Ask Dr Amy – Questions

You’ve asked. Dr Amy has answered.

Our Ask Dr Amy segment is no longer available but our answers to those tricky questions about sex and relationships are still available to read.

Got a sexual health question you need answered? Call SHINE SA’s Sexual Healthline on 1300 883 793 and speak to a sexual health nurse for free. The Line is open Monday – Friday, 9:00am – 12:30pm.


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You can talk confidentially to a SHINE SA nurse for free on the Sexual Healthline on 1300 883 793. The line is open Monday – Friday, 9:00am – 12:30pm.

You can also contact us at SHINE SA on 8300 5300.

Most STIs have no symptoms, so you could have an infection without knowing.
If you’re sexually active it’s best to get tested regularly!
Also if you’re under the age of 30 it’s best to get an STI test every 6-12 months.

Our team of clinicians recently covered this topic on SHINE SA’s Sexual Health Matters Podcast.
The Sex After Having a Baby podcast is approximately 16 minutes, we suggest having a listen.

It’s normal for pubic hair to cover the mound between your legs. Typically it should cover all of the pubic mound to the inner surface of the thighs and up to the pubic bone-roughly shaped like a triangle. It can be normal for pubic hair to grow on the inner thighs outside of the so-called bikini line.

Pubic hair does have a purpose, providing a cushion against friction that can cause skin injury and protection from infections such as STIs. Usually pubic hair is darker and courser than the hair on your arms or head. People with darker skin or hair may find they have very dark and thick pubic hair. All of this is normal but due to social norms some people find it less acceptable.

There are no rules that say pubic hair must be removed. If you do decide to remove some or all of your pubic hair you should know that pubic hair removal naturally irritates and inflames the hair follicles left behind, leaving tiny open cuts. Ingrown follicles can occur leading to boils, abscesses and scarring. Laser hair removal from the vulva has been linked to vulval pain syndromes. The safest way to reduce pubic hair is by clipping it, rather than removing the hair from/at the roots. Remember pubic hair is natural and has a job to do. You shouldn’t be embarrassed by it or feel pressured to remove it.

You can definitely go to a GP for an STI test. GPs understand that some people feel embarrassed talking about sex but STI tests are really common so there is no need to feel ashamed. It is understandable that you might not want to see your “family” GP even though your appointments are confidential, so it might be time to find a GP of your own.

Universities usually have a GP clinic for students and depending on where you live, you may also be close to a sexual health service such as SHINE SA or Adelaide Sexual Health Centre. These services specialise in all thing sexual health and are always inclusive and friendly. You can always come along with a friend to support you.

You will be asked some personal questions but this is only to find out what tests you may need. Testing is as easy as peeing into a pot or collecting a small cotton bud swab yourself. Sexual health clinics can usually supply you with condoms and emergency contraception. They can also give you advice about any sexual concern and discuss contraception if you are having sex and don’t want to get pregnant.

Periods are different for everyone and can be affected by many things, including stress and changes in weight. Generally the menstrual cycle is between 21 to 35 days and last between 3-7 days. Not everyone has a regular cycles and it is very common to be irregular in the first few years after you start getting a period.

Condoms are very effective at preventing STIs but they are not 100% at preventing pregnancy. If your period is more than a week late you should think about doing a pregnancy test even if you have been having protected sex and definitely if you are having unprotected sex.

If the test is negative there are many other reasons why you period might be late and occasionally can you can “skip” a period completely. Keeping track of days of your period will assist you to know what is your normal. If your cycle has changed and continues to be unpredictable you can see a GP for advice .

If you get your second injection within 12 -14 weeks of the first injection then it is immediately effective and there is no gap in your contraception. If you are more than 14 weeks from the last injection then it would take 7 days to start working again and you would need to use condoms or avoid sex until then.

If you continue to get the injection every 12 weeks without being late, it will always be working, even if you are bleeding. It is OK to get the injection even if you are still having a period and you shouldn’t wait until your period stops if your injection is due. Irregular bleeding and spotting is common with the first couple of injections and usually settles down.

