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Protect Yourself from Sexually Transmitted Diseases

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It's important to understand that when you are sexually active, you can be at risk of getting a sexually transmitted disease (STD). This is true for all forms of sexual activity whether it is oral, vaginal, or anal. It's possible to get an STD even if you are in a long-term relationship. Anytime you have unsafe sex, you are at risk.

STDs are caused by different bacteria or viruses that are passed between partners during sexual activity. Some STDs are easily treated with no long-term effects, while others can be carried for life or cause serious or life-threatening diseases.

Except for not having sex (abstinence), there is no sure way to avoid contracting an STD. You can reduce your risk by practicing safer sex:

• Limit the number of your sex partners.
  
• Use condoms correctly and consistently.
  
• Know the sexual practices of your partner(s).
  
• Don't do something if it feels unsafe.
  
• Wash sex toys with a bleach solution before use. Use 1 part bleach to 10 parts water.

Oral sex

Some STDs, such as herpes, gonorrhea, and genital warts, are easily transmitted by oral sex. HIV is less likely to be passed through oral sex, but it is possible. Using condoms and oral dams can greatly reduce your risk.

Anal sex

Many diseases, including STDs, are easily transmitted by anal sex. Fecal material carries germs that can cause many different kinds of infectious diseases. Any time you have unsafe anal sex, you are at risk. Protect yourself and your partner(s) by using condoms or oral dams. Always wash sex toys and put a condom over them before use.

Protect Yourself from a Surprise Pregnancy

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Did you know that up to half of all pregnancies are surprises? A surprise pregnancy can seriously affect your health. Choosing and continuing to use an effective form of birth control is one of the most important ways that women can stay healthy. If you are sexually active and are not using a highly effective form of birth control, now is the time to consider your options and choose a method that is best for your current lifestyle. You may need to try more than one before finding a method that works best for you. Birth control methods often change over a woman's lifetime.

What Safer Sex Choices Can I Make?

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There are many safer sex choices that you can make. You can choose to use barrier methods like condoms or oral dams. If used correctly and consistently, condoms are effective at protecting you from sexually transmitted diseases (STDs) and preventing pregnancy.

Some women choose to have intimacy without sex. There are many ways you can enjoy being intimate such as kissing, touching, massage, or watching each other masturbate. Be creative while being intimate!

Be cautious, especially with a new partner. Physical intimacy does not always equal trust and honesty. Getting tested for STDs before choosing to have sex is another way to protect yourself and your partner. Even if you do not have any symptoms, you can get confidential HIV and STD tests at Kaiser Permanente. This means that your test results will not be shared with anyone without your signed authorization (unless required by law).

If you think that you may have been exposed to an STD, even if you don't have any symptoms, talk to your doctor or nurse practitioner right away.

How can I talk to my partner about safer sex?

Clear communication about sex with your partner(s) provides many benefits. It can build trust and intimacy, and you can feel better and safer about the choices you make. Many women find it difficult to talk about sex with their partner(s). Here are some tips:

• Tell your partner how important communication is to you.
• Be clear about what you will and won't do.
• Be direct about what you need and expect.
• Be honest about your feelings.
• Say that you want to be safe and protect your partner(s).

Sex can be an awkward topic. It's normal to have conflicting feelings. Talk to friends who practice safer sex and find out what works for them. You can also talk to your doctor if there is a problem that causes you distress, like pain during sex, or if think you may have a sexual disorder.

How to Use a Condom

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The male condom, or rubber, is a sheath, usually made out of latex. Condoms are the best way to protect yourself from sexually transmitted diseases if you choose to engage in sexual activity.

The risk of pregnancy if you only use condoms is about 15 percent. This means that if 100 women use condoms for one year, about 15 women will become pregnant. The risk of pregnancy for you may be higher or lower than stated, depending on how closely you follow the directions. If you use vaginal spermicide with the condom, your chances of preventing pregnancy improve. The man has to put the condom on his penis before there is any sexual contact. If he doesn't, the risk of pregnancy is much higher than 15 percent. It's a good idea to have a backup method of birth control and not rely entirely on condoms.

