Sexually transmissible infections (STIs)
I slept with someone and didn’t use a condom. Do I need to get tested for STIs? What does this involve?
If you’ve had sex without a condom you should consider getting tested for STIs at the doctors or at a sexual health clinic.
What happens during the test depends on what STIs are being tested for, and if you have any symptoms. The health professional performing the test will usually ask some questions about your sexual history to determine what tests you require, taking into account any unusual symptoms. Sometimes a physical examination will also be recommended.
Testing for common infections such as chlamydia and gonorrhoea is generally quick and painless and involves a urine test. For women who have an unusual vaginal discharge, a sample of the discharge will be taken with what looks like a long cotton bud. For men who have an unusual discharge from the penis, a quick swab will be taken of the discharge (from the end of the penis, not inside).
Sometimes it may also be recommended that you have a blood test to test for other STIs such as HIV, syphilis and Hepatitis B. You can also request a blood test if you think there’s a chance you have one of these infections.
It can be useful to confirm with the health professional afterwards exactly what they have tested for, as this can be confusing. If you are diagnosed with an infection, it’s important to let your partner/s know so they can get tested as well. You may also be offered the option of contact tracing, which means the doctor or clinic will contact your sexual partners to advise them to get tested (while keeping your name and details confidential).
Where do I get my test results from?
The health professional performing the test will explain how you will receive your results. A follow-up appointment may be recommended, especially if you have symptoms. It is advisable to follow-up your results over the phone after two weeks if you haven’t heard anything. Blood tests for HIV, syphilis and Hepatitis B can give a negative result for up to three months after the initial exposure, and if there is a chance you have been infected the test will need to be repeated three months later.
I have lumps on my genitals…is it herpes?
Lumps on your genitals can be caused by a variety of conditions. Some lumps are completely normal, but some lumps may indicate you have a condition like genital warts or genital herpes. If you are concerned by any new lumps or bumps in the genital area, please see a health professional.
Genital herpes is caused by the herpes simplex virus HSV-1 or HSV-2; type 1 generally infects the mouth (causing cold sores), while type 2 generally infects the genital area (genital herpes). However, more than half all of new cases of genital herpes have been passed on through oral sex (ie with someone about to get a cold sore). Most of the time people with either of the viruses are unaware they have an infection.
While many people experience no symptoms at all, the first symptom of a herpes infection is often an itching or tingling sensation in the genital area. You may have flu-like symptoms with fever, headaches and muscle aches and pain. Within one to two days a cluster of small blisters appears. They break and weep after a few days leaving sores that may crust over. The first ‘outbreak’ can be very painful.
In women, outbreaks of herpes can be anywhere on the genital area, but commonly occur around the vagina, urethra, cervix or anal area, and may include vaginal discharge. In men, outbreaks usually occur on the penis and under the foreskin, or around the anal area. There are treatments available which can help to improve symptoms. If you are getting recurrent outbreaks, there is medication you can take to help reduce their frequency.
The emergency contraceptive pill (ECP) is available over the counter at pharmacies, so you don’t need to see a doctor to get a prescription. ECP is most effective at preventing pregnancy when taken within 24 hours of having unprotected sex (the sooner it is taken the more effective it is). It is a very safe to use.
ECP is sometimes incorrectly referred to as the ‘morning after pill’, when in fact it can be taken up to 5 days after unprotected sex. The effectiveness of ECP decreases as time passes and is significantly reduced beyond 3 days (72 hours) afterwards. As the ECP is not as reliable as many other forms of contraception, it is not recommended for everyday use.
Another option is to have a copper IUD inserted. This is a very effective means of emergency contraception up to 5 days after unprotected sex, but can only be inserted by specially-trained doctors. For more information please phone the Sexual Health Helpline.
Emergency contraception does not protect against sexually transmissible infections (STIs). If you have had unprotected sex you should get tested for STIs by a GP or at SHQ.
Does the emergency contraceptive pill cause an abortion?
No – ECP prevents pregnancy happening in the first place. It won’t have any effect on an established pregnancy.
Does using hormonal contraception such as the Pill for a long time cause infertility? Should I have a break?
Long-term use of hormonal contraception such as Implanon® or an IUD has not been shown to have an impact on fertility. Fertility usually returns almost immediately upon ceasing use of hormonal contraception.
I haven’t had children: can I still get an intrauterine device inserted?
An intrauterine device (IUD) is a small, flexible device which is inserted into the uterus (womb) by a health professional to prevent pregnancy. IUDs are usually a very suitable option for women looking for reliable long-acting reversible contraception, or those who can’t take oestrogen (found in most oral contraceptives and the vaginal ring).
Despite common misconception, they can be used by women before or after having children, and can be removed at any time (and fertility returns immediately). Your health professional will take a detailed medical history and pelvic examination to ensure that an IUD is suitable for you.
I am travelling to Australia from overseas – is my contraception available here?
If you are an overseas visitor needing contraception, it is best to make an appointment at SHQ to discuss the options available. Most methods available overseas are also available in Australia, apart from the contraceptive patch and Cerazette (a progestogen-only pill).