If this is a new bump and if feels different then you should get it checked, especially if it does not go away or it starts to get bigger. The skin on genital is naturally bumpy but these natural bumps should feel soft. A single painless lump could be a wart, molluscum or skin tag, all of which can be treated. It could also be a cyst which is harmless and may go away by itself. But it is always better to know than worry so go to a GP or sexual health clinic.

An STI test is a check up for common sexually transmitted infections such as chlamydia and gonorrhorea. All people under 30 are recommended to have a chlamydia test at least once a year. If you don’t have any symptoms of an STI you can collect a sample yourself at your GP or sexual health clinic.

For people with a penis this involves a urine sample at least 20 minutes after the last time you went to the toilet. For people with a vagina it’s best to do do a self collected swab which is a small cotton type swab. Sometimes a self collected swab of the anus is recommended and some people may also have a throat swab taken by the doc=otor or nurse. A full STI check can also include a blood test for blood borne viruses such as HIV, hepatitis B and syphilis. This can be discussed with the a doctor or nurse. If you have Medicare the tests won’t cost anything. If you don’t have Medicare the cost depends on the type and number of tests. Some sexual health clinics can provide free testing for people without Medicare. All visits to a doctor are confidential unless you are being harmed by someone or are at risk of harming yourself or others.

In those cases the doctor may need to notify someone to help you, for example in cases of sexual abuse. For people under 16 doctors can provide tests and treatment without parental consent if they assess you as competent. This means you understand the consequences of any test or treatment. Generally if you are asking for an STI test this is considered a sign you are making mature health decisions.

Unfortunately the only way to get chlamydia is through sexual contact. You can’t get it from the toilet seat or sharing towels. Very occasionally people can have what’s called a false positive chlamydia result where the sample tests positive even though they don’t have chlamydia, but this is rare.

The only way to check this would be to repeat the test before treatment is given. If your partner has chlamydia and you’ve had sex since your last STI test, you need to get another test as there is a high chance of getting infected yourself.

It depends on the weird smell! The vagina is a clever structure and looks after itself. It has good bacteria which keeps the area healthy. It has a low PH which means its natural smell can seem musty. One thing is certain, vaginas will not naturally smell like perfume, flowers or candles – I’m talking to you Gwyneth Paltrow.

People should not use soaps/shower gels or feminine products in the vagina as this changes the PH and affects the good bacteria. If this happens then other bacteria can multiply and cause an infection called bacterial vaginosis (BV). This causes the normal discharge to change and can produce a fishy smell. People may wash more to get rid of the smell and this continues to change the PH of the vagina and stop the good bacteria from coming back. If this is the smell you are smelling and you are washing with soaps/shower gels or other feminine products, the best thing to do is to stop!

The best way to wash the vulva is just with warm water and there is no need to wash inside the vagina, also known as douching. The vagina can be seen as self-cleaning and it looks after itself if left alone. If the smell is a result of bacterial vaginosis, there are antibiotics that can treat this. This is not a sexually transmitted infection, it is caused by a PH imbalance. If you have a new change in your discharge such as a change in smell or colour you should get a sexual health check as it could be an STI or thrush as well as BV.

The easy answer is no! If you think about your genitals and where infections occur – on or inside the penis, on the vulva or inside the vagina – and then you think about how you sit on a toilet, generally your genitals don’t make contact with the toilet seat.

The skin on your legs and bottom, which do make contact with the seat, are a barrier to infection getting into your body. Also, the bacteria and viruses that cause STIs only like to live in the warm moist parts of your genitals.

Even if they managed to get on the toilet seat, they wouldn’t be able to survive on a cold hard surface and would die very quickly, making it impossible for the next person to catch.

P.S. If someone tells you they caught an STI from a toilet seat, they are lying!

The normal skin texture of testicles is naturally bumpy due to the hair follicles. If they are touched they usually will feel soft and not much different to the rest of the genital skin. They can be more noticeable after hair removal. Sometimes, skin tags can grow on the genitals. They should also feel quite normal or soft, even though it is an unusual bump. Genital warts can also cause bumps and are generally firmer and will feel different when you touch them.

