How Do I approach a doctor about it?
Many patients are justifiably hesitant to talk to their doctors about sex. Will the doctor be “funny” about it? Embarrassed? Authoritarian? Judging? Avoiding? Ignorant??
If you are sexually active and are unsure about the correct precautions to take or need medical advice about what is safe and not safe, you can take your chances and get this advice off the Internet (but please go to a reputable site.) OR, you can see a doctor in-person or on-line doctor via a video telemedicine visit.
Some things to consider:
Here are some tips though, in this article (written by me, S. John Guha, MD, a medical doctor trained and licensed to practice medicine on-line or in person in the United States).
- Minimize the number or sexual partners you have, preferably with one (monogamous) partner whose sexual health history you have verified as “clean.” More on “clean” below.
- Use “barrier protection,” that is, CONDOMS, unless the risk is zero.
- Men who have sex with men (MSM) may develop extra-genital sexual infection, such as rectal chlamydia and gonorrhea. 1 Hence, condoms are important with anal sex, for men and for women.
- Verify recent STD testing results that your partner(s) have – avoid “one-night stands” and DON’T just believe someone if they tell you that they have never had an STD. Many people may have an STD and NOT know it.
- Having a totally unremarkable and safe STD record (free of STDs) has:
- to be complete and done 6 months after the last sexual encounter.
- The completeness of tests results should include, at a minimum, chlamydia, HIV, syphilis, gonorrhea, and herpes.
- If you want to be further cautious, a recent examination to rule out genital or anal warts or open sores is recommended. Ask to see the medical record of this exam. It can be done in-person or on-line with a physician (a phone camera can show everything to an on-line physician). There are many types of STDs, not just HIV, so a medical examination along with full testing is optimal. Many laboratory tests can be done in the comfort of your own home, completely confidentially, and these can be ordered by a physician.
- There are medicines that can be taken within 24 hours after sexual intercourse to prevent certain diseases (e.g., for HIV), but the best/safest thing to do is to avoid the risk in the first place.
- Certain medicines can be taken daily to try to prevent certain diseases (e.g., PrEP with Descovy for HIV), but again, avoiding the risk in the first place is optimal.
The World Health Organization defines sexual health as a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.2 This is what is strived for.
Talk to a doctor... you have confidence and trust in, in-person or on-line, and please be honest and complete with her/him. A doctor bases the tests ordered and the treatment recommendations assuming that accurate information is given. If the doctor asks you a lot of “personal” questions, that means she/he is doing a good job.
S. John Guha, MD