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Sexual health advice

An archive of expert responses to questions on sexual health submitted by NHS Choices users.
  • "When I have sex with my partner I always feel like I'm about to wet myself. I have had an STI check which has come back fine. It's only been happening for the last 2 years. I go to the toilet before so I can't understand why this is happening. Do you have any suggestions?" (Female aged 21, no previous pregnancies)

     

    It has taken a while to answer your question because this problem is rarely talked about or researched in younger women. You've been sensible enough to exclude infections, although I can't think of any which could cause this particular symptom - except, perhaps candida (Thrush) or Trichomonas, which would show up in the tests, be easy to treat and shouldn't have occurred continuously for 2 years.

     

    Actual urine leaking during sex occurs much more commonly in women who've had children (especially after one or two difficult births) and is a major problem in older women after menopause when lack of the female hormone oestrogen causes the bladder muscles to be more irritable - thus more easily triggered into contracting when stimulated (in other words, prodded around). Lack of hormones also causes inflammation of the urethra (urine tube) and bladder lining known as "interstitial cystitis", which further increases discomfort, irritability and feeling of an urge to pass urine much more frequently.

    In young women there are several possible reasons why the feeling of being about to leak urine during sex could occur, and your problem may be due to an unfortunate combination of all of them.

    Firstly, you should think about simple mechanics:

    The larger - in this case I mean wider rather than longer - your partner is, and the more vigorous he is, then the more the base of the bladder (known as the trigone) will be pushed into and stretched and the more the urethra will become irritated. This mechanism usually causes what used to be called "honeymoon cystitis", which most women have experienced at some time when starting with a new partner or in long-distance relationships where periods of separation increase desire. However, it doesn't usually cause leaking or your particular feeling of an urge to leak.

    Also, on the mechanical front, position during sex could be important. If the man is behind you - as in "spoons" or "doggy-style" positions - the penis pushes directly into the front wall of the vagina and thus the bladder trigone. This is great for G-spot stimulation but is even more certain to trigger bladder contraction if this has been a problem. The position least likely to cause this is so-called "male astride", a variant of the missionary position where the man's legs are outside the woman's hips. This causes shallower penetration and greater clitoral stimulation, and almost no bladder pressure - great for women who get pain on deep thrusting and worth trying.

    Secondly, think hormones.

    If you're using methods of contraception which contain only progesterone and no oestrogen - i.e. the injection (Depoprovera), the implant (Implanon) or a progesterone-only pill (usually Cerazette) - then the amount of oestrogen you need to keep the vagina well lubricated, the bladder muscle correctly toned and the bladder & urethra lining completely healthy might have reduced in your particular case to a level where symptoms - similar to those found in older women - can occur. Although the majority of women taking these methods will be OK, the problems of reduced bladder capacity and poor lubrication are well-recognised (especially after long-term use of the injection) by contraception specialists in continental Europe, where most of the research on this has been done, but seemingly not so much in Britain.

    If you are using one of these methods, you might benefit from using a little natural oestrogen supplement by way of a small pellet or cream put into the vagina on a regular basis. You'd expect to notice some improvement around 2-4 weeks after starting treatment. This is safe to use even if you aren't allowed to take the combined pill containing artifical oestrogen (for instance because of severe migraine with neurological symptoms). Alternatively, if you were originally put on a long-acting method (injection or implant) because you had difficulty remembering to take the combined pill, you could take the pill at the same time as the injection or implant to use as an oestrogen supplement (this is often done to help control abnormal bleeding patterns). Better still, set up a system which ensure you take the pill reliably (for example, plan to take it when you wake up, but set your mobile phone alarm for tea-time every day to remind you) and think about switching from the long-acting method - but only when you haven't missed a pill for over three months or so.

    Finally a possible, temporary fix might be the use of tablets to reduce bladder irritability. These are normally offered to much older women with this problem, but might provide some relief of your symptoms - for instance if taken an hour or two before intercourse. However, they won't tackle the underlying cause, which is by no means obvious in your case.