A virus called molluscum can be transferred by skin to skin contact and can occur anywhere on the body, including the testicles. Molluscum are small round lumps of 1-6mm and often have a shiny look with a small central pit. General advice is, if they have always been there it is usually OK.

If you have a new lump or bump or it is getting bigger it’s best to get it checked out. Skin tags, warts and molluscum can be treated with freezing by a health professional. Remember, not everything on the genitals is sexually transmitted. To best look after your genital skin do not use soaps/shower gels when washing, only wash with warm water and pat dry.

Sexual arousal can be a powerful feeling and difficult to shut down, and it’s important not to get caught up in the heat of the moment. You need to have a clear idea of exactly what kind of contact you are willing to have in any physical encounter before it happens.

This may be kissing or touching over clothes only, or may include non-penetrative sexual contact such as oral sex. Consent needs to be present before and during any sexual activity and you should make your partner aware of what your boundaries are as well.

It’s best to avoid drugs and alcohol as these can lower your inhibitions and lead to decisions you might not make when you are sober. If you feels yourself getting carried away when things are getting hot then you might need to walk away. Remember you can always go home and masturbate to finish yourself off.

Most importantly, you should never feel pressured into having any kind of sex that you aren’t ready or wanting to have.

The best treatment for vaginal thrush is an antifungal called clotrimazole. This medicine comes in a cream or pessary (pellet for the vagina). It comes in many different brands but the dose for vaginal thrush is kept behind the counter at the pharmacy and you have to ask for it or have a prescription.

If you are having many episodes of thrush you should see a doctor because some things that can look or feel like thrush but actually need different treatment. Sometimes when people are self-treating repeated times they can cause an allergic reaction which itches like thrush.

Yes, you can pass on thrush to people with a penis, especially if they have a foreskin. They can pass the thrush back to their partner with a vagina but also occasionally get a rash or inflammation of the foreskin, which can be quite painful and need treatment.

If you have a new symptom after sex you should get a check-up straight away. But generally the test for chlamydia and gonorrhoea is most reliable 2 weeks after an individual sexual encounter.

You can get a test for blood borne viruses such as HIV, hepatitis and syphilis at the same time but this should be repeated after 3 months as it can take this long to show up in a blood test. People with more than one sexual partner should have a sexual health check every 3 months and it’s recommended every person under 30 who is sexually active have a chlamydia test at least once a year even if they haven’t had a new partner.

It can be normal to bleed after anal sex, particularly the first time you try it. This is because small cuts or tears can occur inside the rectum and around the anus. The bleeding should stop after 1-2 days. If it doesn’t or is heavier/getting heavier you should see a doctor.

Bleeding can often be caused by too much friction, rough penetration or cuts from finger nails. It’s important to use plenty of lubricant and go slowly. The person providing anal sex should keep their nails trimmed and shouldn’t attempt full penetration straight away.

Using fingers and butt plugs can be a way to prepare for anal sex. Sometimes small tears can develop into a chronic condition called anal fissures that need medication and sometimes surgery. Fissures can be associated with pain and bleeding when you do a poo so you should see a doctor if this is happening.

Other things that cause bleeding after anal sex include haemorrhoids, overuse of enemas as well as some STIs so you should be checked for all of these if the bleeding persists.

It is normal for couples to go through a “honeymoon” period. This is the time at the beginning of the relationship when you’re so loved up you can’t keep your hands off each other. Everything seems perfect and your partner can do no wrong. This time can last anywhere from 6 months to a couple of years. The reality is that most relationships couldn’t sustain this level of intensity forever.

Over time, things can feel less exciting as the newness fades and you may be dealing with the everyday minor issues such as who forgot to buy the milk. This can lead to less interest in sex with your partner. You should see your GP to check for any medical issues if you are generally feeling a bit flat and these can include low iron, low thyroid hormone and depression. If this is not an issue, the Pill can also change your libido so you might want to discuss changing contraception if this is relevant.

If you still enjoy sex with your partner but just don’t feel like initiating it you may need to schedule it in – plan a time when you have sex rather than just waiting for your body to tell you it wants it. Make time to have couple time or dates where you focus just on each other, doing something new and not just sitting at home in front of the TV. You could also spend some time apart and go out with your friends so that you appreciate each other more when you are together. If none of this helps and you are unhappy with your lack of libido you could see a qualified counsellor, psychologist or sexologist.

