Sexuality and Sexual Health

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Sexual health is more than deciding on birth control and protecting yourself from sexually transmitted diseases, it’s about making positive choices for both you and your boyfriend or girlfriend.

Sexual health and learning how to look after yourself is important. Anyone who has sex can be at risk of catching a sexually transmitted infection (STI). Some people don’t show any symptoms and there are serious consequences if infections are left untreated.

On these pages you can find advice on body changes, sexual health issues such as contraception, how to avoid infection, and how to get tested and treated. You can also find information here about sexual orientation and gender identity.

Puberty

If you’re reading this then you’ve probably heard about Puberty and are aware of the changes that will/are happening to your body and your mind. Your voice, your body, hair under your arms, it’s all very new (and a bit weird at the time!)

Many people worry about Puberty and whether they are “normal” but you should know that everyone goes through Puberty – some people go through it sooner than others and some take longer – it’s up to your body. Around about this time sex starts to become sort of a “big deal” when you’re a teenager, but it doesn’t have to be something that worries you. Every teenager who has ever lived has worried about sex!

You’re probably thinking: when is it “normal” to have sex? What do I do? Should I tell someone? And loads of other questions. The answer is simple: you should wait until you are comfortable, confident and ready. You should never feel pressured into doing anything you don’t really want to just because “everyone else is doing it” or because it’s “cool”! There is no normal age to have sex for the first time and there is absolutely no rush. It’s important that you and the other person should respect each other.

When you do start having sex there are things you can do to keep you and your sexual partner(s) safe – although sex is perfectly normal there are risks including pregnancy and sexually transmitted diseases – here are some tips to be aware of:

  • No contraception is 100% effective but a condom is your best defence against both pregnancy and STIs
  • To avoid unwanted pregnancies there are a variety of contraceptive methods you can use including the combined pill, the pill injection, IUDs and more. There’s currently no male-equivalent but scientists are working on it! A sexual health practitioner can give you advice on which will be most suitable for you
  • If you ever need emergency contraception or treatment, such as the “morning-after” pill you may need to see your GP, GUM Clinic or go to a Pharmacy as soon as you can. These treatments are rarely effective after 72 – 105 hours so the sooner you have them the better – more advice can be found on the NHS website. Also there is a Pharmacy Finder and Clinic Search
  • If you are afraid you have had sex with someone who is or might be HIV-positive then you should ask your GUM clinic or A&E department about PEP (Post-Exposure Prophylaxis) within 24 – 72 hours after having sex. GPs cannot prescribe PEP.

On the topic: there’s one question that we get all the time – can I visit the GP or other health practitioner without my parents? The answer is yes, as long as you’re 16 or over. If you are 14 years or older then you can visit GUM clinic or sexual health nurse without your parents and they will not tell your GP that you have visited UNLESS they feel you are at risk; they will then legally HAVE to pass your details on to external agencies that could support you, for example, if you are under 16 and you have an STI or you’re pregnant.

Here is a list of services that can offer information, advice and support around sexual health, Contraception, HIV and more:

Terrence Higgins Trust (THT)

THT’s website says:

We are the largest voluntary sector provider of HIV and sexual health services in the UK, running services out of local centres across Great Britain.

THT Direct: 080880 21221          Local service finder

 

Brook

Free & confidential information for under 25s

AskBrook24/7

NHS website.

The National Health Service is the publicly funded national healthcare system for the UK.

Pharmacy Finder

Clinic Search

Family Planning Association (FPA)

The FPA website says: We’re a sexual health charity. We give straightforward information and support on sexual health, sex and relationships to everyone in the UK.

Sexually Transmitted Infections (STIs)

If one person has an infection it can pass to another person through vaginal, anal or oral sex. This type of infection is known as a sexually transmitted infection (STI) or a sexually transmitted disease (STD).

Anyone who has sex can get a STI, whether they are male or female, heterosexual or homosexual. Not everyone who has a STI shows symptoms and sometimes they can go away and come back again.

If you suspect you have an STI, visit your GP immediately. Don’t be embarrassed; it is very important to your health to get treatment right away.

Types of STI

Chlamydia

Chlamydia is one of the most common STIs, but left untreated it can cause infertility. It is caused by bacteria found in semen and vaginal fluid which is easily passed from person to person during sexual activities.

