Talking about sex can feel extremely awkward, even with people you’re close to.
Even so, there are important conversations people can have around the issue of sexual health, both with their partners and their physician.
The Six Principles of Sexual Health were developed in collaboration with the World Health Organization (WHO) to provide a personalized vision to an individual’s own sexual health and wellness. The principles are:
- Consent
- Nonexploitation
- Honestly
- Shared values
- Prevention of sexually transmitted infections and blood borne infections (STBBI’s)
- Pleasure
“Balancing your sexual safety and pleasure while upholding your sexual rights is encouraged to foster sexual health,” said Jennifer Nierstheimer, PsyD, RN, a psychologist with Endeavor Health who is training in sex therapy.
Here are four conversation points when it comes to talking about sex:
Consent and boundaries
The most universal sexual health principle is consent. It is defined as “voluntary cooperation” and ensures interactions are rooted in mutual agreement and respect. It’s an ongoing conversation participants should have whenever they engage in a sexual encounter. Consent should be asked for and given throughout a physical encounter. Not necessarily as a Q&A, but by paying attention to your partner’s verbal and physical cues. Consent may vary across cultures, religions, and laws, however the fundamental basis is providing safety and pleasure is aligned with each individual’s desires. Physicians can help clarify consent if you have questions.
STI testing and prevention
As mentioned above, one of the 6 principles of sexual health is prevention of sexually transmitted infections and blood borne infections (STBBIs). Whether taking active precautions such as PreP, condoms, vaccinations, barriers/dams, and open communication, testing and screening methods are additionally helpful, along with navigating post exposure with antibiotics that can cure bacterial infections, including gonorrhea, chlamydia and syphilis, and antiviral medications that can suppress HPV and HIV that will remain in the body.
The HPV virus, strains of which can cause cervical cancer, has a safe, effective vaccine that prevents infection by most of the strains that can cause cancer. The vaccine is typically given in two doses between ages 9-14 but can be given in three doses between ages 15-26.
Contraception
Contraception plans, communication, and shared responsibility play a crucial role in the experience of unplanned and unwanted pregnancies. While this can affect people differently depending on many factors, informed choice is critical for healthier relationships with sexual and reproductive wellbeing. Your doctor and the support of a trained sex therapist would be perfect resources to explore which contraception plan might be right for you. Read about over-the-counter birth control.
Sexual dysfunction
There are many factors that can influence sexual health, including medication, physical factors like pregnancy, diseases like cancer, mental health issues, and body changes with aging.
For women, arousal and vaginal dryness or pain are common. Men often face erectile dysfunction and premature ejaculation. Talking this over with your physician can lead to personalized treatment.
Aging brings hormone changes, which can affect sexual health. Pregnancy can as well. Be sure to discuss any problems that arise with your doctor and keep your partner(s) in the loop as well.
"Many people experience sexual difficulties at some point in their lives, and thankfully, medical science has made significant progress in this area. We have a range of treatments, from medications and therapy to lifestyle changes, that can make a real difference,” said Dr. Nierstheimer.
How to start a conversation
Before broaching any topic related to sexual intimacy with a partner, set your mind on a non-judgmental, open conversation.
Use “I” statements and try to truly, actively listen to what your partners have to say. The more you talk about your sexual relationship, the easier it will become.
Protect yourself and improve your relationship by having sexual health conversations with your loved ones and physician.
Talking to your providers about your sexual health is an important step in your journey, while it is also important for our providers to offer permission to talk about sex.
Dr. Nierstheimer is in the process of becoming an American Association of Sexuality Educators, Counselors, and Therapists (AASECT) certified trained sex therapist. Endeavor Health has additional trained providers that can discuss important areas of sexual health such as pain, body image, medical diagnosis and its impact, cancer, pregnancy, menses to midlife and beyond, and STBBIs.
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