It’s a good idea to pee both before and after sex to prevent urinary tract infections (UTI).

Having sex causes friction and can disrupt bacteria that lives on the skin and is usually harmless. If this bacteria enters the urethra (where you pee from) it can cause a UTI. Peeing before and after sex cleans and flushes away any unwanted bacteria that could enter the urethra. Peeing does not flush away the bacteria that causes sexually transmitted infections.

Sperm are actually quite fragile and need precise levels of warmth and humidity to survive. They can live in semen outside of the body for a few hours but only if stored correctly, such as during semen collection for fertility treatment. In a pool, they would die almost instantly due to the temperature and chemicals, so no it is not possible to get pregnant from a pool or hot tub.

Yes, you can get sexually transmitted infections such as gonorrhoea, herpes and syphilis from oral sex. To prevent this you should use a condom or dental dam during oral sex.

The cervical screening test is a test for HPV (humanpapilloma virus) which is transmitted through skin to skin contact.

Four out of five people who have ever been sexually active have come into contact with HPV and this includes oral sex, same sex partners and sharing of sex toys or mutual masturbation. This means that you can be exposed to HPV through any sexual contact and not just from vaginal penetration alone.

Most people will get rid of the virus within a couple of years and cervical screening will detect those people who haven’t cleared the virus. You will be invited to have your first cervical screening at the age of 25 and if you aren’t sure if you need the test you should discuss it with a health professional.

The terms bisexual and asexual refer to sexual orientation which is the romantic or sexual attraction that a person feels towards another person.

People who identify as bisexual are romantically and/or physically attracted to both to the gender the same as their own, and to other genders. Some people also identify as pansexual which means they can be attracted to anyone regardless of gender or gender identity.

People who identify as asexual may not be interested in sex, but they can still feel emotionally close to other people. It is normal for people to wonder about their sexual orientation, especially in their teen years.

Many people have emotional or physical thoughts about people of the same gender and other genders without identifying a particular orientation. Sexual orientation can also change over time or be fluid. Identifying as a particular sexual orientation can be helpful in finding a community and peers who can support you, but you don’t need to label yourself if you aren’t sure.

Absolutely yes! Most STIs have such mild symptoms or no symptoms at all which is why they are so easy to catch and pass on without knowing. As many as 3 out of 4 people with chlamydia have no symptoms and this is the most common STI. Blood borne viruses such as HIV, hepatitis and syphilis might cause a rash or flu like symptoms which many people think is just a virus and ignore.

That’s why it’s important to have regular sexual health checks. People under 30 who are sexually active should have a check at least once a year and if you have new or multiple partners you should get checked at least every 3 months.

Yes, erectile dysfunction (difficulty getting or keeping an erection) is a common problem and may affect up to 1 in 4 people under 40 at some point in their lives. It can be caused by medical problems such as diabetes and high blood pressure, and although this is more likely in older people, you should see your GP for a check up if it keeps happening.

In young people, erectile dysfunction is most often psychological and is usually caused by performance anxiety, which is when you are worried about “performing” well for your partner. Depression and anxiety disorders (and some of the medications that treat these conditions) can increase the chance of erectile dysfunction. Drugs and alcohol can also affect the ability to get an erection.

It can be very upsetting to be told you have HPV but it is important to remember that it’s common.  Four out of five people who have ever been sexually active have been exposed to HPV. I call it the “common cold” of having sex because if you are sexually active you are as likely to be exposed to one of the human papillomaviruses, as you are to have a cold. HPV is passed on by skin-to-skin contact and so can be transmitted by any type of sexual contact including oral sex.

The cervical screening test (previously known as a pap smear), tests for several types of HPV that are associated with cervical cancer but are not linked to genital warts and are not considered an STI. HPV is usually cleared by your immune system within 2 years but you don’t need to wait to have sex, and there is no need to inform past or future partners that you have had a positive HPV result. Your previous partners don’t need any treatment and future partners don’t need to take any additional precautions (other than safer sex for all STIs). There is also a good chance they have already been exposed to HPV previously.

