Sexual health and wellbeing questions

As you get older—especially when you are thinking about sex and relationships—your doctor can be (and should be) a huge resource for problems, issues, or questions you have. Here is a brief list of things you should make sure you think or talk about at a visit.

  1. How often should I have gynecology appointments? (For girls with cervixes, think about Pap-smears and cervical cancer screening. Typically, this is once every 3 years.)
  2. Should I think about taking the Human Papilloma Virus (HPV) vaccine? And how often should I be tested for STIs (sexually transmitted infections)?
  3. Should my partner be tested for STIs? And how can I ask them?
  4. (for guys) How often should I have a prostate exam?
  5. How can I avoid urinary tract infections (UTIs) or bladder issues?
  6. What is a yeast infection and how is it treated?
  7. Who can I talk to when I experience sexual problems or issues?

And here are some questions where we can offer some thoughts from our experiences.

Should you get lubricant for sexual activity? And, if so, what kind?

In general, we suggest water-based lubricants that seem to work better and also work well with condoms. We suggest KY lubricant or Astroglide. Additionally, some people use oils like coconut oil and find it works well, but you need to experiment. If you use a condom, you should not use oil-based lubricants.

Can you use estrogen cream?

Doctors in some countries give a prescription for vaginal estrogen cream as directed. Some people use this when they are sexually active to plump up the vaginal area and help nourish their vagina. This isn’t intended as hormone replacement, necessarily, and for all women with DSD, this may be helpful. Some people even use this to prevent urinary tract infections.

Also, when you start the process of dilating, you might use the cream as lubrication and put it at the tip of the dilator. Many doctors think this may help the tissue stretch because estrogen can improve elasticity of skin. Even if you are taking HRT or have hormones naturally, using the vaginal cream is a good additional way to specifically target the V area. Talk to your doctor to see if this may be right for you.

Do you pee (or urinate) after sexual activity?

When you are having sexual experiences, bacteria that naturally live in your vagina or genital areas can get into your bladder. Because of this, we suggest going to the bathroom to pee immediately after ‘sex’-y time (whatever that is to you.) This will help clean out your urinary tract to avoid an uncomfortable UTI (urinary tract infection).

How do you wipe (in the bathroom?)

Also, (we know this is gross…but) when you are wiping in the bathroom, always wipe from the front to the back (from urethra/urine part to the bottom/anus part.) This is also a good way to prevent UTIs, too.

What about oral sex? Do I need condoms and what risks are there? I can’t get STIs from oral sex, right?

It can seem like oral sex (genital touching incorporating mouths and hands) is a less risky choice, in terms of STIs. Unfortunately, you can still get STIs from oral sex—from HPV to HIV to herpes. Remember that condoms reduce your risk of contracting an STI orally. Talk to your doctor about oral sex more.

Should my partner be tested for sexually transmitted infections (STIs) and how do I ask them? And what do we do before and after?

Questions to ask before you are sexually intimate with someone…

  • Ask you partner, “Have you been tested recently for STIs?” especially if your partner has been intimate with someone before.
  • If you don’t feel comfortable talking to your partner about this, that’s normal. It’s a hard conversation to have, but they will understand. If they don't understand, that person may not be the right partner for you. Prioritize this conversation! It is very important.
  • If you and your partner have not been tested or might also be seeing other people, you should use condoms to decrease the chance of getting an STI.
  • If you and your partner have both tested negative and are in a trusting, committed relationship (only sexually intimate with one another), you might decide not to use condoms when you are intimate—it depends on birth control and whether you can have biological children. This is still not without risks, and only you can decide if this is right for you.
  • To be safe, if you are in an intimate relationship or have been, get tested once a year and with each new partner.