While menstrual cycles and menopause are finally being discussed more openly, other sexual health topics – such as STIs, vaginal discharge and sex during pregnancy – remain taboo.
We think it's time this changed. Talking about sexual health helps women understand what is 'normal' for them – and can save lives.
To mark Sexual Health Awareness Week, we asked Dr. Daniel Cichi, GP and medical advisor at Doctors 4 U, to share the sexual health questions he gets asked most by women– along with his answers.
Is thrush an STI?
Thrush is not necessarily classed as a sexually transmitted infection, however, it can be triggered by having sex and can sometimes be passed on through sex, so it sometimes falls under the umbrella term of an STI.
Thrush is caused by a fungus called candida that is in most cases harmless and should clear up on its own after a few days. There are topical creams you can take to help ease itching and soreness in and around the vagina. Also try to avoid washing this intimate area with soap or bathing with soapy water as this can disrupt the healthy balance of bacteria and pH levels in the vagina.
How do I know if I have an STI?
A lot of STIs do not show symptoms, so testing is the only way to find out if you’re infected. If you have engaged in unprotected sex its best to get yourself checked out just in case as some STIs such as Chlamydia may not show symptoms but if left untreated can have detrimental effects on a woman’s reproductive system. Look out for any changes to the vaginal discharge, and any sores, itchiness, or pain when peeing as this could indicate a sexually transmitted infection.
Can I get an STI from non-penetrative sex?
Yes. STI’s are not only passed on through penetrative vaginal sex, but also passed via anal and oral sex as well as sharing sex toys.
Is my discharge normal?
A woman’s discharge can change all the time depending on where she is in her menstrual cycle and it’s usually nothing to worry about. Normal discharge is usually clear or milky. Some women may only release small amounts or larger amounts.
Unusual discharge which could indicate an STI may have a change in colour or consistency, and it may have an odour. Green or yellow discharge is symptomatic of STIs such as gonorrhoea, and discharge that is greyish in colour and has a watery consistency is a common symptom of bacterial vaginosis. If you experience any unusual discharge it’s best to get this checked out by your GP.
Why does it hurt after I have sex?
In most cases, women who experience pain after sex are not sufficiently stimulated – this means their vagina is not lubricated enough for comfortable or pleasurable sex.
Vaginal dryness can happen due to a number of reasons such as changes in hormones which is common during the menopause; not being turned on, not enough foreplay, your mind being elsewhere or, in some cases, it can be from rough aggressive sex. It is usually nothing to worry about, but you should speak to your GP if you experience any pain during – or after – sex as it could be caused by an infection. You may also be suffering from vaginismus. This is a condition whereby the muscles in your vagina tighten prior to penetration meaning its near on impossible to have sex.
I have never orgasmed during sex, is there something wrong with me?
It’s quite common for women not to experience orgasms during vaginal penetration. In most cases, the clitoral area needs to be sufficiently stimulated in order for a woman to climax, and sometimes this can be done more easily through masturbation.
Talk to your partner about this and try out different foreplay techniques to help you reach climax, sex toys and vibrators may also help. It might also be useful for you to explore yourself alone, so you can see what feels good and then get your partner to copy these motions.
Will sex still be enjoyable after having a baby?
There is no rush when it comes to having sex post-baby, and every woman is different. It will still be enjoyable providing you are properly stimulated and lubricated.
Sex sometimes hurts as I am not wet enough down there, does this mean I am perimenopausal?
There are a number of reasons why you are not properly turned on during sex which means your vagina could feel dry and uncomfortable. It does not usually mean you are perimenopausal, however, this is a symptom of the menopause, so it might be an idea to check in with your GP to see if you’re at this stage.
Will my partner and I stop having sex when I start the menopause?
The lack of oestrogen and testosterone during menopause can lead to changes in a woman’s body and sex drive. She may find that she becomes less interested in having sex or reaching orgasm.
You may notice that you are not easily aroused, and your vagina may become less sensitive to touching and stroking – this of course can lead to less interest due to less enjoyment. If you are finding that you are less interested it might be worth exploring new ways to seek enjoyment, whether that’s introducing sex toys, role play, or something else that could reignite your interest.
If your menopausal symptoms are reducing your quality of life or impacting your sex life and relationships, speak to your GP about treatment options and ways to manage your symptoms.
Will I be able to have sex whilst pregnant? Will sex harm the baby?
It is perfectly safe to have sex during pregnancy unless advised otherwise. Having sex will not harm or hurt the baby as your partner’s penis won’t be able to penetrate beyond your vagina, and your baby is protected by strong muscles and amniotic fluid.
Some women find their sex drive increases during pregnancy, so you may find you want to have sex more, or for some, it can decrease.
I’m worried my vagina doesn’t look normal
Every woman is different and so, of course, this is the same for their vaginas. Vaginas vary in size, shape, and colour, and just because yours may differ to another woman does not mean you have a medical problem or are unattractive.
Some women have a larger labium that sits just outside the outer labia, and some have a smaller labium that sits inside. Both are completely normal and quite common.
If you have a sexual health concern or worry, speak to your GP.
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