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Health

19th Sep 2014

Ask a Doctor: Your Sexual Health Concerns Covered

All your questions on sexual health covered.

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When you’ve got a sexual health worry it can play on your mind all day, every day. Sometimes it develops into that niggling feeling in the pit of your stomach, which is even harder to get rid of. But these deep-set concerns don’t necessarily make it easier to talk to a health care professional face-to-face. We’ve got Dr Gigi Taguri from Lloyds Online Doctor to answer as many of your sexual health concerns as she can handle, so read on for answers to those questions you’ve dared to ask.

When I have sex it’s very painful. I’ve been with my boyfriend for six years and have noticed a lot of discharge and I haven’t had my period since I had my two kids (two years and five months). My boyfriend thinks I’m making it up but I need to know what’s wrong.

Sorry to hear you’ve been having a hard time of it – especially with two kids under two which must be very stressful. As you’ve told me that you’re not having any periods, the first thing I would do is check you’re not pregnant again. As for the pain you describe, this is actually very common amongst women who’ve just had a baby and I urge you not to worry. It’s likely that your mind may not be focused on sex right now – which is normal if you’re very busy and stressed – and this may be affecting your body’s reaction. If you’re breastfeeding, your body’s oestrogen levels are supressed, which can affect your libido as oestrogen is the main chemical responsible for driving sexual arousal and enjoyment during sex.

There is also a psychological condition called vaginismus which can manifest itself physically and cause the vaginal muscles to tighten during penetration which can lead to pain. Once this pain starts, there becomes an intrinsic fear of sex which can lead to pain each time, and so a repetitive psychological cycle ensues. Treatment depends on each woman, but many find that hypnotherapy or counselling works, so if things don’t get better you could try this. You’re first move, however, should be to communicate your worries to your partner and try to reintroduce intimacy and/or sex slowly. Good luck.

I get blister like sores every few months…do I have herpes? And what’s the difference between herpes and warts? I went to my doctor but she couldn’t tell tell me what was wrong since it wasn’t present at the time.

Some of you have written in asking about herpes and genital warts which are two easily confused yet very different viruses. They are commonly spread as STIs but can also be found on other parts of the body too.

What is herpes?
Herpes is caused by the herpes simplex virus (HSV) which comes in two forms: HSV-1 which mainly creates blisters on the lips, face and mouth and HSV-2 that causes sores mostly on the genitals, anus, thighs and buttocks, but they can overlap. You haven’t described on which part of your body the sores are, but it sounds to me like you could have the HSV virus. Once you have the HSV virus it is for life and if you are newly infected, you can expect an outbreak every few months, but the good news is the number of outbreaks generally reduce each year thereafter and you can get treatment to reduce the frequency and severity of these outbreaks.

What are genital warts?
Genital warts are caused by the human papilloma virus (HPV) which is also responsible for the verrucas and warts found on hands and feet. Most people with the HPV infection don’t even know about it, and it often clears up on its own before any symptoms appear. Sometimes warts can crop up months or even years after contracting HPV so it can be hard to know from whom, or how you contracted the virus.  It’s also worth knowing that genital warts can still be contracted even if you’ve used a condom and they aren’t always contracted through sex. However this is the most likely reason for their occurrence as there are around 30 different types of HPV that can live in and around the genital area.

How can I protect myself against these viruses?
HSV and HPV can be easily spread during penetrative sex, oral sex and by sharing sex toys so it is important to tell your partner about the infection and avoid having intercourse while you receive treatment. For the best protection against STIs, you should practice monogamy and/or use condoms.

I’m 23 and have a sharp pain in my abdomen which gets worse after sex. I frequently go to the bathroom during the day and wake in the night. It’s ruining my sex life and I don’t know what to do.

To be honest I need a bit more information to know exactly what is going on and if you’re in this much discomfort I would advise you to see your GP. You could have cystitis which is inflammation of the bladder, characterised by that horrible burning and stinging sensation when you urinate and the need to pee – often passing only small amounts of urine. People with cystitis also have a pain in their lower stomach above the pubic bone or in the lower abdomen. If it is cystitis, you should avoid intercourse until it has cleared up, as sex can actually make the symptoms worse.

Remember to drink plenty of water and try some over the counter painkillers to ease discomfort. Mild cystitis usually clears up on its own, but your GP may be able to prescribe you antibiotics which can speed up recovery by one to two days if your case is more severe. Sexually transmitted infections such as chlamydia and pelvic inflammatory disease can also cause similar symptoms, so again I think you ought to see your GP for an examination and simple tests.

If you’re worried you might have a sexually transmitted infection and don’t have the time, or are too embarrassed to go a clinic, at Lloyds we offer easy to use discreet home testing kits for chlamydia, gonorrhoea and HIV, in partnership with the Irish Family Planning Association.

Our last session with Dr Gigi Taguri is about stopping smoking.  Click here to submit your confidential questions which will be answered on October 3rd. And don’t forget to follow @LloydsOnlineDoc

Lloyds Online Doctor provides women with consultations for repeat prescriptions for the contraceptive pill or patch, treatment for weight loss, stop smoking and cholesterol for only €25. Launched in July 2013, the service has treated over 20,000 Irish patients so far. To find out more about the service visit https://www.lloydsonlinedoctor.ie