Sexual health FAQs

I’m a man. What sexually transmitted infections should I test for?

If you are male and don’t have any symptoms you will need to provide a urine sample, which we will test for chlamydia and gonorrhoea. Men will also do a blood test for HIV and syphilis, and occasionally hepatitis B or C.

I’m a woman. What sexually transmitted infections should I test for?

If you are female and don’t have any symptoms you will be given a swab to test for chlamydia and gonorrhoea. You can do the swab yourself. The swab involves inserting a small cotton bud into the entrance of the vagina and rotating the swab a few times against the walls of your vagina. Women will also do a blood test for HIV and syphilis, and occasionally hepatitis B or C.

What are some symptoms of sexually transmitted infections in women?

Common STI symptoms in women include:

  • change in vaginal discharge (fluid)
  • redness or itching
  • pain
  • pain during sex
  • heavier periods
  • spotting
  • needing to urinate frequently
  • discomfort when urinating
  • ulcers or sores
  • lumps on the skin

If you’ve been having anal sex, you may notice a change in bowel habit such as pain, constipation or diarrhoea, blood or mucus in your stools.

If you have any of these symptoms, come see us as soon as possible.

What are some symptoms of sexually transmitted infections in men?

Common STI symptoms in men include:

  • discharge (fluid) coming from the tip of the penis
  • redness or itching
  • pain in the testicles
  • discomfort when urinating
  • needing to urinate frequently
  • ulcers or sores
  • lumps on the skin

If you’ve been having anal sex, you may notice a change in bowel habit such as pain, constipation or diarrhoea, blood or mucus in your stools.

If you have any of these symptoms, come see us as soon as possible.

How do I protect myself against sexually-transmitted infections or HIV?

Have safe sex. Safer sex means having sex with less risk of transmission (catching or passing on) an STI. The risk of catching each infection is different and varies according to the type of sex you are having (eg oral, vaginal or anal sex). For example. herpes is often passed on through oral sex, but HIV is rarely passed on this way. Anal sex carries the highest risk of passing on infections such as HIV and hepatitis, followed by vaginal and then oral sex.

Non-penetrative sex (such as body rubbing and mutual masturbation) carries the lowest risk, but some infections (such as warts and herpes) can be passed on in this way. Come in and speak to a health adviser for more information.

Find out more about STIs.

How do I make sex safer?

You can reduce the risk of all infections by using condoms for all types of penetrative sex (vaginal and anal). You may also want to consider condoms for oral sex. Having non penetrative sex, such as body rubbing and mutual masturbation, and reducing the number of partners you have sex with, reduces the risk of transmitting infections.

You should always get tested for STIs before having sex with someone new and advise that they get tested too.

If you are at risk of hepatitis B, get vaccinated. Ask a doctor, nurse or health adviser about this.

Plan ahead regarding how you will protect yourself and your sexual partners from infections when under the influence of alcohol or other recreational drugs.

How risky is oral sex?

Oral sex can include fellatio (sucking a penis), cunnilingus (licking female genitals) or oro-anal contact (anal licking or "rimming"). Herpes, warts, gonorrhoea, chlamydia, syphilis, HIV, hepatitis B and other infections can be transmitted through oral sex.

The risk of catching an STI through unprotected oral sex is lower than for unprotected vaginal or anal sex, but is not zero. For most infections (except herpes), the risk of catching an infection is greater for the one giving oral sex than for the one receiving.

How do I make oral sex safer?

Reduce the number of partners with whom you have oral sex and avoid brushing teeth or flossing before having oral sex. Avoid oral sex with ejaculation to reduce the risk of HIV and other infections. Insertive fellatio (being sucked) is lower risk than receptive fellatio (sucking a penis).

If you have oral cuts or sores, or a sore throat, avoid oral sex or use condoms.

What about making other forms of sex safer?

No form of sexual contact is entirely without risk of STI transmission. Non penetrative contact (body rubbing or mutual masturbation without penetration) carries the lowest risk.

Herpes can be transmitted through kissing and it may be possible to transmit other STIs (including syphilis and hepatitis B) in this way, although the risk is lower than for penetrative sex. If you are fingering, using sex toys or fisting your partner, the risk of transmission is related to the degree of trauma – how much damage is done to the delicate lining of the vagina or anus. If you think there is a risk of trauma, use latex or non-latex gloves for penetrative sex.

What about safer sex if my partner or I am living with HIV?

If you are living with HIV, staff at your clinic will be able to give you detailed advice on safer sex. Taking effective antiretroviral therapy (ART) and having an undetectable plasma/blood HIV viral load significantly reduces the risk of HIV transmission during sex. Poor adherence (missing doses of ART) may increase the risk of HIV transmission. Continuing to use condoms for vaginal, anal and oral sex will further reduce any remaining risk of transmission.

If you are living with HIV or you have partners who are or may be HIV positive, have an STI check regularly depending on your sexual activity, and at least once a year if you're sexually active.

Where can I find my nearest sexual health clinic?

The British Association for Sexual Health and HIV (BASHH) have a great clinic finder.

Can I have a pregnancy test when I come to a sexual health clinic?

If you think you might be pregnant, why not pop in and see us for a free pregnancy test? Whether you are planning a pregnancy or not, we can talk through your options with you.

What contraception or contraception advice can you provide?

It is important to plan for the future when thinking about having sex. There is a wide range of contraception available (see the list below) and our friendly staff will help you decide which type is right for you. Come in and see us so we can chat about your options.

  • Long acting contraception
  • Combined hormonal contraception
  • Progestogen-only pill
  • Barrier methods
  • Emergency contraception

I have a sexual health problem and I don't know what to do

Men and women can both experience problems that affect their sexual health and their sex life. The Royal Free London can support you to overcome, or live with, your problem. Get advice on sexual health or phone our health advisers on 020 7830 2847.