Continuing our Love and Sex Special focusing on embarrassing questions, NHS GP Dr Preethi Daniel has expert advice to one of the questions she is most-asked by women in her clinic
Whether you’ve been caught up in the heat of the moment, the condom slipped off or you simply forgot to use protection, try not to panic. The spontaneity of sexual intercourse is one of the attractions of getting hot and heavy. The aftermath of such spontaneous activities can result in days and nights riddled with anxiety. Am I pregnant? Have I got chlamydia? What are the symptoms of syphilis? The list of questions is endless and I have heard them all.
Unprotected sex is considered as intercourse where protection has not been used, or if the contraception could be deemed ineffective (FYI, that 15-year-old condom you carry for emergencies is probably out of date). The risk of contracting a sexually transmitted infection and pregnancy are high. You only need to have unprotected sex once to catch one or more STIs or become pregnant. The most concerning factor surrounding the more common infections such as chlamydia and gonorrhoea are that you may not get any symptoms at all.
There are many myths around some non-traditional contraception methods, which are incredibly risky and have no proof of working. These include the ‘withdrawal method’ (also known as pulling out), having sex when the woman is out of her ovulation period and having sex in different positions which supposedly ‘lessen’ the chance of pregnancy. Sperm can stay alive inside the body for up to seven days and has the potential to fertilise an egg – and remember, it only takes one to get pregnant.
with chlamydia and gonorrhoea you may not get any symptoms at all
The morning after…
There is a reason there is a ‘morning after pill’ and if you go to the pharmacy up to five days (120 hours) after an episode of unprotected sex they can administer the medication for you. Potential side effects of emergency contraceptive pills are nausea, tiredness, dizziness, headaches and breast tenderness. The medication works by preventing or delaying ovulation. After a discussion with the pharmacist, they will be able to suggest the most suitable medication for you.
There is an alternative to the tablet, which is the Copper IUD. This type of coil can be inserted for free at sexual health clinics or at certain GP surgeries within five days after unprotected intercourse. The difference between the IUD and emergency contraception is the copper IUD – if kept in – is effective for 10 plus years.
Side effects of the copper IUD include cramping and bleeding between periods. Please remember that this form of medication does not protect you against sexually transmitted infections (STIs). You will need to follow further procedures to test for any potential exposure to STIs.
Sexual health testing…
Men and women will experience separate symptoms if they have contracted a sexually transmitted infection. As mentioned previously, it may be the case that you remain asymptomatic (no symptoms) even if you have contracted an infection. This reason alone emphasises the importance of getting a sexual health test after any form of unprotected sexual activity.
If you do suffer any symptoms, watch out for any of these:
- Unexplained bleeding
- Pain when you urinate
- Unusual discharge
- Sores around your genitals
It is recommended that you go for sexual health testing within a couple of weeks of having unprotected sex. If you are concerned about HIV and hepatitis, the recommendation for the most accurate results is to be tested three to six months after unprotected sex. Most of the common infections can be tested for with a vaginal swab or urine sample along with a blood test. We can even get some results within the same day. If you are found to have a bacterial infection, we will issue an antibiotic to treat it. Usually, two weeks after treatment has been undertaken, further testing is necessary to ensure the infection has cleared.
Remember to avoid sexual intercourse until you’ve been given the all-clear so that you don’t risk passing the infection on to someone else. STIs such as genital herpes may not always be obvious and many of those infected with the Herpes Simplex virus may be carriers but never experience blisters or sores. A swab of any sores can easily diagnose herpes. There is treatment available to reduce your symptoms and stop spread but it does not cure the body of the virus.
The after effect…
If you have sourced the emergency contraception pill as a precaution after unprotected sex, it is vital that you keep an eye on the due date of your period. You will have to remember that a side effect of the morning-after pill can be light bleeding (also known as spotting) which can affect your period, and make it hard to tell if you are pregnant. If your period is more than a week late, take a pregnancy test. You can buy them in all pharmacies, or visit your GP where a pregnancy blood test can be organised for you.
Get another STI test 3-6 months after the initial one. Infections such as syphilis, hepatitis B and HIV can take up to six weeks to three months to develop in the body, so it’s important to get tested again following this period to make sure you’re negative.
Always check the expiry date when buying condoms (yep, you’re going to start buying condoms, right?) and look to see if CE is marked on the side of the packet. This means that they comply with European safety standards. If you want the condom to work, not only do you have to use it in the first place but you also have to use it correctly from start to finish.
If you are sexually active, you may want to go to your doctor to seek a contraception option whether it is the pill or an implant. You can discuss with your doctor to seek the best long-term option for you. Regular sexual health testing is advised every three to six months if you are sexually active.
Have fun everyone but remember to be safe!
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Dr Preethi Daniel is an NHS GP in Hertfordshire and Clinical Director at London Doctors Clinic. She graduated from Kings College London in 2010 and has since gained extensive experience in various hospital specialties during her postgraduate medical and surgical training before becoming a GP. During her junior doctor years, she successfully published a paper on a rare condition affecting the intestines causing excessive vomiting, in GUT magazine. She has well-rounded clinical knowledge in Women’s Health, Child Health, Emergency Medicine and Mental Health. She has experience working with Herts Valleys Clinical Commissioning Group to optimise patient care pathways in the NHS. She currently teaches Community Geriatrics to UCL medical ents and mentors young people on career and interview skills for Universities. Dr Daniel also works as an NHS GP in a busy Hertfordshire practice of over 10,000 patients.