    Yours is a rare, specialized problem which needs a specialist assessment either by an expert in gynaecological hormones or gynaecological urology. I suggest you start by going to your nearest main contraception/sexual health clinic and asking to see a senior doctor there, if possible. A list of these clinics can be found at: www.fpa.org.uk or by phoning the fpa helpline on 0845 122 8687

  • I have recently started a loving relationship with a wonderful man, at first we waited on the sex front. After a long while of waiting I started to worry that perhaps he was not attracted to me. As we share a bed but he never jumped on me as it were. So this weekend we had a conversation about it. He did confessed that when he is erect his balls go up inside him and this causes him pain. He said it only  started to happen a few months before I met him. After he mentioned  it I too have noticed it. And I am worried for him. He is very healthy but is tired all the time, sometimes sleeping for over 14 hours with ease. He works, goes to the gym but I feel the sleeping and the lack of sex drive may all be related. Do you think it may be because he trains hard in the gym. He has assured me he never did steriods. Perhaps this is a lie and a side effect of usage. Please advise me on what it may be.

    I'd encourage him to speak to his GP first as genital pain during or after sex should never be ignored.  He should also mention his tiredness and lack of sex drive to the doctor as these may be related.  His doctor can identify what the problem(s) might be and refer to a urologist or a psychosexual therapist if appropriate (if some of his problems have a psychological cause).  His doctor will have seen many men with intimate problems and will be able to help.

    He might find it helpful to take a brief list with him to the doctors where he notes exactly when the problem started, what (if anything) he thinks contributed to the problem, what causes the problem (aside from getting an erection), how severe the problem is, whether it seems to be getting any worse and what (if anything) brings relief.  It may also be useful for him to think about his upbringing and attitudes to sex as well as whether he has had any problems with his sex life previously as that could have a bearing on his current situation.

    As some of these issues are highly personal he might prefer to only speak to the doctor about them and not discuss with you, so don't be offended if he makes that decision.

    It might be he doesn't go and seek help immediately so be patient.  However this is important to his health and your relationship so you should expect him to show he is considering getting help and set yourself a deadline for how long you are able to continue with the relationship if he refuses to do so.

    He may want to cut down on the amount he spends at the gym to see if that makes any difference.

    You describe him as "wonderful" which is a great place to start from.  I'd believe him when he tells you he's attracted to you, but obviously has avoided intimacy because of his worries about his physical response and related pain.  Focusing on other positive areas of your relationship can help while you wait to get the physical/psychological problems he's experiencing sorted.

    It may be you try other things like him masturbating you, giving you oral sex or watching you masturbate - but if this leads to him experiencing pain then it may be best to leave this while he is seeking treatment.  Exploring cuddles, massage and other affectionate contact can help you feel close during this time.

    Hopefully he will be willing to seek help and while your relationship is important the presence of pain is the main worry here and he ought to get help for that as soon as possible.

  • My boyfriend and I are 19 and neither of us have ever had another sexual partner. Recently we've started exploring oral sex. I was wondering whether it's possible to catch anything from this if, like I said, neither of us have had a partner before?

    Thank you for getting in touch about this as it's always good to ask when you are not sure.

    To reassure you, as this is both yours' and your boyfriend's first ever sexual experience, it is very unlikely that either of you could pass on an STI to each other. This is because in order to catch an STI you have to have unprotected sexual contact with someone who has an STI (either anal, oral or vaginal sex or close genital skin-to-skin contact).

    One thing to be aware of, though, is that if either of you get cold-sores on your lips or mouth then these can be passed on to the genitals during unprotected oral sex, which can lead to genital herpes.

    For future reference, you can protect yourself from the risk of infection by using a condom or dental dam every time you have oral sex. Flavoured condoms can make oral sex taste and smell nice and make it more fun for the person giving oral sex. Dental dams (thin squares of latex) can also be used as a barrier during oral sex performed on a woman involving contact between the mouth and the vagina.

    You can get free condoms and dental dams from your local Brook Centre, at a local young person's service, family planning clinic, or at your GP surgery. You can also see a doctor or nurse at any of the above services too if you have any concerns.

    You may find the following leaflet useful: Oral sex: looking after your sexual health

    All of the above services are free and confidential. 

    If you would like to speak to an Ask Brook Advisor on the Ask Brook helpline for more information, you can call 0808 802 1234. It is free, confidential and open Monday to Friday 9am to 7pm.

  • I’m sorry to hear about your situation. It isn’t clear if you’re currently in a relationship or not, so this answer is tailored to help whether you are single or with a partner.

    There are sources of help available, but first it may help to work through the following questions.

