The Journal.ie: Most of you said alcohol has affected your decisions around sex - here's what else we learned
WHEN WAS THE last time you had a chat about your sexual health to a partner, friend or medical professional? Maybe it’s a huge source of worry for you, or maybe you don’t think about it at all.
While the number of teenage pregnancies has fallen by 64%, we haven’t been paying the same care to sexually transmitted infections – there’s been a sharp rise in HIV, syphilis and gonorrhea and the level of STIs diagnosed among teenagershas grown by 8.3%.
For the latest instalment of The Health Check with Irish Life Health, we asked you – what do you really make of your sexual health? While most said it wasn’t a worry (3.7/10), when asked how likely they’d be to attend a GP for it, readers rated 4.7/10 . Similarly, the majority said they’d be likely to seek information about it online (8/10).
To gain some insight into your ratings, we put the results to genito-urinary consultant and sexual health expert Dr Derek Freedman of Dublin’s STD Clinics and executive director of Cork’s Sexual Health Centre, Dr Martin Davoren.
So, how is our sexual health?
Readers rated their feelings around their sexual health as 6.6/10 for satisfaction with it and 3.7/10 as a source of worry. For both experts, this is quite reflective of what they encounter day-to-day: “That would be what I’d expect as sexual health is as variable as the population”, explains Dr Freedman:
There’s a huge spectrum of feelings about sexual health – we’ve some people who are very careful and a wide range of people who don’t think about it too much and a small group who just don’t care.
Dr Freedman says that the most important thing is that “we should be more open about it and feel at ease to discuss it”. Dr Davoren says that while there’s still “a large amount of stigma around the topic”, Irish people are becoming more open in relation to their sexual health:
Sexual health has evolved dramatically in Ireland over the last 30 years if you consider our attitudes to abortion care, sexuality, consent and sexual education. We’re really at a juncture right now.
In his eyes, the change to becoming more open “has to come with sexual health and it will – look how brilliant that was for us as a nation when it happened with mental health”.
Discussing it with doctors
However, our readers rated how likely they would be to attend a GP for their sexual health as only 4.7/10 and Dr Freedman says that it’s a common problem he encounters in his clinic:
I think privacy is a big thing for patients – people don’t like to put their escapades on the table if they’ve known their GP for a long time.
Dr Davoren agrees: “It’s such an intimate topic, often people would rather go to a private anonymous service, especially if they’ve known their GP since childhood”. This is why he advises that if you do feel this way, you can visit your local clinic instead for total anonymity.
This factor might explain why there were almost 4,000 calls to Sexual Health Centre’s anonymous helpline in 2017: “People are often unsure of where to find the best information and want a professional to answer their most private questions.”
When it came to how easy it was to have these conversations with their GP, readers rated 6.4/10. This could explain what Dr Freedman refers to as what doctors call “door handle conversations” – that patients sometimes leave the question that’s most making them anxious until the end of the consultation, often after a doctor has put away their notes.
Dr Davoren reminds that in this case, every person has a sexual health history, including the doctor they are speaking to. He gives the following advice:
Take a breath and realise that everyone has been there at some point – tell us why you’re worried and what questions you’d like an answer to. You’ll feel a lot better when you get these answers.
According to Dr Freedman, the worst possible thing you can do when you’re worried about having an STI is to start taking antibiotics before you’ve had a full screening: “This can conceal an infection for many years.”
When do we tend to get ourselves in trouble?
While the majority of readers said they’d be likely to have safe sex in a new relationship, most also rated that alcohol has previously affected their decisions around safe sex (6.8/10). Dr Freedman calls this a “huge issue”: “I would say alcohol would account for over 70% of people who come in for an STI screening.”
The most common situation where he tends to encounter patients who haven’t had safe sex is the case of one-night stands with alcohol:
This is where major problems arise and people are having unprotected and unplanned sex under the influence and putting themselves at great risk.
Dr Davoren agrees that alcohol can be a major issue for safe sex: “Risk-taking happens in clusters”, just like social smoking usually occurs when drinking. Secondly, alcohol is known to reduce inhibitions. It’s something that his team encounters often in the clinic:
We’d see individuals who are nervous after a night out who had unintended or unprotected sex and are worried about STIs, relationship choices, dignity, respect, consent and want to talk to us.
The other major risk we can take with our sexual health is assuming that if we had caught something, that we’d have symptoms. Readers rated their ability to recognise STI symptoms as 6.4/10, a figure that worries Dr Freedman, who says that the figures show a “total lack of knowledge of readers because no symptoms are reliable”. He explains:
Only around 10-20% actually experience symptoms and the most serious STIs are usually silent. Many look up “Dr. Google” with non-specific symptoms or images, and obtain a long list of possibilities. This can lead to a huge amount of anxiety which is usually misplaced.
He explains that infections can take “anywhere between two days and ten years to develop”, so if you are worried about an infection it’s imperative to have a full comprehensive screening. Especially if you develop a growth, sore, wart or ulcer, Dr Freedman says you need to be screened and assessed immediately.
Dr Davoren agrees: “If you are waiting for a sign, it’s really important to get tested – it may never appear.” However he adds that if you are seeing any discharges, you should definitely make an appointment with your GP or local STI clinic.
Secondly, it’s very important that you don’t rely on self-examination which does not compare to a face-to-face consultation with a professional, explains Dr Freedman: “You can’t examine yourself – particularly for girls or men who have sex with men and may have interior lesions.”
How can we have better sex?
With his patients, Dr Freedman has three important points – the importance of ‘quality sex’: “being with someone you know and that you can have a good relationship with”. Secondly, the idea of ‘slow sex’: “a bit like the mindfulness movement – you savour it”. Lastly, he says that we should view it as “giving sex, not getting – it’s a valuable gift you can give.”
Secondly, he says that communication should be a key component of any sexual encounter, and has the following advice for those who are single and likely to have new partners:
Talk to the person you’re thinking of having sex with, get their name and phone number and start off with a condom for any sexual activity.
Dr Davoren echoes that good communication skills are crucial for any positive sexual relationship: “Talk to your partner, say what you want and what you don’t want, what you enjoy and what you don’t enjoy – whether you’re single or monogamous.”
And if you’re unhappy about any aspect of your sexual health: “Ask a question or get support from a professional.” He adds: “Sexual health is an integral part of everyone’s life and we all have a right to good, healthy relationships.”