Using a condom can reduce your chances of getting infected. At least half of all men and women infected show no symptoms at all. However symptoms can include:

  • For Women:
    • An unusual vaginal discharge
    • Pain when passing urine
    • Bleeding in between periods
    • Bleeding after or during sex
    • Lower abdominal pain
  • For Men
    • A white/cloudy and watery discharge from penis
    • Pain when passing urine
    • Painful swelling of the testicles

Chlamydia can also infect the eyes and the throat.

Treatment of Chlamydia is simple and effective – just a course of antibiotic tablets. Even if you don’t show any symptoms, you might want to get tested, especially if you have ever had unprotected sex or a partner has had an STI. Please visit your GP or sexual health clinic for a test.

Syphilis

Syphilis is relatively rare but can cause extremely serious health problems if left untreated.

It is caused by bacteria that can pass from one person to another through sexual contact. Using a condom can prevent the infection spreading during vaginal, anal and oral sex.

The symptoms of syphilis are the same in men and women but can be easily missed. They include:

  • Stage 1: one or more sores will appear on the body, usually around the genitals, anus or mouth. These are very infectious
  • Stage 2: painless rash, flat warty-growths on genitals and anus, flu-like illness, tiredness, loss of appetite and swollen glands, white patches in mouth and patchy hair loss

If left untreated for years, it can damage the heart, brain, eyes, bones and nervous system. It could be fatal at this stage.

Visit your GP or sexual health clinic for a test – treatment is a single antibiotic injection or a course of tablets, such as Penicillin.

Gonorrhoea

Gonorrhoea is becoming more and more common and can cause infertility if left untreated.

It is caused by bacteria that can pass between two people during sexual contact. Using a condom during vaginal, anal and oral sex will reduce your chances of catching or spreading the infection. It is also possible to pass the infection from the genital area to the eyes by fingers.

10 percent of infected men and 50 percent of infected women have no symptoms.

Symptoms for women include:

  • An unusual vaginal discharge – thick, watery or yellow/green in colour
  • Pain when passing urine
  • Lower abdominal pain

Symptoms for men include:

  • A white, yellow or green discharge from tip of penis
  • Pain when passing urine
  • Pain in the testicles

You won’t know if you have the infection without a test, which can be done by your local GP or sexual health clinic. Treatment is very effective, involving a single dose of antibiotics.

Genital warts

Genital warts are the most common STI. They are caused by a virus called the human papilloma virus (HPV) and are passed from one person to another by sexual contact.

There are over 100 types of HPV and different types affect different parts of the body, such as hands, feet or genitals. They can be visible or invisible. Most infected people have no symptoms and no visible warts. Visible warts vary and can be small, fleshy growths or bumps to large pink cauliflower-like lumps. They are usually very tiny and painless.

In most cases, a doctor or nurse can just look at your body to see if you have the virus. Genital warts can be removed by painting a liquid chemical on them, using a cream at home, freezing (cryotherapy), heat (electrocautery), surgery or laser treatment.

Pubic lice

Pubic lice (sometimes called crabs) are tiny parasitic insects that live in pubic hair. They are yellow-grey, about 2mm long and have a crab-like appearance.

‘Nits’ are the eggs which appear as brownish dots fixed to the hair. Pubic lice are easily passed from one person to another by close body contact or sexual activity. Some people may not notice the lice or eggs in their hair.

Other symptoms include:

  • Itching or irritation in affected area
  • Black powdery lice droppings in underwear
  • Brown eggs on hair
  • Tiny specks of blood on skin

A doctor or nurse can check for lice simply by looking and they can be treated with a cream or shampoo.

Scabies

Scabies is caused by tiny parasitic mites that burrow into the skin and lay eggs. It is easily passed from one person to another through close body contact or sexual activity.

Symptoms can include:

    • Intense itching
    • Itchy rash or tiny spots
    • Inflammation or raw skin

The mites are impossible to see with the naked eye. A doctor or nurse can often tell if you have scabies by simply looking at your skin and it can be easily treated with a cream or lotion.

Genital Herpes

It is caused by a highly infectious virus spread through sexual contact. It can be easily passed from one person to another during sex with someone who is having an outbreak of genital herpes at the time or by skin-to-skin contact with a sore.

Symptoms can include:

    • External or internal blisters or sores around genitals or anus, which quickly burst leaving small red sores
    • Stinging, tingling or itching in genital or anal area
    • Symptoms such as fever, fatigue, swollen glands, Pain passing urine.