    How long have you felt like this and can you identify a time when you did feel desire? Working out when you did feel like wanting sex can highlight what was going on in your life then that made this possible and identify what could be a barrier to wanting sex now.

    There are often very practical reasons women don’t feel desire. Do any of these apply to you?

    • Concerns over body image
    • Unrealistic ideas about what desire should feel like (and assuming desire must only relate to wanting penis/vagina sex, not any other pleasurable forms of intimacy)
    • A lack of sex education or knowledge how your body works
    • Not knowing what turns you on, or feeling unable to share what does turn you on with your partner
    • Psychological or physical health problems (including sexually transmitted infections)
    • When sex is painful (during or after intercourse)
    • Past or present sexual abuse or domestic violence
    • A partner who has a sexual problem
    • A partner who does not know how to turn you on effectively or feels they know what you should like during sex
    • Pressure from a partner to have sex
    • Relationship difficulties including arguments or jealousy
    • Being overworked and lacking support from family and/or partner
    • Having a young family (particularly if there’s little support provided to care for them)
    • Concerns over fertility, problems with contraception use
    • Lack of privacy to relax enough for sex

    If you think any of these might be the cause of the problem then you can begin to get additional support. Such as, help with childcare and housework; asking your GP to refer you to a counsellor to talk about body image worries or past abuse; or talking with your partner about ways to explore intimacy together.

    It isn’t clear if you are having sex currently. Sometimes when women don’t desire sex they still are intimate with a partner. If this is the case with you do you enjoy intimacy when it happens? And if you could describe really pleasureable sex, what would that be like for you?

    We’re often encouraged to think about rediscovering desire in terms of just sex, but it helps more to focus on your relationship as a whole. Remember as well as desiring sex we can also crave affection, romance, seduction, good communication. Most women who say they don’t desire sex do want other intimate pleasures, and sometimes not having those needs met can explain why they don’t feel sexual desire. This can often be the case when a partner isn’t supportive, or where both of you feel overwhelmed by the situation but don’t know how to fix it.

    Work together with your partner if you are able. Together you may be able to spot key barriers that stop you enjoying each others company. Finding solutions may not mean you suddenly feel desire, but you may feel happier within your relationship and less tired and pressured, which will go a long way to making you feel more like wanting sex. It helps to agree affection is possible but not a green light for sex, reducing the pressure on you and ensuring your partner can still show they care.

    You should not feel you must make yourself have sex to jump start your libido or keep your partner happy – particularly if sex is psychologically or physically painful. It will only increase problems in the long term. Nor should you attempt to boost your libido with herbal products or drugs sold online or in pharmacies.

    However, there’s no reason why you can’t explore ways to find pleasure. Desire often won’t magically reappear but you may find if you explore masturbation, using a lubricant or reading/watching erotica that you can feel excited. You may wish to try this alone, or with a partner.

    I would recommend Sandra Pertot’s ‘Perfectly Normal: Living and loving with low libido’ (Rodale Books) which is an excellent practical guide to understanding desire. It also has several helpful chapters for partners. The NHS Choices 'good sex' bundle also has lots of good information.

    In the event these suggestions seem too uncomfortable or difficult to attempt on your own, if they aren’t working, or if your partner is not helping you may want to refer yourself (alone or with your partner) to a psychosexual therapist. You can find one in your area at http://www.basrt.org.uk

    Your GP can also refer you to a psychosexual therapist via the NHS (although waiting lists do vary). You should speak to your doctor if you experience pain during or after sex, or if you can’t spot any underlying possible causes of your lack of desire, or if you are struggling with other physical or mental health problems.

    I wish you all the best. Please do let us know if this advice isn’t clear or if you need further information.

  • Both my girlfriend and myself have Genital Herpes (the first type). We both had our initial outbreaks recently although mine was far less severe.

    I had some questions about future sexual contact:

    1) I assume we should not have sex at all (including masturbation) when showing symptoms? If not why exaclty?

    2) When we are not showing symptoms is there a chance that if one of us is shedding the virus that we can spread the virus to other parts of our genitals where it has not developed before and therefore increasing the amount of potential places it could reoccur? Now that we have developed antibodies is this kind of reinfection likely?

    3) Would having sex whilst shedding or in the early stages of an outbreak (before we noticed) cause the other partner to have an outbreak too?

