MEDTalk with Dr. Kiran Sex & Contraception Health Advice

This is for any teenager who’s ever thought about sex. Which is all of you...​​

Sex

Whatever your thoughts about sex, sex is a big deal! You’ve probably had sex education at school and for many of you, mum or dad will have given you the ‘talk’. If you haven’t had a conversation with your parents, it might be something to think about doing, as they’re there to guide and support you. And they want you to be safe.

So I'm going to give you a GP’s perspective on what you need to know about sexually transmitted infections and contraception. I will give you useful tips and help you understand some of the important issues, but it’s no substitute for advice given by a healthcare professional face to face. There are helpful links at the end of this blog.

The Law

In the UK you can consent to any form of sexual activity once you are 16 years old, regardless of your gender or the gender of the person you’re having sex with. However it is an offence to have any sexual activity with someone under the age of 16, regardless of your own age. Sex must be consensual between both individuals as otherwise this may constitute either sexual assault or even rape. Know Your Rights?

Contraception

Even if it’s just once, having penetrative vaginal sex can lead to pregnancy, so it’s vital to use contraception every time you have sex if you’re not trying for a baby.

What options do you have for contraception? Your GP or family planning clinic will be able to start you on contraception, and there are many different types to consider, but it will be much easier to discuss with the doctor or nurse which is best for you once you've read this blog.

I won’t list every type of contraception, but I will mention the most commonly used, and list some pros and cons of using each type of contraception:

I won’t list every type of contraception, but I will mention the most commonly used, and list some pros and cons of using each type of contraception:

Condoms

If you’re having sex with a new partner, always use a barrier method of contraception (condom), even if other forms of contraception are used. Barrier methods are the only way to stop transferring many sexually transmitted infections (STIs), and it's possible to carry an infection even if there are no symptoms.

Pros:

• A reliable method if used correctly, however not as reliable as some other methods of contraception.
• Significantly reduces the risk of contracting STIs.
• Gives immediate contraceptive protection.
• Gives men more responsibility when thinking about contraception.
• There are other more reliable methods of contraception.
• Need to carry condoms.
• Chance of failure, for example: a tear or leak.
• Studies have shown that if condoms are not used correctly then the risk of becoming pregnant may be up to 18% per year of use (If used correctly this is 2%).

Cons:

• Whether you’re male or female, you should know how to put on a condom. Here are some tips:
• Always check the use by date and check the condom packet has a BSI and CE mark, which means they are reliable and safe to use.
• You should roll the condom down to the base of the penis and make sure this is done before any physical genital contact between partners.
• After ejaculation make sure to withdraw fully before removing the condom.
• You should be able to get free condoms from contraception clinics or sexual health clinics. There are further links below for advice on how to use a condom.

Hormonal contraception (for women)

Young women, there are many more options for you when thinking about contraception. However. young men also take note, you may still need to use condoms to prevent spread of STIs if your sexual partner uses hormonal contraception. I’ll talk more about this later.

There are two main types of hormonal contraception:

• combined contraception containing estrogen and progestogen hormones.
• Progestogen-only hormonal contraception.

Combined hormonal contraception's main action is to prevent an egg being released by the ovaries (ovulation).

There are different ways of taking combined contraception but the most common is by taking a ‘pill’ everyday. Other options include use of a patch or using an internal vaginal ring. The pill is taken daily, the patch needs changing just weekly and the vaginal ring just once a month

There are some medical risks associated with hormonal contraception and this risk may also depend on any other conditions you have. Combined contraception is associated with a small increased risk of certain cancers however it is protective against other cancers. Your doctor or family planning clinic will discuss these risks further to help you decide which contraception is best for you.

Combined contraception

Pros:

• Can help to regulate periods if they’re irregular or heavy and may help with acne.
• No need to think about contraception at the time of having sex, but may need to use condom to protect against STI.
• The pill, ring and patch all provide more than 99% protection when used correctly.

Cons:

• Does not protect against STIs.
• Increased risk of developing certain medical conditions, but also protective against others.
• If forgetting to take pills or use contraception as directed will put at risk of pregnancy.

Progestogen-only contraception

There are different types and the most commonly used is the ‘mini-pill’. Alternatively there is an implant, which is a small rod about 4cm long which is placed under the skin, and there is a ‘coil’ which is a small T-shaped device which sits just inside your womb. Again there are some risks associated with use of progesterone only pill so you should discuss this further with your GP or contraception clinic.

Pros:

• The implant only needs changing every 3 years and the coil once every 5 years.
• May reduce heavy bleeding during periods and sometimes completely stop periods.
• No need to think about contraception when having sex, but may need to use condoms to protect against STIs.

Cons:

• Does not protect against STIs.
• Associated with some side effects and a small increased risk of medical conditions, which need to be taken into consideration.
• Some women have prolonged bleeding (although usually very light), which can be problematic.
• If you don’t use the contraception as directed this could put you at risk of pregnancy.

There are other forms of contraception which I haven’t detailed further including the copper coil, progestogen injection and female barrier methods. These tend to be less commonly used in young adults but you can find out more information from the links at the bottom of the page.

Emergency Contraception

So you’ve had sex… did the condom break? Or perhaps you didn’t use contraception? You can still get emergency contraception to prevent a pregnancy but don't wait around as there is just a small window of opportunity to prevent pregnancy, and the longer you wait, the less reliable the treatment is.

You can get access to emergency contraception from many pharmacies, your GP or contraception clinics. It's possible to get contraception up to 5 days after having sex, but the longer you wait the less effective taking a pill could be, and they often cause short-lived side effects.

The most effective form of emergency contraception is the copper coil, which can be inserted up to 5 days after unprotected sex which prevents more than 99% of pregnancies. Remember, you may also need further screening for sexually transmitted infections with unprotected sex.

That's a lot of information to take in! But it should be easier now to discuss the different contraception available when you see a healthcare professional and you might even have an idea what might work best or you.

Remember, non-barrier methods of contraception, essentially anything except condoms, do not protect against STIs, so even if you are taking other forms of contraception you may still need to use a condom to practice safe sex.

Hollyoaks: What Is Consent? Watch this one off documentary on what sexual consent means

Advice & Information on issues covered in this article can be found on Channel 4's Help & Support Page