In most cases a doctor or nurse can tell you have herpes by looking but they may use a swab to collect a fluid sample too. Treatment involves taking antiviral tablets.

HIV and AIDS

HIV stands for Human Immunodeficiency Virus and is a viral infection that attacks the body’s immune system. In most cases, the immune system will need help from anti-HIV drugs to keep the virus under control, but they cannot cure the virus.

AIDS stands for Acquired Immune Deficiency Syndrome but is also known as advanced HIV. It describes the point when a person’s immune system can no longer cope because of the damage caused by HIV. People do not die of AIDS, they die from the cancers, pneumonia and other conditions the body cannot fight because of its weak immune system.

HIV can be passed from one person’s bloodstream into another’s in several ways:

    • Semen and seminal fluid released before ejaculation
    • Vaginal fluids, including menstrual fluids (periods)
    • Breast milk
    • Blood

There are ways to reduce the risk:

    • Always use a condom during sexual activity and sexual intercourse. The risk is small during oral sex, but there is still a risk
    • Intravenous drug users (who inject into the body) should always use fresh needles and never share drug equipment with anyone else

You cannot catch HIV from touching someone infected or sharing cups, glasses and cutlery, towels or toilet seats.

A HIV test shows whether someone has the HIV infection. It is not a test for AIDS. It works by looking for the antibodies created by an infected person’s body and involves a simple blood test. Taking a test less than three months after possible infection might not give an accurate result as not enough antibodies may have been produced.

There is currently no cure for HIV.

Most sexually transmitted diseases don’t show any symptoms at all but can seriously damage your health. If you do suffer any symptoms or have had unprotected sex, it is important to consult your GP, family planning clinic or sexual health clinic as soon as possible to have a test and start any necessary treatment.

The doctors and nurses have done the tests many times before, so don’t be embarrassed. Your parents or guardian won’t be told and the tests are confidential. If you are suffering from an STI, contact past partners to inform them so they can also be tested. It might seem embarrassing but getting tested could save your life.

Contraception

The Youth Engagement and Participation Service works closely with the sexual health team across Rhondda Cynon Taf and many of our staff are able to provide young people aged 14 – 25 with condoms in Extended Provision. Every school in RCT runs extended provision between 5.00pm and 8.00pm at least two nights a week. The Youth Engagement Officer in your school can tell you whether or not they run the C-Card Scheme in your club. You can find your local club here on WICID’s ‘What’s On ‘ tab.

Don’t worry if your school doesn’t, there are plenty of places that can provide you with condoms and other sexual health advice and services, including contraception, STI screening, and some run dedicated Youth time-slots known as YAS sessions. If you feel like you’ve taken a risk, have had unprotected sex, or just need some advice then you can find local sexual health services on the Cwm Taf Health Board website.

Remember: no form of contraception is 100% effective.

Male condoms

  • Made of very thin latex, a condom is put over the erect penis to stop sperm entering the women’s vagina
  • Condoms are 98% effective if used properly
  • Condoms can protect partners against pregnancy and sexually transmitted diseases like HIV – see the Sexually Transmitted Infections (STIs) section
  • Condoms are free at any family planning clinic, sexual health clinic and places participating in the C-Card Scheme
  • They can also be purchased in chemists, supermarkets and toilet vending machines
  • A new condom must be used each time you have sex
  • Only use condoms with a BSI Kitemark (BS EN 600) and CE Mark on the pack
  • Always check the expiry date before using a condom and if the packing looks damaged the condom probably is too
  • If using lubrication oil-based products (e.g. hand cream, Vaseline) can damage latex condoms so it’s important to avoid these and use a water-based lubricant
  • Non-latex condoms are also widely available

Contraceptive pill

  • Also known as the combined pill, the combined contraceptive pill or simply the pill, it is over 99% effective if used properly and is taken daily by the women to prevent pregnancy
  • The pill will not protect partners from sexually transmitted diseases
  • The pill works by using two hormones – oestrogen and progestogen – to stop ovulation (when the ovary releases an egg)
  • It can reduce period pains and bleeding during periods
  • The pill is not suitable for all women and can have rare, but serious side effects, such as blood clots (thrombosis), breast cancer and cervical cancer
  • It is not suitable for smokers
  • If you are more than 12 hours late taking a pill, always use a condom for the next seven days as you might not be protected
  • The pill may also not work if you vomit or have diarrhoea, so use a condom if you think you might not be protected
  • There are different types of contraceptive pill. Please see your family planning clinic or GP to find the right one for you

LARC

LARC stands for long acting reversible contraception.