    4) What are the chances of reinfection to other parts of our body e.g. arms, legs, eyes etc. I assume the chances of facial herpes are high (if we dont both already have it there)?

    5) I am English but I had my first outbreak while in America shortly after my girlfreind who is American. She was given Acyclovir and her insurance has covered a certain amount of tablets which we both took and arrested the spread of it until it healed. However I am going to be in China for another year and wondered if there is anyway at all I can get the Acyclovir myself through an English doctor?

    Genital herpes can be caused by both types of herpes simplex virus (HSV). Although type 1 more commonly infects the mouth, lips & face and type 2 usually infects the genitals, nowadays, over 50% of young people who catch genital herpes have HSV-1, largely because most people do oral sex. In this context it may cheer you up to know that some 70% of people in their 20s have got type 1 herpes - whether they know it or not - mostly because they've been kissed by their parents or other relatives when they were babies. So genital herpes is the one sexually transmitted infection you could catch or pass on without you or your partner EVER needing to have had sex with anyone else.

    If you and your girlfriend both have the same type of herpes (HSV-1) on your genitals, then the good news is that you can't re-infect each other, even if you have sex during a recurrence. Although it's not a great idea to have sex or masturbate during recurrences, because of physical discomfort or simple aesthetics, no serious harm is likely to occur if both partners are already infected, as it is highly unlikely that infection will be passed to other parts of the genitals, or even the mouth, because you will both have developed antibodies to the infection. If by very rare chance, another inoculation of infection were to occur in a more vulnerable area - for instance, in the anus - then the infection is very unlikely to show any symptoms. The only situation where you could pass infection elsewhere on your body - or to your partner - is if you were to stick your finger into the blister or ulcer and then rub it in your eye. Not very likely you might think, but this very serious form of eye infection (called "herpetic keratitis") occasionally affects people who have cold sores and wear contact lenses.

    Another piece of good news is that people who have HSV-1 on their genitals are very unlikely to get recurrences at all, unless their immune system is seriously diminished by other illnesses, very severely stressful life events (e.g. bereavement), persistent sleep deprivation or cancer treatment. So having sex is highly unlikely to trigger a recurrence in your partner - this is different to the situation for those who have genital HSV-2.

    The oral Acyclovir tablets you both took will have speeded up the rate of healing of your first episode of infection, and, if taken within the first day of any recurrence, will significantly reduce the severity of any new outbreak - although, as above, this is unlikely to occur because you have HSV-1. If you do get recurrences then treatment is available from any sexual health / genito-urinary medicine clinic in the UK, and some may offer you pre-emptive treatment to carry with you in case of future recurrence: (to find your nearest specialist centre go to www.bashh.org and spool down the page to put in your town or postcode). Note that Acyclovir cream - although it can help reduce the severity of cold sores - is no use in genital herpes of type 1 or 2 because the nerve cells where the virus is stored are in the base of your spine, some 12 inches distant from the genital skin surface.

    If you have any more questions about genital herpes you are should speak to the health advisor at your local sexual health clinic, or check out the Herpes Viruses Association FAQs at http://www.herpes.org.uk/faq.html or phone their confidential helpline on 0845 123 2305

    More on genital herpes from NHS Choices.

     

  • My foreskin has always been quite tight and sometimes overstretching can 
result in tiny fissures all round the edge. These can become sore on 
contact with my wife's fluids or when stretched during intercourse.
 They heal up eventually, but I was wondering if there is any long-term
 solution other than circumcision. For example, are there any ointments 
or creams that can help?

 My wife is aware of the situation and takes great care during foreplay, 
but sometimes the condom can make it worse.

 We're both 49 years old.

    This type of fissuring - known as radial splitting - is a common occurrence in men with tight foreskins. The cuts usually occur in the lower 2 centimetres of the foreskin, running lengthways up the penis for a few millimeters. Each cut usually forms in a small diamond shape, which heals crossways with variable speed depending on how much further friction is "generated" during the scar formation. Each scarring episode draws in the foreskin little by little, which, eventually and inevitably, reduces its circumference making further splitting or "phimosis" (complete inability to retract) more likely.

    This means that - in most cases where splitting is a frequent and regular consequence of intercourse - circumcision is the only permanent solution to the problem. Although people have tried mild-to-moderate steroid creams to attempt to strengthen the skin, there is little evidence of success.

