Talking about sex… with a healthcare provider?

In the Healthy Heels blog, we’ve talked lots about communicating with partners about if and when one may engage in sexual activity, various methods for practicing safer sex,  talking with partners about STIs, and even the benefits of open communication around sexual health with your peers.

In honor of our “Let’s Talk About It, UNC” (LTAI – which we’re pronouncing, “la-tay UNC”) program this month, we ask: “what about talking to your healthcare provider about sex?”

Sexual health is a personal topic and oftentimes a very sensitive subject to talk about with anyone, so when you are asked sensitive questions in an exam room with a healthcare provider you’ve only met a few times, it can be a little uncomfortable.  This blog post is dedicated to de-awkwardizing those discussions: we’ll cover why it’s important to talk about sex and sexual health with a provider, expectations for some questions to anticipate, and questions you may want to ask.

Why talk about sex?

Sexual activity and sexuality are normal parts of our lives, and sexual health is an important part of overall health.  As such, it can be important for both the healthcare provider and patient to talk openly and candidly about sex and sexual health during clinical appointments or exams.

From a healthcare provider’s perspective, talking about sex during an appointment is a normal part of talking about one’s general comprehensive health behavior.  In most settings, a health care provider will ask about sexual activity routinely. IMPORTANT: This does not mean that talking about sexual behavior necessarily relates to a specific health concern or to you! Even if you have not previously engaged in sexual behaviors, or are currently abstinent for a variety of reasons, it may seem unrelated to talk about sex, but it’s important to remember that your sexual health as an integrated component of your overall health and wellness is related to other areas of health in your body and life.  Here are some examples:

  •   Some nutritional supplements or drugs that you might take for infections may have an interaction with prescription contraception.
  •   Some drugs may influence one’s sexual health – like anti-depressants influencing sexual libido.
  •   Some drugs or supplements may change body chemistry and increase risk for yeast or other infections, particularly when regular sexual activity is involved.

Healthcare providers may also ask about the type of sex you’re having and the birth sex and gender of sex partners in order to give personalized screening and prevention recommendations. For example, if someone is only having oral sex with females, they may recommend using dental dams, but if someone is having vaginal sex with males, they may recommend using condoms.

From a patient’s perspective, clinical appointments are an opportunity to voice health concerns and get reliable, personalized information on sexual health questions or concerns.

Questions to anticipate

Providers frequently ask about the following during a clinical appointment:

  • Sexual activity – whether or not you’ve had sex before
  • Number of sex partners in some period of time (currently, in the last year, etc.)
  • Types of sex (oral, anal, vaginal, other)
  • The gender of sex partners (if you have specified a sexual orientation, this question may still be asked because a person’s orientation may not always correlate with their sexual partners)
  • Use of contraceptives or barrier methods (hormonal birth control, condoms, or dental dams, for example)
  • Testing history for HIV/STIs
  • Appearance of symptoms such as rash, sores, fever, etc.
  • Alcohol or other drug use around sex
  • Pap history, including whether you have had an abnormal pap and subsequent tests
  • Pregnancy history (if you have been pregnant before and whether those pregnancies resulted in a live birth, miscarriage, c-section, or abortion)
  • Some providers will ask about sexual satisfaction too

It’s important to note that there are no right or wrong answers to any of the above, though it is important to be honest about your responses. Remember, everything you talk about with a provider is protected information.

Things to bring up or ask about

A provider may ask you lots of questions, but it’s important that you feel comfortable speaking up about sexual health during appointments as well! Even if a health care provider doesn’t ask questions about sexual health, you should feel free to bring up any of the following:

  • Any changes since your last appointment (ex: appearance of symptoms, changes in lubrication or sensation)
  • Problems or challenges using contraceptives or barrier methods (side effects, itching or burning with condoms, etc.)
  • Results of any previous tests
  • HIV/STI testing recommendations, if not already offered by the provider
  • Any questions you may have about HIV/STI testing or prevention
  • Concerns you have about any prescriptions suggested by your doctor (ex: negative experiences in the past, fear of side effects). If something affects your willingness or ability to start or complete a treatment, speak up!

Didn’t get all the answers to your questions? If you have questions about sexual health, you can always ask a trained sexual health educator at Student Wellness by using our confidential online C.H.A.T.S feature, or by emailing You can also make an appointment to talk to staff in Student Wellness in a face to face  setting by calling 919-962-WELL.

Let’s Talk About “IT”, UNC!

Student Wellness is starting a new program this Spring called “Let’s Talk About It, UNC”, or LTAI UNC (which we’re pronouncing “la-tay UNC”).  LTAI UNC is an awareness campaign LTAIthat strives to encourage dialogue surrounding sexual wellness and connect students to reliable sexual health education and resources. College-aged adults are disproportionately affected by outcomes such as unintended pregnancy and STIs, and these outcomes can go on to impact self-esteem, academic performance, and relationships with peers and partners. Despite the availability of many resources on campuses, misconceptions around sexual health are common and many topics – from keeping relationships healthy, to STI testing, to communicating with partners – remain taboo or uncomfortable to talk about. LTAI UNC is about addressing that. And since April includes both National Public Health Week and STD Prevention Month, what better time is there to get students talking about “it”?

We believe that effective dissemination of reliable information and the degradation of social barriers such as stigma are possible by starting conversations. The idea is that meaningful gains in knowledge, awareness and healthy behavior can start with talking about “it”– with healthcare and wellness providers, friends and partners.

So, what’s “it”?