These methods of contraception last more than a month.

Once in place you do not have to think about them until they need replacing. LARCs start working very quickly, are completely reversible, are suitable for women of all ages and don’t affect your fertility. They are 99% effective.

There are four types of LARC:

  • The IUS (Intra Uterine System) – A small T-shaped plastic device is placed in the uterus by a doctor or nurse and slowly releases the hormone progesterone. It works for five years
  • The IUD (Intra Uterine Device or coil) – A small plastic and copper device is placed in the uterus by a doctor or nurse. It lasts for up to 10 years depending on the type
  • The contraceptive injection (Depo) – An injection given every 11-12 weeks at your GP surgery or sexual health clinic
  • The Implant – A small flexible tube is inserted under the skin in the inner upper arm. It slowly releases the hormone progesterone. It works for three years
  • All of these methods of contraception are free and available from your GP or local sexual health clinic

LARCs prevent pregnancy. They do not protect against sexually transmitted infections (STIs). A condom is the only form of contraception that will protect against STIs. Young people aged 13-25 can access free condoms from the C-Card Scheme.

For more information about LARC visit www.youchoose.wales.nhs.uk or www.fpa.org.uk.

You can also make an appointment at your GP surgery or local sexual health clinic to talk about your options.

Other forms of contraception include:

  • The female condom – Female condoms are like male condoms except they fit inside the vagina instead of covering the penis. They are 95% effective in preventing pregnancy if used correctly every time you have sex
  • The diaphragm – A contraceptive diaphragm is inserted into the vagina before sex, and it covers the cervix so that sperm can’t get into the womb (uterus). You need to use spermicide with it (spermicides kill sperm). The diaphragm must be left in place for at least six hours after sex. After that time you take out the diaphragm and wash it. They’re reusable. Diaphragms come in different sizes – you must be fitted for the correct size by a trained doctor or nurse
  • The cap (92-96% effective) – Caps are small rubber domes which fit into the vagina and go over the cervix and you need to use spermicide with it. The cap must be left in place for six hours after sex. After that time, you take out the cap and wash it. Caps are reusable. They come in different sizes, and you must be fitted for the correct size by a trained doctor or nurse
  • Progestogen-only pill (99% effective) – stops ovulation. Suitable for smokers
  • Contraceptive Patch – The contraceptive patch is a sticky patch, a bit like a nicotine patch, measuring 5x5cm. It delivers hormones into your body through your skin. In the UK the patch’s brand name is Evra. It contains the same hormones as the combined pill, and it works in the same way
  • Vaginal Ring – The vaginal ring is a small, soft plastic ring that you place inside your vagina. It’s about 4mm thick and 5.5cm in diameter. You leave it in your vagina for 21 days, then remove it and throw it in the bin (not down the toilet) in a special disposal bag. The ring releases oestrogen and progestogen
  • Female sterilisation (over 99% effective) – cuts the fallopian tubes permanently to stop sperm ever reaching an egg. Requires an operation
  • Male sterilisation (over 99% effective) – cuts the tubes carrying sperm so no sperm is present in semen. It is permanent and requires an operation. There are ways to reverse the sterilisation, but it is difficult and expensive

If you have any questions about choosing contraception, pregnancy or sexually transmitted diseases, please visit your GP or family planning clinic for advice or see the links below.

Emergency contraception

If you’ve had sex without using contraception or think your method might have failed, there are two emergency measures you can take:

  • Emergency contraceptive pills (known as morning-after pills) – These are available free from your local family planning clinic or GP and must be taken up to 72 hours (three days) after sex to be effective. The earlier they are taken, the more effective they will be. You can also buy them from a chemist if you are 16 or over for approximately £20
  • An IUD – see information above. This can be fitted up to five days after sex

Sexual Activity

The age of consent for both heterosexual and homosexual intercourse in England and Wales is 16-years-old.

This means it is illegal to participate in penetrative sex, oral sex or mutual masturbation under the age of 16.

The law isn’t there to make life difficult. It’s there to protect people. Everyone is ready for sex at different ages. But the law has to generalise so as to protect those who are most vulnerable from exploitation.

