15 Sexual Health Questions You're Too Shy to Ask Your Doctor

Let’s get the obvious out of the way: no one enjoys talking about STDs. It doesn’t matter if you’re negative, positive, or just had one in the past, speaking with a partner or health professional always seems to have cringe-potential. So, while no one article can or should replace a doctor’s visit, we took the time to compile some, ahem, burning questions.  Talking to Dr. John Rimmer, an ER doctor and co-founder of sexual health app Biem, NSFW got straight to the point of fifteen surprisingly common queries and misconceptions. Thanks to apps like Biem, talking about STDs and sexual health doesn’t need to be uncomfortable (but knowing the answers to the list below doesn’t hurt, either).

1. What's this bump/rash?  The most common “bumps” in the genital region are related to folliculitis, ingrown hairs, or poor grooming techniques, but if a bump doesn’t go away, spreads, becomes very painful, or if it appears after a sexual encounter, it’s probably worth seeing a doctor.  Rashes may be something as simple as dermatitis from a new soap, or more complex and STD-related. 

2. Are STDs and personal hygiene related?  Yes, and no. The best defense to STDs is barrier protection- namely condoms, but also intact skin. Small nicks or cuts from shaving or waxing can predispose to bacteria or virus entry, and hence infection.  Beyond STDs, staph infections are also a concern, especially with evolving antibiotic-resistant bacteria.  Overall, common-sense hygiene techniques (soap and water), avoiding risky sexual exposures without barrier protection, and proper grooming methods will help lower your risk.

3. Can you get an STD from a toilet seat?  Thankfully most viruses like HIV die very quickly when exposed to air, and bacteria like chlamydia or gonorrhea have never had proven transmission off surfaces such as toilet seats.  But, some bacteria, like staph (which isn’t an STD), do survive on hard surfaces, hence common sense hygiene, skin care, and vigilance is helpful. Overall, worry more about your partner than your toilet seat.

4. Is my cold sore an STD?  Cold sores around the mouth are a type of Herpes Virus (HSV1) that are incredibly common, with the majority of the global population being exposed at some point in their life.  It’s unclear why some people are prone to repeat outbreaks.  HSV1 can be spread to the genitals, so if you have a cold sore near your mouth, it’s important to avoid close contact, kissing and especially oral sex, during that time. Antiviral medication can help suppress an outbreak.

5. Am I legally obligated to disclose my status to my partner?  Broadly speaking, no.  But certain states have different legal obligations, especially for notifying partners if you are HIV positive. That said, knowingly transmitting an STD can involve civil and criminal penalties. Often this foggy area of law involves intent and what’s considered informed consent, and naturally it’s always best to inform a partner of any STD history.

6. What happens after I test positive? This all depends on which STD is discovered.  Some STDs, like chlamydia, are easily treated with one dose of oral antibiotics.  Others, like HIV, become life-long conditions for which daily medication and vigilance is necessary.

7. My partner has an STD, now what?  First, abstain from sexual contact until you are also tested and treated, and your partner is treated.  Some STDs require oral medications; others require an injection of antibiotics.  Depending on the particular infection, your doctor will tell you when it’s safe to resume sexual activity and what precautions you need to maintain. Regardless, condoms are an excellent idea afterwards.

8. It hurts when I pee, do I need to see a doctor?  Yes.  Burning with urination is a sign of inflammation or infection in the urethra or bladder.  Most often it’s a simple Urinary Tract Infection, treated with oral antibiotics.  But, the burning can be from an STD also, so it’s important to tell the doctor your sexual history and request testing for STDs if you are concerned.  If left untreated, urinary infections can progress to kidney or systemic problems. 

9. Can you get an STD from a hot tub?  Bacteria are known to inhabit hot tubs, but acquiring an STD because of one is very unlikely (unless you are having sex in a hot tub, naturally).  Rather, other non-STD bacterial infections like staph or pseudomonas, which can infect the skin, genital tract, lungs or intestine, can be transmitted.  It’s best to avoid highly-trafficked hot tubs if you are prone to infections, pregnant, or have other complicating medical problems.

10. Can you get an STD from unwashed hands?  As a general rule, no.  But, good hand washing techniques can prevent other dangerous infections.  Hand washing after genital contact of any kind is recommended, regardless of the concern for an STD.  Open sores, cuts or abrasions can transmit HIV, thus skin and wound care is a vital part of sexual health. 

11. Is a UTI an STD?  Most UTIs are not STDs, but rather caused by bacteria that normally colonize the intestine, skin or urogenital tract.  An STD can mimic a simple UTI however, so it’s important to be tested for STDs if you are sexually active and have any urinary symptoms.  Also, proper genital hygiene and always wiping front-to-back after going to the bathroom are good rules-of-thumb.

12. What does it mean to be "undetectable"?  Patients who are HIV positive and are taking medication to suppress the virus will have frequent testing done to determine their “viral load”.  This is the amount of HIV virus actively replicating in their body. HIV medications are now very good at eliminating active viral replication, thus making a viral load “undetectable”.  Someone with an undetectable viral load has a low, but not zero, likelihood of transmitting the virus to others. It’s important to remember the virus isn’t eliminated, just suppressed enough where our testing can’t detect it.

13. I'm a women, should I be on Prep? There have been studies, mostly performed internationally, that show lower HIV transmission rates for at-risk women on PrEP.  Per CDC guidelines, if you meet certain criteria (high number of sexual partners, a partner with known HIV, commercial sex workers and others) you could be eligible for PrEP as a woman.  Commitment and adherence to taking the medication everyday with testing every 3 months is also required. 

14. What are the best preventative measures against STDs?  Condoms, condoms, condoms!  Barrier protection is still the most effective method to avoid most STDs.  Frequent monitoring, with convenient platforms such as Biem, are also very helpful, because knowledge is power.  Finally, transparency and open conversations with your partner(s) is essential to helping prevent STDs.

15. How should I go about telling a new partner I have an STD? Asking them if they have one?  This is a hard question… there’s no emoji to say “I had chlamydia last month”.  Ice-breakers are helpful, and confidence in sexual health has been shown to be a major turn-on in surveys.  One can ask “What was the scariest moment of your prior sex life?” or “Do you Biem?”  Biem makes it easy by allowing partners to connect with each other (after both consent) and share results automatically for a period of 6 months. 

For a limited time enjoy $35 off your first visit when you download Biem app and use code NSFW1. #checkyourself