Sexual Health & Health Maintenance

Sexual health is as important as general health. Just as periodic general health check-ups are necessary, so is sexual health maintenance. Although basic sexual health may begin with the health care provider, it continues to be an important factor in everyday life, so it is critical that everyone starts in a safe and comfortable place with their doctor or examiner.

Sexual health exams should begin at the age of 18 or when first sexually active, and are especially important for women. STDs and other disorders of the urogenital tract, contraception, and cancer surveillance are three main issues addressed during the exams.

In women, cervical cancer has been linked to viral agents (HPV) and other low grade inflammatory effects on the cervix, and is easily screened for by a Papinicalou smear (”Pap smear”). Since HPV is extremely common and cervical cancer can be deadly if not treated, all women over 18 should have an annual exam that includes a Pap smear. Because HPV is transmitted through skin-to-skin contact, even women who have not engaged in penile-vaginal intercourse can still be at risk. Breast, ovarian, and endometrial (uterine) cancers, although uncommon in a younger population, rely on accurate history taking and thorough examination of the breasts and pelvic organs at the time of an annual visit.

For men, the annual exam is less mandatory and may be performed every few years instead. However, having a testicular exam performed and being instructed in the technique of self testicular examination is of great benefit to ensuring early detection of this treatable cancer.

Sexual health exams can be very intimidating. Try to relax and remember that the doctor is there to help you maximize your health. To do this she or he needs to know about your concerns and factors or situations that may impact your health. If you do not feel comfortable revealing these things to your doctor or examiner, they may not be able to help you as fully. You should have a physician you trust and feel comfortable talking to. If you don’t feel right with a certain doctor, find another.

An understanding physician should:

* Be willing to listen, attentive and open, and should take time during each visit
* Use gender neutral language instead of assuming patients are heterosexual
* Show respect for the individual patient and gentleness during the physical exam
* Be willing to include your partner in health care visits and discussions if that is your wish

If you have specific health considerations, make sure you feel comfortable that they will be properly addressed.

Remember:

* It is important to give your doctor a complete medical history
* It is not your sexual identity that puts you at risk, it is your specific behavior
* If you are engaging in un-safe anal sex, it is a good idea to discuss an anal pap smear with your doctors during your check ups.