenic factors. The pathogenesis of sexual and ED in CKD has been attributed to several risk factors, but to none of them conclusively. Importantly, ED as a serious handicap for normal life should be considered as a marker of endothelial dysfunction and atherosclerosis as well as an indicator of possible silent coronary heart disease.
Several factors contribute to sexual dysfunction (SD) in patients with chronic kidney disease (CKD) and some of them are less frequent in general population. Hormonal alterations along with vascular, neurologic, and psychosocial factors and drugs contribute to the development of SD. Low levels of testosterone in men with CKD can be responsible to alterations in libido, erectile function, spermatogenesis, and sperm motility. Erectile dysfunction (ED) is the persistent inability to achieve and/or maintain an erection sufficient for satisfactory sexual intercourse. Risk factors for ED can be grouped into those that have an effect upon the vasculature, those in which the mode of action is nonvascular in nature, and age.
Many hormonal abnormalities occur in women with CKD, such as lack of pulsatile luteinizing hormone release and consequently anovulation and infertility. The frequency of reported SD in females increases as kidney disease progresses. Sexual function can be assessed in women, using the 9-item Female Sexual Function Index (FSFI) questionnaire or the 19-item FSFI. It is important for nephrologist and physicians to incorporate assessment of sexual function into their routine evaluation protocols.
Despite common co-morbidity of sexual and urinary dysfunctions, the interrelationship between the neural control of these functions are poorly understood. The medullary reticular formation (MRF) contributes to both mating/arousal functions and micturition, making it a good site to test circuitry interactions. Urethane-anesthetized adult Wistar rats were used to examine the impact of electrically stimulating different nerve targets (dorsal nerve of the penis or clitoris - DNP / DNC; L6/S1 trunk) on responses of individual, extracellular-recorded MRF neurons. The effect of bladder filling on MRF neurons was also examined as was stimulation of DNP on bladder reflexes via cystometry. In total, 236 MRF neurons responded to neurostimulation: 102 to DNP stimulation (12 males), 64 to DNC stimulation (12 females), and 70 to L6/S1 trunk
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