Doctors Answer The Most Commonly Asked Sexual Health Questions So You No Longer Have To Wonder
Netflix’s Sex Education return to screens this Friday (17 January) with its second season.
In case you haven’t seen season 1 yet, the hit show is about a student named Otis, who becomes the go-to person for sex advice at the high school he attends, thanks to the copious amount of information he picks up at home from his mother, a well-known sex therapist.
Although Sex Education revolves around teenagers in need of guidance, in real life, adults also often have questions around sex and sexual health.
From STI symptoms to discharge, genital appearance to oral sex, we set out to investigate the questions that come up more often than others and asked gynaecologists and urologists to tell us the answers.
Let’s start with sexually transmitted infections (STIs).
How do I know if I have an STI?
Dr Shree Datta works as a consultant obstetrician-gyneacologist at MyHealthcare Clinic, is a member of the Royal College of Obstetricians and Gynaecologists (RCOG) and has done award-winning research into ovarian cancer.
She says: ‘It’s important to know that up to 50% of those with an STI never experience any symptoms – so if you have had unprotected sex since your last STI test – I would recommend you get tested.
‘It also depends on the type of STI you have contracted – some alter colour and smell of your vaginal discharge for example.’
Is thrush an STI?
Dr Shree says: ‘Thrush is not categorised as an STI, as it is a yeast infection. However, it can be triggered by sex or at certain times within your menstrual cycle.’
According to the NHS, symptoms of thrush in women include white vaginal discharge, itching and irritation and stinging during sex or when you pee.
Thrush can affect men, too, presenting itself as irritation, burning and redness and white discharge, as well as potentially making your penis smell funky and making it harder to pull back the foreskin.
‘Thrush is normally easily treated with an anti-fungal cream or tablets, however I would recommend you speak to your GP or go to a sexual health clinic before you self-diagnose, to rule out any other STIs and to ensure you receive the correct treatment,’ Dr Shree adds.
Can I catch an STI from a partner who was previously treated for chlamydia?
The short answer: yes, if your partner has an active sexually transmitted infection, explains Dr Shree.
She recommends that you not get freaky in the sheets for a minimum of seven days after finishing your course of antibiotics, to avoid infecting your partners (and in turn, reinfecting yourself).
‘I would recommend getting retested for a test of cure just to be safe and you may also want to let your partners know so that you don’t get re-infected,’ Dr Shree adds.
‘You can contract chlamydia more than once, so I would recommend you both get tested for STIs before having sex or wearing a condom with any new partner.’
Can I get an STI from non-penetrative sex?
The chances of getting an STI from non-penetrative sex is lower, but it’s still possible.
‘There is a risk of contracting an STI with any sexual contact, so this includes oral sex, although the risk might be slightly lower – I would still recommend getting tested when you change partners to ensure you and your partner(s) aren’t putting each other at risk,’ says Dr Shree.
Don’t forget, you can also use a condom during oral sex (but really, if you’re afraid that the person you’re with has an STI – or if you have multiple partners – it’s worth having a chat with them about it).
How do I get tested for chlamydia?
Chlamydia is the most common STI in England, accounting for 46.1% of all STIs diagnosed in 2015, according to The Family Planning Association.
Dr Andrew Wilson at The Wilmslow Hospital (part of HCA Healthcare UK), explains how to get tested.
‘Chlamydia testing is simple and painless,’ he says.
‘The sample often doesn’t have to be collected by a doctor or nurse – we can give you the kit and you can test in private.
‘It can be tested on a urine sample or by using a swab that can be inserted into the vagina. Men often talk about a painful swab that is inserted down the urethra – this is not the case.
‘A urine sample is often all that is needed. If you are under 25 and sexually active, it is recommended that you get tested for chlamydia at least once a year or whenever you have a new sexual partner.’
What happens if I test positive?
‘If you test positive, most clinics will ask you to come back to discuss your results or tell you over the phone and ask you to come in,’ says Dr Shree.
‘At the clinic I work at we offer instant results which means we can let our patients know with in 20 minutes while they wait, which can be really helpful if you are anxious or symptomatic.
‘Most STIs can be cured with antibiotics, other may not have a cure such as HIV, but there are treatments and support available.
‘Depending on the STI and treatment, you may be asked to abstain from sex for a certain period during and after your course of antibiotics, if that is the course of treatment.
‘Where an infection cannot be cleared, you may be informed of how you can prevent and minimise the risk of transmitting it to others. You may also be asked to return for a test at the end of treatment to check that you have been cured.’
What is PrEP?
‘There is lots of talk at the moment about the drug PrEP,’ Dr Wilson tells us.
‘It stands for pre-exposure prophylaxis and is used to prevent HIV infection in those at risk.
‘In England it is not widely available on the NHS just yet, though there are trials that are taking place through sexual health clinics (IMPACT trial). Good resources for further information are the websites Prepster and Iwantprepnow.’
If you’re living with HIV, there are also services that you can use for emotional support. Find more information on the NHS website or through Terrence Higgins Trust.
Let’s settle this now: no genitals – male or female – look exactly the same.
Some men have low-hanging balls while others don’t, some women have protruding inner lips, while others have uneven lips.
Your genitals can also change appearance as you get older; as an example, penises can develop a deeper curve.
Dr Shree says: ‘A very common worry is whether you look normal around the vagina but the truth is – we all look slightly different down there and that is completely normal.’
Is my discharge normal?
‘Vaginal discharge can vary from person to person and throughout your menstrual cycle – so what’s normal for you, is normal for you only,’ Dr Shree explains.
