The sexual health questions you’re still too shy to ask

My new man gets cold sores on his lips. I don’t kiss him when he has one, but should we also be careful about sex?

In a word – yes. ‘Herpes is categorised into two main types: HSV-1, or oral herpes, and HSV-2, or genital herpes. However, during an outbreak, oral herpes can be passed to the genitals,’ says Helen Knox*, a clinical nurse specialising in sexual health. ‘There’s no cure, and it affects people in varying degrees – some can be symptomless carriers, some experience one outbreak and others have recurring flare-ups that can last a long time,’ she explains. ‘But it’s manageable, as long as you take steps to protect yourself. That means avoiding any kissing and mouth-to-genital contact during the “tingle stage”, when the cold sore is forming, while it’s erupting and until it’s fully healed.’ Tough – but worth it.

I’m newly divorced and want to use condoms, but I’m confused by all the options.

‘Give yourself a high five for being proactive about protection,’ says Helen. ‘We’re seeing an increase in people aged 50 and over being diagnosed with chlamydia, warts, herpes and HIV. One reason for this could be that they’re new to the dating scene and aren’t aware of the risks. STIs, including herpes and warts, can be passed on through skin-to-skin contact, so always put on a condom before any genital contact occurs – yes, even heavy petting,’ she says. ‘And as condoms don’t cover the entire genital area, you may both want to consider an STI screening test.’ Some people worry that sex won’t be as enjoyable when using a condom, but many types are designed with your enjoyment in mind – with a thinner feel, or textured for heightened pleasure. ‘If you’re worried about your sexual health, there are slightly thicker condoms available to give you peace of mind,’ says Boots pharmacist Scot Taylor. ‘There are really thin condoms for extra sensitivity; some that can delay male climax; latex-free varieties for anyone who’s allergic; and even different sizes for a better fit.’ So you’ll really be able to get on a, er, roll. And don’t forget that you can turn to your Boots pharmacist for help if you need more info – speak to them in the consultation room** in store if you want a private chat.

My partner struggles to get – and keep – an erection. How can I help?

Firstly, he’s far from alone – there’s even a National Impotence Day on 14 February to help raise awareness. ‘It can affect men of all ages, but is more common as they get older, with around 50% of those aged 40-70 affected by it to some degree,’ says GP Dr Nupur Yogarajah, who has a special interest in sexual health†. ‘The causes can be physical (high blood pressure, high cholesterol or diabetes), psychological (depression or anxiety), and psychosexual (anxieties around performance),’ she explains. ‘Smoking, obesity, alcohol consumption and medication may also contribute. It’s a sensitive subject, so I advise approaching it delicately – and away from the bedroom. Reassure him that it’s very common and discuss the next steps together.’ Boots offers an In-store Erectile Dysfunction Service†† for men aged between 30 and 65. ‘The consultation will include blood pressure, cholesterol and weight checks,’ explains Scot. Treatment can be prescribed and lifestyle changes discussed – from dealing with everyday stresses to drinking less alcohol.’

My smear test always brings fear of the ‘C’ word. How can I protect myself from cervical cancer?

Almost all cases of cervical cancer are caused by the human papilloma virus (HPV). ‘HPV is the name given to a group of 100 viruses, some of which can be passed on through sexual contact,’ says Dr Yogarajah. ‘Most are symptomless and will be dealt with by your immune system, but two (HPV16 and HPV18) are linked to cancer of the cervix, and others are associated with vaginal and anal cancers and genital warts. While there are treatments for pre-cancerous changes and genital warts, there’s nothing for other HPV infections. Using condoms can help prevent HPV transmission, while your routine cervical smear can help detect any pre-cancerous cells early.’ A free HPV vaccine is now offered to girls aged 12 and 13 in schools, and it’s thought to be responsible for a decline in genital warts in women aged 19 and under. Apart from keeping up with your smear tests, stay aware of your vaginal health. Look out for discharge that’s not normal for you, pain or discomfort during sex, or unusual bleeding – and don’t be scared to speak to your GP about any concerns.

I have more discharge than normal. Could I have picked up an STI?

It’s easy to think the worst when something changes down there, but as Helen explains, there can be many causes: ‘Although this may be an indicator of an STI, such as chlamydia or gonorrhoea, it might also be thrush or bacterial vaginosis.’ [The latter, also known as BV, is a common vaginal infection, but not an STI. It can be caused by sex, or factors such as using perfumed soaps, taking bubble baths, or douching. Scot explains, ‘If your discharge is thick and white and you’re experiencing itching, it might be thrush; if it’s grey and watery with a fishy odour, it could be bacterial vaginosis.’ If you’ve had unprotected sex, it’s always best to go for a screening at a GUM (Genito-Urinary Medicine) clinic. ‘It’s also helpful to get to know your normal,’ notes Helen, ‘so keep track of your cycle and what the discharge looks and smells like. A clear mucus is common in the lead up to ovulation, and white discharge just before your period.’ You can ask your Boots pharmacist for advice – most stores have a consultation room if you’re feeling shy. ‘We stock a home-testing kit that helps check for common vaginal infections, but we recommend seeing your GP,’ adds Scot. ‘We can also suggest treatments where appropriate, such as pessaries for thrush.’ So you can help get your vagina (foofoo/mimsy/bajingo/noonie – delete as appropriate) back to normal.