    One possible tip to reduce risk of splitting would be to use a technique called "gel charging", where you put some lubricant into the condom before putting it on. As long as the lube is "condom-friendly" (see http://www.nhs.uk/conditions/condoms-(male-and-female)/pages/things-to-consider.aspx for more on this) this will significantly reduce friction on the foreskin and - so I am told - makes the sensation of intercourse more like the real thing (feeling as if the condom isn't there). Perhaps we should be skeptical of this claim, but the only way to find out is to try it for yourself.

    Realistically, if you've got to the age of 49 and are getting very frequent, painful and almost inevitable splitting, then you will probably have had a circumcision by the time you're 55 - this will be even more likely if your wife doesn't take hormone replacement therapy after menopause, as her own natural lubrication will diminish, further increasing the friction trauma.

    My best advice would be to seek out a sympathetic specialist opinion from a Urologist, after having done some more homework: Most men who've been circumcised in later life are happier with the outcome, being freed from the pain of continual splitting (see: http://www.aafp.org/afp/2002/0915/p1080.html). Although there's no doubt that the glans (head of the penis) becomes hypersensitive for a few weeks after the operation, with annoying discomfort as it rubs against underwear, this process gradually thickens up the skin, reducing sensitivity. Some men will find that their enjoyment of fellatio diminishes, but this may trade off against reduced tendency to premature ejaculation.

    More on circumcision on NHS Choices.

  • My problem is that i have a white (vaginal) discharge frequently, but recently after sex i have experienced a very painful burning sensation. I've also experienced a very increased need to go to the toilet after sex but also just in general! What could this be?" Woman, aged 19

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    The simplest explanation for your symptoms could be candida (thrush), but this is more likely to cause itching at any time or dryness and discomfort throughout sex rather than only immediately afterwards. Many women need to urinate after sex, as the friction of intercourse irritates the urethra (the tube through which urine passes), and pushes normal skin bugs into the bladder causing cystitis symptoms and genuine urine infections.

    The burning sensation after sex is also very common, sometimes caused by friction and poor lubrication, or allergy to condoms, or irritation of the vulval and vaginal skin by contact with semen. Although very few women are genuinely allergic to semen, these symptoms may get worse the longer you are re-exposed to the same partner. You can experiment to find out the cause of the problem by using non-latex condoms and/or getting your man to ejaculate away from the vulva & vagina, to see if the symptoms improve. Applying a small amount of mid steroid cream (Hydrocortisone) immediately after sex may help, as long as there are no infections.

    The solution to your problem is likely to revolve around which method of contraception you are using, and whether there are any actual infections present. This combination of symptoms can be seen in women using the 3-monthly injection (Depoprovera) or less commonly, the progesterone-only pill or implant, because of a reduction in the female hormone, oestrogen, which keeps the vagina healthy and well lubricated. This may also occur in some women taking a pill with higher “androgenic” side-effects (such as Microgynon), and could be improved by switching to a less harsh pill (such as Cilest or Marvelon).

    Your problem needs a careful, considered approach to sort it out. I suggest that you visit a sexual health clinic which can deal with both infection and contraception issues at the same time.

  • My partner & i were talking about the male contraceptive pill. We did some research about it but want to get more professional details & advice. My partner is 21 years old and has no health problems. Im unable to take the contraceptive pills as i have epilepsy and the implant caused me to have epileptic fits as well. My partner feels that if i cannot take anything then he would like to take something if there is anything possible. Apparently the male pill isnt avalible at the moment but we arent sure. Is the pill avaliable now? What are the side effects if any? and has the pill been tested on males?"

    --------------------------------------------------------------

    Thank you for your request. 

    I understand that you have had some issues regarding the contraceptive methods that you have used and would like more information on the male pill.  

    The male pill contains a progestogen that is used in the female pill, as well as the male hormone testosterone. This combination blocks the production of sperm while maintaining male characteristics and sex drive. As with the female contraceptive pill, it must be taken daily. Very few side effects have been reported in the trials. The male pill is not currently available in the UK, although trials have been ongoing for the last 20 years. 

    Currently, the only alternative male contraceptive would be the male condom, which if used consistently and correctly each time you have sex, is 98% effective. If this is not a suitable method for you and your partner, it may help you to know that epilepsy is not a condition where there are restrictions on which contraceptive methods you can use and there are alternatives to the methods that you have already tried. 