‘If you do have any changes to the colour, smell or texture which you wouldn’t normally expect, I would recommend speaking to your GP or sexual health professional.’
Is masturbation bad for you?
Dr Earim Chaudry is the medical director at Manual, a website that specialises in erectile dysfunction, among other male health concerns.
‘Going blind, growing hair on the back of your hands, becoming infertile from masturbation are all myths,’ he tells us.
‘In fact, masturbation is safe and considered a normal and common part of human sexuality. It’s usually the first sexual experience that most people have, and can be a valuable part of experimenting with what you like and don’t like. It’s also a convenient way to fulfill sexual desires, and it’s safe from an STI and pregnancy risk point of view.’
‘There is no fixed amount of masturbation that is considered “normal”. However, masturbation can become harmful to you if you find it is interfering with your everyday life, or impacting your ability to have or want sex in a loving relationship.
‘This can in some people be linked to porn addiction. If you feel this is becoming a concern, it’s best to speak with your doctor.’
Why does it hurt when I have sex?
Dr Chaudry says: ‘Sex should be a pleasurable experience for both people (or everyone, if you have more!). However, painful sex is quite common.
‘If you are experiencing pain, it can be your your body’s way of telling you something isn’t quite right. Usually, it’s a case of not enough foreplay, lack of sexual arousal or vaginal dryness.
‘Starting sex gently and building up is a good tip. However, there are other important other causes such as infection (STI, thrush), gynaecological conditions (such as endometriosis, pelvic inflammatory disease).
‘It’s important to also know that men can also experience pain from sex. The common causes tend to be tight foreskin, thrush, tears/irritation of the penis or foreskin and STIs.’
If you feel pain during sex, don’t panic. Often it can be due to the issues Dr Chaudry mentions, however, if it’s persistent, frequent or you’re just generally worried, chat to your local GP or swing by a sexual health clinic.
Why can I not get and keep an erection?
If you’re experiencing erectile dysfunction, know that you’re not alone.
The Sexual Advice Association estimates that half of men between the ages of 40 to 70 in the UK are suffering from some level of ED, and it does also affect younger men.
‘The causes of ED are varied,’ Dr Chaudry explains.
‘From cardiovascular to psychological to medication-related problems. Smoking, obesity, excessive alcohol consumption, recreational drugs, pornography and vitamin deficiencies can also all be contributing factors to ED.
‘Unfortunately, for a lot of men, embarrassment often prevents them from seeking professional help.
‘It’s always a good idea to talk to your GP to get to the root cause. Luckily there are treatments like Sildenafil (the active ingredient in Viagra) that can help men get and keep an erection when they need it.’
Also, while we’re on the topic of ED, avoid licking pavement lichen to treat it (please, don’t).
Is oral sex safe?
‘While oral sex is generally safer than penetrative sex it still carries the risk of passing or contracting STIs,’ says Dr Chaudry.
‘This risk is higher if you have sores or cuts around the mouth/genitals/anus.
‘This is because the viruses and bacteria that cause STIs may be present in semen, vaginal fluid or blood, and so can travel more easily through breaks in the skin.’
Also, if you’re giving head, avoid using teeth or be extra careful if you do, says gynaecology doctor Dr Sarah Welsh.
Disaster struck recently when a man got a cut on his pride of joy from oral sex, which resulted in the penis becoming necrotic.
Also, if you accidentally get semen in your eye during an oral sex session, read our nifty guide on what you should do.
I have never orgasmed during sex, is there something wrong with me?
Dr Sarah Welsh is the co-founder of the condom brand, Hanx, and regularly gets questions from young and older people about why they can’t get to the big O during sex.
‘There are many reasons why you may not have experienced an orgasm and people with orgasmic dysfunction may have difficulty achieving orgasm during sexual intercourse or masturbation,’ she explains.
‘The condition of never having had an orgasm is known as primary anorgasmia, and if you have difficulty reaching orgasm, but have experienced them before, you may have secondary anorgasmia.
‘Commonly people can only orgasm during certain situations, such as when masturbating or having oral sex. General anorgasmia is the inability to achieve orgasm at all, even when you’re highly aroused and sexually stimulated.
‘It is important you see an expert to discuss your unique situation in person. It may be that you have an underlying medical condition that is affecting your ability to orgasm, or it is due to the side-effects of medication.
‘There is a lot that can be done to help, depending on what your doctor finds, including using medications (sometimes hormones or antidepressants), cognitive behavioural therapy, or couples/ individual counselling.’
Is passing gas normal when you orgasm?
Speaking of orgasm, don’t sweat it if you accidentally pass wind during sex. Sure, it’s a little awkward but it’s also very common.
‘When you climax, the sphincter muscle that is close to your genitals relaxes, so passing gas is entirely normal,’ Dr Larisa Corda tells us.
‘This can also be encouraged by the penis rubbing against the anus when in the vagina.’
Where is my G-spot?
Dr Welsh says: ‘The G-spot, an area felt through the wall of the vagina, an inch or two behind the back of the pubic bone near the junction of the bladder and the urethra and made up primarily of tissues of the clitoris.
‘When stimulated, it causes intense sexual pleasure in some women.’
Meanwhile, for men, the closest thing they have to a G-spot is the prostate – the walnut-sized gland behind the penis. The prostate has nerve endings that arouse all kinds of good feelings.
What are the best sex positions to conceive?
‘There is no proven answer to this and many hypotheses, but the most common position recommended by experts is the missionary, simply because anatomically it brings the sperm closest to the cervix,’ says Dr Corda.
‘Also using a pillow to tilt your pelvis forward during sex can help but of course, you should use the position that you find the most comfortable for you.’