Generally speaking, the average person produces about a teaspoon of vaginal discharge a day. Texture may range from thin to thick and slippery to creamy. The colour of the discharge can range from clear to white or off-white. The discharge should be relatively odourless.

If you are not on hormonal contraception you may have more or less discharge depending on where you are in your cycle. At ovulation (about halfway through a monthly period cycle) you can see lots of clear or slippery discharge. Once the egg is released, discharge amount lessens and becomes thicker and whiter. If this sounds like your discharge, then this is normal physiological discharge.

If you are on hormonal contraception this may also increase your discharge, but the amount/texture is not likely to vary throughout your cycle. To reduce physiological discharge avoid washing or douching inside the vagina with soap or perfume. Gently clean the outer area (vulva) and rinse well with water and pat dry. Wear cotton underwear as it’s more breathable and try not to wear underwear at night.

Avoid wearing tight pants and avoid bubble bath and hot tubs. If your discharge is new or changed, smells bad or is discoloured see a GP or sexual health clinic for an examination and test. This can rule out STIs and other non-STI infections such as thrush or bacterial vaginosis.

It can be difficult to find the right contraception (as in the contraception that’s right for you). Some people are more sensitive than others to the hormones in the contraceptive implant and the Pill.

In this case you could try an intra-uterine device (IUD). There are 2 type of IUDs in Australia that contain the progestogen hormone, these are very low dose and don’t usually cause the same side effects as other forms of hormonal contraception.

You could also go completely hormone-free and have the copper IUD. All IUDs in Australia are better than 99% effective at preventing pregnancy and last for 5-10 years depending on the type. SHINE SA has a factsheet about IUDs on our website and you can make an appointment to discuss this with one of our doctors or nurses.

STIs can be passed from person-to-person through any form of sexual activity and some STIs can be passed through skin-to-skin contact alone.

STIs such as chlamydia and gonorrhoea can be passed on through oral sex, genital-to-genital contact, fingering and sharing use of sex toys. Safer sex includes reducing the risk of STIs by preventing sexual bodily fluid transmission. A dental dam is a thin, flexible piece of latex that protects against direct mouth-to-genital contact during oral sex while still allowing stimulation. Wearing gloves during fingering/fondling also reduces STI transmission as well as washing hands after sex.

If you’re sharing sex toys such as dildos or vibrators you can put a condom over the toy or use a surface disinfectant such as Viraclean on the toy afterwards. Dental dams can be purchased via SHINE SA or online. If you or your sexual partner has any sores, lumps or ulcers around the mouth or genital area, or unusual discharge, avoid sex or any activity involving skin contact with the affected area.

The best way to protect yourself against STIs is to get regular sexual health checks and ask your partner/s to do the same.

We don’t define risk of getting an STI by sexual orientation, but there are different types of STIs than can be transmitted in different ways.

Chlamydia and gonorrhoea are highly infectious and can be passed on the penis in vagina and penis in anus sex. They can also be transmitted via oral sex to both the giving and receiving person. If you are having any kind of sex with someone who has chlamydia or gonorrhoea there is a very high chance you will get the STI.

The risk of getting an STI increases with each act of unprotected sex with someone who has an STI so you can’t really give a %. If there are no sexually transmitted infections present then it is 0% but everyone involved would need to have had a recent STI test to be sure, if they have ever been sexually active.

You may not always ‘catch’ an STI as it will depend on what the infection is and what sexual activity is taking place, but that would be unlikely. The best way to be sure is to get regular testing if you are sexually active and use condoms/dental dams with any sexual partner/s unless you are certain of their STI status.

You can’t tell just by looking! Many people who have an STI (up to 75% of people with chlamydia for example) don’t have any symptoms so they won’t even know they have an STI. Even when people do have symptoms they may be mild and pass quickly.

Infections such as genital warts and herpes may be visible but they are not always easy to see. Blood borne viruses such as HIV, syphilis and hepatitis B can also be transmitted during sex and many of these symptoms are either mild, or may be confused for other infections such as the flu.