    Restrictions only apply if certain antiepileptic drugs (AEDs) are used, as some AEDs induce liver enzymes which can reduce contraceptive effectiveness.  Also some AEDs can be affected by hormonal contraception which can result in the frequency of seizures.

    The contraceptive injection, diaphragms and caps, the Intrauterine device (IUD), the Intrauterine system (IUS), female condom and Natural Family Planning are all methods that are all suitable for someone with epilepsy and taking AEDs.  You may want to consider these methods in more detail.  The following link will take you to FPA’s contraceptive information, which will go through these methods providing you with the necessary information on effectiveness and any side effects.

    http://www.fpa.org.uk/Information/Readourinformationbooklets/guide

    You may also find this booklet on Longer acting methods useful as well, as three out of the four methods could be suitable for you, the contraceptive patch being the method which you previously found to be unsuitable.   

    http://www.fpa.org.uk/Information/Readourinformationbooklets/larcs

    The organisation Epilepsy Action has specific sections on contraception for people affected by epilepsy, which you may also find it helpful

    I hope that this information highlights that there are a range of contraceptive methods within which I hope that you will be able to find one that is suitable for you.

  • I am a 15 year old girl and I'm a relationship with a boy of 17 and we've started to have sex but only using condoms. I'm scared of the condom slipping or even coming off while we are having intercourse, so i was wondering if you could you give me some advice on how to tell my mum I want to start he pill or even have the implant. Please help, I dont want a baby at this age. Thank you. Lauren."

    Hi Lauren

    Thank you for your question.

    It’s great that you are using condoms at the moment and the good news that should reassure you is that if you use them correctly, condoms are 98% effective and the only method that protects against pregnancy and sexually transmitted infections (STIs).

    It’s excellent that you want to talk to your mum about going on the pill or having the implant fitted. You might find it helpful to start the conversation by talking about a story you have read about in a magazine or heard about on the TV, radio, or seen in a film, and bring up the subject of contraception that way. You may also find it useful to say that ‘a friend’ was thinking about using contraception, and see how she reacts this way.

    If you can speak to your Mum she may be able to provide you with some extra support in making a decision about the method of contraception you would like to use. However, if it is too tough to do you can get contraception from a doctor or nurse at contraceptive services confidentially, without your Mum being told, even if you are under 16.

    There are many other methods of contraception as well, and you can get free and confidential information from a doctor or nurse about the best method for you.

    For extra protection and peace of mind you can use condoms with another method of contraception such as the implant or the pill, so if the condom does slip off or split, you will still be protected from getting pregnant.

    Rachael Wyartt is manager for the Ask Brook information service, which offers a confidential helpline, online enquiry service and text information service. Ask Brook is available free and in confidence to young people on 0808 802 1234 or via Ask Brook on Brook’s website.

    Brook is the UK’s leading provider of sexual health services and advice for young people under 25, including free and confidential sexual health information, contraception, pregnancy testing, advice and counselling, testing and treatment for sexually transmitted infections and outreach and education work.

  • A number of sexually transmitted infections (STIs) can be passed on through oral sex. Oral sex involves a person using their mouth, tongue and lips to stimulate a partner’s genitals or anus. The STIs most commonly passed on via oral sex are herpes simplex, gonorrhoea and syphilis. Others less frequently passed on are chlamydia, HIV, hepatitis A, hepatitis B, hepatitis C, genital warts and pubic lice.

    The exact risk of transmission is not known, but infections can be passed on even if there are no signs or symptoms. Below is a quick look at how infections can be passed on, and how you can help to protect yourself against them.  

    STIs can be passed on through oral sex in a number of ways, including:

    Body fluids
    This can happen with chlamydia, gonorrhoea, hepatitis B, hepatitis C, HIV and syphilis. Infected bodily fluids, such as semen, pre-ejaculatory fluid (pre-cum), blood or vaginal secretions can pass on STIs if they come into contact with:
    • sores,
    • cuts,
    • ulcers, or
    • inflamed cells

    on someone else’s lips, mouth, genitals or anus. Body fluids can also infect the membrane of the eyes and cells of the throat, allowing viruses or bacteria to enter the bloodstream or live in the cells.