LTAI UNC focuses on sexual wellness. Specifically, we want to encourage dialogue on the topics that so frequently go unaddressed, oftentimes due to lack of knowledge, embarrassment, stigma, and other barriers. These topics include:

  •          Partnerships
  •          Contraception
  •          Sexual decision-making, including abstinence
  •          Sexual health risk reduction for STIs and pregnancy
  •          Communication

What will LTAI Do?

This month, we’ll be using in-person events and social media to connect students to resources and bust many common sexual health myths. We’ll also be posting sexual wellness themed blogs here at the Healthy Heels blog.

Start Talking

Get into the spirit of LTAI UNC by:

Coming to one of our LTAI events!

  • April 2nd– April 8th, 10AM-2PM: We’ll be tabling in the Union to bust sexual health myths, providing more information on LTAI UNC, offering some awesome giveaways from Student Wellness and the Daily Grind.
  • April 4th, 6-8PM: Let’s Talk Shabbat at UNC Hillel.
  • April 9th, 8-10PM:  Sexual Health Trivia at Steel String Brewery (Must be 21 or older).
  • April 1st through April 30th:  Talk about it, and get entered to win prizes. Re-tweet our posts, or contribute your own with the #LTAIUNC hashtag between April 1st and April 30th, you will be entered into a drawing to win your choice of a FitBit Fit or Chromecast. Only full-time matriculating UNC students are eligible.  If you are a UNC Chapel Hill student and use the C.H.A.T. S. feature between April 1st and April 30th and complete an anonymous evaluation following your chat conversation, you can elect to be entered into a drawing to win your choice of a FitBit Flex or iPod nano. Access C.H.A.T.S.  here!

Check out our resources on talking about sexual wellness:

  • Check out our blog posts about tips on having difficult conversations. There’s one for talking about STI diagnosis, another about talking with partners.
  •  Have a sexual wellness question? Ask a trained Wellness educator by making an appointment by calling 919-962-WELL, or use our confidential health assistance and talk around sexuality (C.H.A.T.S.) program. Bonus! If you use our C.H.A.T. feature this month you can volunteer to be entered to win a prize! Drawing will be {Insert date}.

Let’s start talking! The more we talk, the closer we get to making the UNC campus a healthier, safer place.

Having The Talk……

No, not the awkward sex talk with your parents.  But the talk you have with your partner to tell them about you, your likes, desires, wishes and needs, and to maybe learn more about theirs! Open communication is a cornerstone of any healthy relationship, and this applies to telling your partner that while you love them cooking for you, you really just don’t like olives in everything, to telling your partner what you like in the bedroom.

Telling your partner about your sexual likes and dislikes can be a little scary, but just ltalkingcouplesike talking about condom usage, it’s just as important.  There are a million and one different ways that people can have sex, and a million and one fantasies that each individual has, and letting your partner know what you want is an important part of your relationship, and your sexual well being.

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Go Ahead and Bring It Up

Communication is an important part of healthy relationships because it can build trust, improve your sex life, and facilitate understanding. However, questions like ‘What’s your number (of sexual partners)?’ and ‘What was your last relationship like?’ tend to be avoided in conversations with partners.

A study asked male and female college students to list topics they avoided  discussing with their romantic partners. The results show that the most avoided topics of conversation are past romantic relationships and sexual experiences.

Study participants said that they avoided talking about past relationships because they wanted to respect their partner’s privacy, did not want to be compared with past partners, or thought that discussing the past may threaten closeness in the relationship. Some even disliked discussing the past because they did not want to know if their sexual experience level differed from that of their partner’s.

A lot of people probably share the concerns found in this study, and obviously you do not want to know everything about a person’s past on a first date. However, eventually talking about past sexual experiences can protect your health (you may learn about your partner’s STD status), and talking about past relationships may bring a new level of understanding to the current relationship.

Here are some tips for communicating about your past:
• If your partner brings up a past relationship, don’t immediately change the subject because you think their past is none of your business. Give it a second and listen; you may learn something worth knowing (good or bad).
• Find your own way of telling your partner that they are not in a competition with your past.
• Keep it honest.  Never lie about what happened between you and another person, your health, or your sexual history.

Getting to know each other is part of being in a relationship. So go ahead and bring the past up. Your health and the health of your relationship may benefit from doing so.

Reference: Anderson, M., Kunkel, A., and Dennis, M.R. (2011). “Let’s (Not) Talk About That”: Bridging the Past Sexual Experiences Taboo to Build Healthy Romantic Relationships. Journal of Sex Research, Volume 48, Issue 4, p.381-391.

Sexual Health and the Tar Heel City

 Photo credit: das_sabrinchen

Ever wondered how the hit HBO show “Sex and the City” ran for six years with only a few passing nods to important sexual health topics such as birth control, HIV testing, or abortion?  Despite an endless supply of Sunday brunch banter about the sexual lives and partners of Carrie, Miranda, Charlotte, and especially Samantha, hardly a word was mentioned about these topics.  And lest we think this is a primarily heterosexual media phenomena, the same goes for the group of women who partner primarily with women on Showtime’s popular series “The L Word”.

Ok, maybe you’ve never found yourself lying awake at night wondering about this because…..
1.  You watch these shows for their entertainment value and not to get a lesson on what to talk to your doctor about.
2.  You’re not as unabashedly focused on sexual health as I am.  Who knew you could be a sexual health nerd, right?

But really, even if you haven’t even watched the show, it’s not hard to imagine how shows and movies head straight to the good stuff about sex and conveniently leave out everything else.  Most people wouldn’t consider it “sexy” to talk about your preferred method of birth control or going to get an STI test, right?

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