If possible, please bring your pill pack with you to your appointment so you can be given a similar brand or formulation
I’m having trouble finding a condom size I’m happy with – are there different kinds available?
Condoms come in a variety of shapes, sizes, textures and colours, so try a few and see which variety and brand feels best for you and your partner/s.
Will taking the Pill make me fat?
Research has shown there is no evidence that taking the Pill causes weight gain. Fear of weight gain can sometimes prevent women from taking the contraceptive pill or cause them to stop using it, but in most cases, their fears are unfounded.
However, with so many different contraceptive pills on the market, finding the right one can be difficult for a few women. It is important to remember that some side effects that emerge when starting a pill don’t always last – they may disappear or decrease after the body adjusts to the hormones in the Pill. If problems persist however, women should see a doctor, as a change of pill may be all that is required.
I often skip my period by missing the inactive tablets in my Pill packet. Is it safe to continue doing this or should I let my body have a period every once in a while to give it a “break”?
Research has confirmed that it is safe for women to take the hormone pills in their pill packet continuously and miss the non-active sugar pills altogether if they want to skip a period. This won’t do your body any harm.
How effective is the withdrawal method?
This is when the man removes his penis from the woman’s vagina before he ejaculates (‘cums) so sperm doesn’t enter the vagina.
This method needs to be used consistently and correctly every time for it to be most effective, but even then, the failure rate is higher than that of most other methods of contraception. Even if the man ‘cums’ just outside the vagina, some sperm may still be able to swim inside, and there can also be sperm in any pre-ejaculation fluids. It can also be difficult for the man to remember to withdraw in time.
If you are considering using this method for contraception you should take into consideration the type of relationship you are in and the risks you are prepared to take. The risk of pregnancy is very high, and you also aren’t protected against STIs.
What is a Pap smear? Should I have one?
A Pap smear is a simple test used to detect early changes in the cells of the cervix (the lower end of the womb or uterus). Without treatment, these changes can lead to cancer. Regular Pap smears help detect early warning signs of cervical cancer and allow women to receive treatment before the cancer develops.
One of the main causes of cervical cancer is the Human Papilloma Virus (HPV), which is passed on through sexual activity. Every woman over 18 years who has ever had sex is advised to have a Pap smear every two years until they turn 70. Your clinician may recommend you have more frequent Pap smears if a previous one showed significant cell changes.
Every woman needs to have regular Pap smears, regardless of her age or number of sexual partners. Women who no longer have periods or haven’t had sex for a long time still need to have a Pap smear every two years.
It is important to remember that a Pap smear only tests for changes to the cervix. It is possible, however, to be tested for some sexually transmissible infections at the same time as your Pap smear – talk to your clinician for more details. There may also be other times in your life when a vaginal examination is required – this is not the same as having a Pap smear. If you are unsure what the clinician is testing for, please ask.
A cervical cancer vaccine is available for young women – talk to a GP or SHQ clinician for more details. It is important that women who are vaccinated continue to have regular Pap smears however, as the vaccine only protects against certain types of HPV.
More information on Pap smears, including future changes to the National Cervical Screening Program.
I can’t have an orgasm through intercourse – is there something wrong with me?
This is a common issue for many women and there are many factors which can be the cause. Lots of communication and practice with a loving and sensitive partner can be the best way to enjoy sex. Many women are able to experience orgasm through clitoral stimulation rather that vaginal penetration. Practicing on your own (masturbation) and working out what feels good can also help, as can spending more time on foreplay.
I often bleed after sex. Is this serious?
The majority of the time bleeding after sex does not indicate a serious problem, but should always be investigated by a health professional. Sometimes it can be a sign of an infection.
Bleeding after sex is rarely a sign of cervical cancer. Having regular Pap smears every two years is the best way of detecting early warning signs of cervical cancer.
I find sex painful…
Many women experience painful intercourse, but it should not be ignored. Some women find it painful when a penis, finger/s or toy is first inserted, while others find it more painful when something is deep inside the vagina.
Painful intercourse can often be linked to vaginal dryness and lack of lubrication. Over-the-counter lubricants, eg KY Jelly, may be helpful, as can spending more time on foreplay. There can also be other different causes such as an infection, a small tear, or the possibility of endometriosis.
Emotional disturbances, such as a history of sexual abuse, can also be responsible for pain. Some women have vaginismus, a condition in which the vaginal muscles tighten so much they make penetration difficult and painful.
If you are experiencing persistent painful sex it is important to see a health professional. It is important to exclude physical reasons for any pain before putting it down to psychological factors.
Do my genitals look normal?
This is a common concern for many women (and men!). Like all body parts, everyone’s genitals looks different, and just as it is normal for two breasts to be slightly different shaped, the same goes for both sides of a woman’s labia (vaginal lips). Remember that genitals shown in the media have usually always been photo shopped; you might like to check out http://www.labialibrary.org.au to see just how unique labias can be! If you are still concerned, please discuss with a health professional.
The information contained in this web site is produced by SHQ for the purpose of disseminating health information free of charge for the benefit of the public. It is not a substitute for independent professional advice. Nothing contained in this web site is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional’s advice. SHQ does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information and recommends that the recipient contact SHQ or their medical practitioner directly for further, more specific, information.