    Skin to skin contact
    The herpes simplex virus can cause genital herpes and cold sores on the mouth, and syphilis can also cause blisters and sores. If these blisters or sores touch a partner’s mouth, genitals or anus the infection may be passed on.

    Ingestion (eating)
    Hepatitis A is passed on through infected faeces, which can be present on a person’s anus even if the area looks clean.

    To help protect yourself against STIs during oral sex, use a condom on the penis, and a dam (a latex or soft plastic square) over the vagina or anus. Avoid oral sex if you or your partner have any cuts, sores or blisters in or around your genitals, anus or mouth – including cold sores.

    For more information on STIs and safer oral sex, see fpa’s information leaflet.

    Natika H Halil is the Director of Information for fpa (formerly the Family Planning Association), the UK's leading sexual health charity. fpa’s purpose is to enable people in the UK to make informed choices about sex and to enjoy sexual health.

    Natika represents fpa on specialist sexual health boards including the Royal College of Obstetricians and Gynaecologists, the Faculty of Sexual Health and Reproductive Health Care, and the Royal College of General Practitioners among others. (www.fpa.org.uk)

  • Hi, thank you for your question. If the condom splits it won’t necessarily come off, as it is possible for the condom to stay on the man’s penis if it splits.
    If the condom does split and you are not using any other method of contraception (for example the pill, or the implant) and if you don’t want to get pregnant, you will need to get emergency contraception.
    Emergency contraception can be used up to five days after sex to help prevent a pregnancy. There are two types of emergency contraception; the emergency contraceptive pill and the emergency IUD (intra uterine device).
    The emergency contraceptive pill can be taken up to 72 hours (three days) after sex. However, it’s more effective the sooner after sex it’s taken. It doesn’t protect you from pregnancy if you have further unprotected sex after taking it, so you’d need to use it again if this happens. The emergency contraceptive pill is available free from:
    • Brook centres (for under 25s).
    • Young people's services.
    • Family planning clinics.
    • NHS walk-in centres.
    • Most sexual health/GUM (genito urinary medicine) clinics.
    • Some accident and emergency departments.
    • GP (local doctor).
    Women over 16 can also buy it from a chemist for around £25, although some chemists can provide it for free.
    An IUD (sometimes called the coil) can be fitted as an emergency contraceptive up to five days after sex. It is a small T-shaped piece of plastic and copper that is inserted into the vagina, through the cervix and into the uterus. It has to be fitted by a specially trained doctor or nurse, so it’s a good idea to check with a member of staff at the service you go to (for example, a sexual health clinic or community contraception clinic) first to see if they have a nurse or doctor that can fit one.
    As the condom split there may also be a risk of sexually transmitted infection, and it is worth speaking to a doctor or nurse to find out more.
    If you have any worries or questions, you can also call the Ask Brook helpline which is free and confidential. The number is 0808 802 1234.

    Rachael Wyartt is Manager for the Ask Brook information service, which offers a confidential helpline, online enquiry service and text information service. Ask Brook is available free and in confidence to young people on 0808 802 1234 or via Ask Brook on Brook’s website.

    Brook is the UK’s leading provider of sexual health services and advice for young people under 25, including free and confidential sexual health information, contraception, pregnancy testing, advice and counselling, testing and treatment for sexually transmitted infections and outreach and education work.

About the advice service

In 2009/2010 we ran a sexual health advice service which allowed people to get answers to their problems from a panel of experts. The service has now closed, but you can see the questions and answers on this page.

If you have any immediate or urgent concerns about your health, you should contact your GP or use our medical advice now section.

The sexual health advice panel

Peter Greenhouse, consultant in sexual health, Bristol Sexual Health Centre, and secretary of the British Foundation against Sexually Transmitted Infections


Dr Mark Pakianathan, honorary senior lecturer in HIV/genito-urinary medicine and chair of the British Associaition for Sexual Health and HIV media group


Dr Petra Boynton, lecturer in International Health Services Research at a London University and adviser on sexual and relationship health for mansized.co.uk and mykindaplace.


Relate Advisers from the helpline of the national charity supporting family and couples relationships


Brook Rachel Wyartt, manager of the Ask Brook helpline, which offers sexual health advice and services specifically for the under 25s


Terence Higgins Trust Advisers from the leading HIV/AIDS charity's support services

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