You’ve spent upwards of an hour mindlessly phone-scrolling in the STI waiting room, desperately avoiding eye contact while you wait for your name to be called.
But aside from getting tested, it’s your chance to ask an expert the questions that throw out paranoia and confusion when Googled. STI nurse Suzie* reveals the most common ‘Oh, and another thing’ questions women ask her.
For more information visitthe NHS's Sexual Health Hub or contact your local GUM/STI clinic.
*name has been changed
Is the morning after pill really safe to take regularly?
“The morning after pill was developed for use in emergencies when contraception has failed or hasn’t been used,” begins Suzie. “We wouldn’t recommend it as a form of regular birth control as the hormone dose is high, which can cause side effects such as nausea, dizziness, and generally feeling unwell.”
Research firms stress that you can use the morning after pill as frequently as you want without any serious side effects and the drugs used in the new forms of emergency contraception (mainly levonorgestrel, rather than oestrogen) have no effect on blood clots or heart disease.
So you’re ok to pop it, just not every Sunday morning with your Bloody Mary. However the subtext to this question is often a fear that even occasional use might result in not being able to conceive when you actually want to. "The morning-after pill won't affect your chances of getting pregnant later on in life,” reassures Suzie. “There’s no evidence to suggest that.”
I had unprotected sex last night and now think I have every single STI. How quickly can they show up on test?
“Different STIs have different incubation periods, and some may not be detected immediately,” explains Suzie. “For example, the average incubation period for Chlamydia is one to five days. If you get tested before this time has elapsed, it is recommended that you test again to confirm your results once the incubation period has passed to ensure you’re clear of the bacteria.”
For Gonorrhea, it I can be up to six days, and again a second text after this time period is recommended. If in doubt, Suzie’s advice is to get tested (and if necessary treated), and then get tested again to double check. The thing to avoid is waiting to see if symptoms develop, or thinking you know ‘the signs’.
“Symptoms of Chlamydia or Gonorrhea might not appear for a month or longer, if at all,” says Suzie. “Genital warts and herpes might not start until months or years after they’re transmitted. By that time you might have passed them on to many more people - so do get tested. You’re not wasting our time.”
Why do you ask me if I have anal sex? Will you be looking for different things if I say yes?
“Anal sex has a higher risk of spreading STIs than some other types of sexual activity,” explains Suzie. This is due to the thin lining of that particular area being prone to being more easily damaged, which makes it more vulnerable to infection.
Nurses ask the question to make sure they have the full facts - they’re not looking for anything different as no infection is spread solely through anal sex. It’s just one of the set questions asked as standard, totally confidentially and without judgement. This set also includes asking you if you’ve slept with a bisexual partner or a man from Sub-Saharan Africa, where instances of some STIs are higher.
Susie says: “We need to gather as much information about your medical and sexual history as possible, so it’s important that you’re prepared to answer questions about your sex life. Being as honest as possible will help you get the fastest and most effective treatment.”
Do I need to worry about HPV?
Researchers recently linked some types of human papilloma virus (HPV) infection, which can be transmitted sexually, to developing certain cancers. While this has understandably caused concern, HPV affects almost everyone at some stage in their life, as it's also spread by skin-to-skin contact, and in most of us our immune system fights it off and it does no harm.
“I’m asked more and more about HPV,” says Suzie. “There are more than 100 types of the virus, and around 15 are associated with cancers. These 15 are known as high-risk HPV types.
“There is no blood test for HPV, but it can be tested for by taking a sample of cells. Every woman aged between 25-64 is offered Genital HPV testing as part of cervical screening [or smear], but it’s not something we test for routinely [at GUM/STI clinics].”
Genital warts can be a sign of infection with low-risk types of HPV and can be diagnosed in men as well as women. Anyone who is sexually active can get HPV, and if you’re concerned you can pay for private HPV testing.
While there is no treatment for HPV, the good news is the infection often clears on its own, and treatments are available for its effects. Most HPV infections don't cause any serious harm and are cleared by your immune system within two years.
Please can I have the morning after pill to take home for next time?
The morning-after-the-night-before (or two nights before) trip to the chemist for the morning after pill is usually a quick and painless transaction. A brief questionnaire with the pharmacist and £25 buys peace of mind. But because GUM/STI clinics offer the pill (usually Levonelle) for free, there’s a high demand for those who have time to sit and wait.
“I get asked whether I can give out the morning after pill to someone to take home to avoid them having to wait next time they need it,” says Suzie. “Unfortunately, we can’t ever do this. We need to always ask about health and sexual history, as well as checking blood pressure, and then have the individual take the pill in front of us.”
Although it might feel like it makes sense to keep a ‘safety net’ pill at home next to the Berocca, Suzie advises against viewing it this way. “Our recommendation is to find a regular contraception method that works for you. Even though the positives of any morning after pill far outweigh the negatives, there are much better forms of contraception and it should only be used in emergencies.”
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