  • Sexual intercourse occurs when a man’s penis enters a woman’s vagina. It is how the human race reproduces
  • Sexual activity is any activity associated with sexual intercourse
  • During sexual activity, the man and/or the women may have an orgasm. This is an intense pleasurable feeling
  • During an orgasm, a man may ejaculate and release semen from the tip of his penis. See Male Genitalia section for more information
  • Sperm released through the penis may enter the vagina unless barrier contraception like a condom is used. See Contraception section for more information
  • If they are not faced with a barrier, the sperm will then swim through the cervix, into the womb and into the fallopian tubes. If there is an egg in the tube, the sperm will try to fertilise it. If they succeed, the woman will become pregnant. See Pregnancy section for more information
  • The best way to avoid unwanted pregnancies is not to have sex. Couples who choose to have sex can use contraception, which may also prevent sexually transmitted diseases, but they need to remember that no method is 100% successful, at either of these tasks
  • Other than the legal age of consent (16), there is no ‘right age’ to have sex for the first time. Many people wait until they feel ready and have a steady partner. Whatever age you feel is right, it is important to remember that sex can mean pregnancy and you need to be ready for that
  • The decision of when to have sex is important and you should not feel pressurised into doing anything
  • Remember that when your friends tell you they have had sex, they might not be telling the truth
  • It is your body, so it is your decision. Make sure you are ready, have someone you can trust to share it with and the right protection before you go any further
  • Remember it is illegal to have sex under the age of 16

Other sexual activities

  • Oral sex is when one person uses their mouth and tongue to stimulate another person’s genitals
  • Masturbation is when you touch your own genitals or another person’s genitals to create pleasure
  • Penetrative anal sex occurs when a male’s erect penis, a finger or an object is inserted into the anus of another person

If you are worried about sex, contraception or pregnancy, talk to someone you can trust or visit your GP or family planning clinic. They are there to listen and give advice.

Periods & PMS

Periods

  • A period is when blood passes through the vagina. It begins during puberty, usually between the ages of eight and 16-years-old although most girls start their periods when they’re about 12
  • Girls are born with thousands of eggs inside their ovaries. When you reach puberty, one egg is released from the ovaries every month and it travels along the fallopian tube into your womb – see the Puberty section
  • Each month your body prepares for the possibility of pregnancy and its lining becomes thick and soft, ready for a baby – see the Pregnancy section
  • If the egg is not fertilised, the body lets the lining and the egg pass out of your body through your vagina as your period. The egg is too tiny to see with the naked eye
  • The process will then start again. The time between one period and the next is known as the menstrual cycle and it can vary from person to person. It is usually around one month although in the first few years they can be a bit more irregular
  • Periods will usually last between two and eight days, but everyone is different
  • Getting your first period can be both exciting and scary so try talking to your mother, your guardian or a female adult, who can offer you advice and support
  • A woman’s periods continue until the menopause, which usually occurs in the late forties to mid-fifties
  • Your body produces different amounts of hormones at different times during your menstrual cycle. This can cause changes in your body and your emotions

Sanitary products

  • During your period, you will need to use sanitary products such as sanitary towels or tampons. These can be bought at any supermarket, local store and in some public toilets
  • Towels (also known as pads or napkins) soak up the blood as it leaves your body by sticking to the inside of your pants
  • Tampons fit inside your vagina to absorb the blood before it leaves your body
  • It is a personal choice which sanitary product you decide to use
  • Both towels and tampons must be changed several times a day, usually every four hours, and always wash your hands before and after
  • If you experience a rash, sore throat, headache, sudden fever, diarrhoea or are physically sick, stop using tampons immediately and see your doctor right away – you may be suffering from a bacterial infection known as Toxic Shock Syndrome, which can be serious

Premenstrual Syndrome (PMS)

PMS is the physical, psychological and behavioural symptoms a woman can suffer from just before her period begins which tend to improve once bleeding starts. It affects one in three woman and is considered a medical condition

Symptoms

There are more than 150 symptoms of PMS including

  • Depression and agitation
  • Breast tenderness
  • Fluid retention and bloating
  • Mood swings and irritability
  • Headaches
  • Skin and hair changes (such as spots and greasy hair)

No-one knows the exact cause of PMS but it is thought to be linked to hormone changes in the body ahead of a period

There are ways to reduce the symptoms of PMS, including:

  • A diet that is low in salt, fat and caffeine
  • Vitamin B6 and E
  • Flower oils such as Oil of Evening Primrose
  • The contraceptive pill (speak to your doctor first)

If you suffer from extreme PMS or any of its symptoms, visit your GP.

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