Hi there, I hope you’ve all had a good week. This week’s blog focuses on matters of sex and relationships. It’s a bit of a mishmash of topics but is based on some of the most common questions that I get asked by students in my practice. I hope you find it helpful.


Firstly if you are planning to have sex and don’t wish to become pregnant, it’s important to think about contraception first. Apologies if this sounds obvious but every year students do become pregnant unexpectedly. Contraception is free in the U.K. and is available from GP’s surgeries and a number of other sites around the city: http://www.fpa.org.uk/find-a-clinic. There are several different types available and more information can be found here: http://www.fpa.org.uk/sites/default/files/your-contraceptive-choices-chart.pdf. It’s a personal choice as to which one is right for you and we are always happy to chat through the options in surgery. It’s also worth remembering that we stock free condoms in the surgery. Condoms are the best way to protect yourself against sexually transmitted infections and we would recommend always using them alongside other methods of contraception. If you have had unprotected sex, you may need emergency contraception to prevent pregnancy. Further information can be found here: http://www.nhs.uk/conditions/contraception-guide/pages/emergency-contraception.aspx

Sexual coercion

Sex should be a pleasurable activity between consenting adults and no one should ever be forced to have sex against their will. If you are ever in a situation where you are unsure if you want to have sex, trust your instincts and decline. A supportive and loving partner will respect your decision. Forced sex with someone against their will is a crime. Please see the West Midlands Police website for more information about sexual violence: https://www.west-midlands.police.uk/node/597 Remember sexual violence affects both men and women in both gay and heterosexual relationships. There is also some very helpful information on the Birmingham and Solihull Rape and Sexual Violence Project website http://www.rsvporg.co.uk You are also welcome to talk to us in surgery in complete confidence.

All of our clinicians have received additional training in domestic violence and we work closely with Birmingham and Solihull Women’s Aid https://www.womensaid.org.uk. We have a counsellor from the organisation who is available for appointments on a monthly basis. Please ask for further details. Students at the University of Birmingham can also get help and advice from the student support and counselling service http://www.birmingham.ac.uk/undergraduate/support/health/index.aspx

Finally in this section, I wanted to highlight the issue of so called “initiations” that can take place within university clubs and sports teams. These are “tasks” which are typically given to new recruits and freshers and they can include sexual themes. Examples might include pictures of an individual taken in a compromising position with a member of the opposite sex which are then posted on social media. There is often considerable peer pressure to participate and actions may well be fuelled by alcohol excess. Such activities are expressively forbidden by universities but do still take place and can cause considerable distress to the individuals concerned. Please be aware of this and if you are uncomfortable with anything that is suggested, decline to take part and walk away. You can also report your concerns anonymously to the university or the police.

Sexually transmitted infections (STIs) 

A really important topic which is relevant to anyone who is sexually active. This is a huge topic and so I will cover the main pointers and signpost you to where you can find further information. We are also very happy to answer any concerns/questions over the phone or in person so please do contact the surgery and speak to reception to arrange this.

Essentially STIs are incredibly common in younger people <25. They are also becoming more common in older people as well (those over the age of 40). You can find some facts about the incidence of STIs in the U.K. here: http://www.fpa.org.uk/factsheets/sexually-transmitted-infections.  Many people have few or no symptoms and therefore will not necessarily know that they are infected. Untreated STIs such as chlamydia and gonorrhoea can precipitate pelvic inflammatory disease (PID) in women which may affect future fertility as well as causing other problems such as chronic pelvic pain. PID can be treated with antibiotics but the mainstay of prevention of PID complications is screening and the early treatment of STIs. HIV is also an STI and can be effectively treated. The earlier it is diagnosed, the quicker treatment can be started. This reduces the likelihood of progression to AIDS.

Where can I get screening for STIs?  
In Birmingham, information about sexual health services can be found online at https://umbrellahealth.co.uk/#

The Umbrella site contains details of all the services available in the city, from sexual health clinics to contraception services. There is also a wealth information about STIs and prevention. You can also order free self testing STI kits which will be delivered promptly to you by post: https://umbrellahealth.co.uk/our-services/self-sampling-kits. These test for all the major STIs (chlamydia, gonorrhoea, HIV and syphilis) and also include blood kits to allow you to take blood for HIV and syphilis. They are very easy to use in general but please contact us or the umbrella health advisors if you have any questions. We can also test our patients in the surgery if you would prefer this.
In women, it’s really important to attend for regular cervical screening tests to screen for early changes that could lead to cervical cancer. This is because the majority of cases of cervical cancer are caused by exposure to the human papillomavirus (HPV) which is sexually transmitted. Women over the age of 25 who are registered with a GP will automatically receive an invite for a cervical screening test: http://www.nhs.uk/Conditions/Cervical-screening-test/Pages/Introduction.aspx

Possible symptoms of STIs 
As I mentioned earlier, many people have few or no symptoms. Some do, however and some of the most common are:

  • Burning when urinating
  • Discharge from the vagina or penis
  • Bleeding after sex or between periods in women
  • Pain in the testicles
  • Lower abdominal pain after sex in women

Symptoms of possible HIV can be found here http://www.tht.org.uk/sexual-health/About-HIV/Symptoms-of-HIV

If you experience any of these symptoms, please think of STIs and obtain a test.
In short, we would recommend that everyone who is sexually active tests themselves for STIs. As a minimum, sexually active people should get tested at least once a year even if they always practice safer sex (using condoms). We would recommend a test after an episode of unprotected sex or if you think that your partner might have a STI. This might be because they have had previous partners or have symptoms themselves.

If it doubt ask us! We are here to help
The blog is designed for educational purposes only and is not intended to replace professional, personalised advice from your doctor. Please, if you feel ill and are unsure or concerned, seek advice from a qualified health professional which could be your GP or Accident or Emergency if you have a life threatening medical problem. If you unsure, NHS 111 http://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx can help you to decide.