To keep yourself safe you can have safer sex using a condom or a dental dam. You should also get an STI screen at least once a year or after having sex with every new partner. So it’s best not to take the risk or assume that because just you know someone, you know their risk of having an STI.

There is no right or wrong way to have sex and lesbians can have sex pretty much the same way as straight couples. For many people with a vagina the main way to reach orgasm is through clitoral stimulation and this can occur without penetration. The clitoris (and other parts of the body) can be stimulated with your mouth, fingers or sex toys such as vibrators.

If penetration is desired by either partner this can also be with fingers or sex toys. You and your sexual partners can enjoy experimenting on what you each enjoy. Practice safer sex by using dental dams and gloves and clean all sex toys thoroughly before sharing.

SHINE SA is a sexual health service, we offer testing for sexually transmitted infections. We are an inclusive and confidential service which means there is no judgement, and we provide a safe space. You will be treated with respect and if you have an infection you will be offered advice and treatment.

There may be a small charge for some treatments but if you have a health care card then there is no fee.

There are a number of treatments for premature ejaculation (PE) and they should be used with the support of a qualified health professional. It’s important to figure out what the likely cause is.

If the PE is associated with trying to ejaculate before the loss of the erection then there may also be erectile dysfunction, which can be treated with specific medications.

If the PE is associated with psychological problems such as performance anxiety or relationship issues, then counselling may be needed with a psychologist or sexologist.

Lifelong PE is a chemical imbalance which lowers the threshold for ejaculation and less stimulation is needed to orgasm. Treatment for this imbalance can include certain medications that are prescribed by a GP.

Behavioural techniques can be used to learn how to “slow down” during sex. These include the “stop-start” and “squeeze” techniques that help to stop sex when you feel close to ejaculation. These techniques should also be discussed with a health professional before using. Certain numbing creams and sprays can be used to reduce sensation or even using a condom.

The first step is to see your GP or a sexual health counsellor as they can help figure out what treatments are the best for you.

HPV on the cervix will usually self-resolve within 1-2 years. Until your body does clear it you will need to have more regular cervical screening. If you are a smoker then quitting will help your body’s immune system do this but otherwise there is no way of speeding up the process. Vaccination won’t help clear HPV that is already there. Remember HPV that is picked up on a cervical screening test is not linked to genital warts and you don’t need any special precautions during sex other than your regular STI prevention/contraception if required.

There is a condition called vaginismus which may explain how you are feeling. Vaginismus is vaginal tightness or burning caused by the involuntary tightening of the pelvic floor muscles which makes any penetration very painful or impossible. For some it has always been that way and for others it can just develop.

The good news is this is a condition which can be managed. Book an appointment with a supportive GP or sexual health service for further assistance.

The National Cancer Screening Register begins inviting people for a cervical screening test at the age of 25. It is looking for the presence of the human papilloma virus (HPV) which is passed on through sexual contact (including oral sex, fingering or shared use of sex toys). If you have never had any form of sexual contact then your risk would be very low and you could discuss the need for testing at age 25 with a GP or sexual health clinic. If the test does not detect HPV then you would be invited to rescreen after 5 years.

The inactive pills (or hormone free pills) in the packaging in standard combined oral contraceptive pills available in Australia are there to help you remember when to start taking the active (hormone containing pills). If you have had at least 7 days of active pills then it is safe to have up to 7 days of inactive pills without ovulation happening (an egg releasing). It is important to never go for more than 7 days without taking an active (hormone) pill.

Also, if you miss a pill in either the week before or after the 7 days of inactive pills that can increase the risk of pregnancy. If you do miss a pill in either of those weeks you should check your pill instructions or the SHINE SA The Pill Fact Sheet for what to do next. The most important thing is never to go more than 7 days without an active pill if you are trying to avoid pregnancy.

SHINE SA is a sexual health service, we offer testing for sexually transmitted infections and are confidential and inclusive. If you are 16 you can consent to your own medical treatment and do not need a carer or guardian’s consent.

Want to make an appointment at SHINE SA? Call us on 8300 5300.