How to talk to your partner about condoms

The first step to safer sex it to talk about it. Be clear what you will and won't do. It can be fun to use condoms. Some people like to use them as part of foreplay. Remember, it is not OK for someone to refuse to wear a condom to protect against pregnancy or STDs.

How to use a condom

If you use latex condoms, never use lotions, baby oil, Vaseline, or cold cream – the oil in these products can weaken the condom. With condoms, always use a water-based lubricant like Astroglide, KY, or Probe.

Do not use condoms with spermicidal lubricant on them already. Condoms with the spermicide nonoxynol-9 have been found to increase the transmission of STDs. You can use a vaginal spermicide to lower the risk of pregnancy. Women with HIV or women at high risk for catching HIV should not use spermicides.

To put on the condom

• Put the condom on before the penis touches the vagina, mouth, or anus. Hold the condom by the tip to squeeze out the air. Leave some space at the tip to hold the ejaculate (cum).
• Unroll the condom all the way down over the erect penis.
• To increase effectiveness, use with vaginal spermicide.

To remove the condom

• After sex, the man should hold the condom at the bottom rim and pull out slowly while the penis is still hard.
• Never use a condom more than once.
  

Sexually Transmitted Diseases

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STDs are infections that are spread from person to person during sexual contact. Some common STDs are chlamydia, gonorrhea, herpes, and hepatitis B. Some STDs are passed by skin-to-skin contact, while others are passed through the exchange of body fluids (semen, vaginal fluids, and blood). Some symptoms of STDs may include:

• Bumps or sores
  
• Pain when urinating (peeing)
  
• Unusual discharge from the vagina or anus 

Many STDs do not show any symptoms at all. Even if you have no symptoms, you may still be infected and can pass the disease on to another person. The only way to be sure is to see your doctor and get tested. If you are diagnosed with an STD, it is important to follow all directions and complete your treatment.

Should I get tested?

If you think you may have an STD, or if your partner or partners recently told you that they have an STD, it is important for you to get tested. Many STDs can be treated successfully. It is best not to wait until symptoms develop.

If you are a sexually active woman under the age of 24, it is important that you get tested for STDs every year, whether you have symptoms or not. For all women, if you have more than one partner, or a new partner, it may also be a good time for you to get tested.

You can get confidential testing (including HIV testing) at Kaiser Permanente. Confidential means that your test results will not be shared with anyone without your signed authorization (unless required by law). Also, many local health clinics provide free testing. You can call 1-800-FOR-AIDS for the nearest HIV testing site in your community. If you think that you may have been exposed to an STD, even if you don't have any symptoms, contact us right away.

Should I get immunized?

There are some STDs that can be prevented by immunizations. It is important to remember that immunizations do not protect against all kinds of STDs; they will only protect you against the specific STD targeted by that vaccine. Currently, there are vaccinations against hepatitis A and B and human papillomavirus (HPV). Many women can benefit from these vaccines. Choosing to get these vaccinations can be a way for you to stay as healthy as possible.

Contacting Me

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You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.

• For nonurgent questions or concerns, you can e-mail me using this site. You can also book an appointment online to see me in person.
• If your concerns are immediate, or you simply prefer to use the telephone, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment for you. 

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How We Coordinate Your Care

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Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit

• At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
• At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
• To help you prepare for your visit, please see additional details under Office Visit. 

If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:

• Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
• Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.

If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to a specialist

My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.

If you are due for preventive screenings or tests

As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.

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Convenient Resources for You

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As your personal physician, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:

Manage your care securely

• View and compose secure e-mail messages.
• Manage your prescriptions and schedule appointments.
• View your past visits and test results.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.

Learn more about your condition

• Read about causes, symptoms, treatments, and procedures.
• Find interactive health tools, videos, and podcasts to help you manage your condition.
• View programs to help you decide on or prepare for a surgery or procedure.

Stay healthy

• Locate health education classes and support groups offered at our medical center.
• Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.

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