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Sexual health

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Sexual health



Contraception

 

Where can I get contraception?
Which method of contraception suits me?
I'm under 16 – can I get contraception?

Whatever questions you have about getting and using contraception, this guide can help. It aims to give practical information to everyone who wants to know more about contraception, including teenagers; women in their 20s, 30s and 40s; and anyone with a question about the method they use or are thinking about using.
 

There are two permanent methods of contraception:


1) Female sterilisation

A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this happening by keeping the egg and sperm apart or by stopping egg production. One method of contraception is female sterilisation. Female sterilisation is usually carried out under general anaesthetic, but can be carried out under local anaesthetic, depending on the method used. The surgery involves blocking or sealing the fallopian tubes, which link the ovaries to the womb (uterus). This prevents the woman’s eggs from reaching sperm and becoming fertilised. Eggs will still be released from the ovaries as normal, but they will be absorbed naturally into the woman's body.  

 

2) Male sterilisation (vasectomy)

A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this happening by keeping the egg and sperm apart or by stopping egg production. One method of contraception is vasectomy (male sterilisation). During a minor operation, the tubes that carry sperm from a man's testicles to the penis are cut, blocked or sealed. This prevents sperm from reaching the seminal fluid (semen), which is ejaculated from the penis during sex. There will be no sperm in the semen, so a woman's egg can't be fertilised. Vasectomy is usually carried out under local anaesthetic, and takes about 15 minutes.


Sex and young people

 

Are you ready for sex?

What should you do if a condom splits? Is your body normal? 

Most people have sex for the first time when they're 16 or older, not before. If someone's boasting about having sex, it's possible they're pretending. There are no rules about how long you have to be going out with someone before you have sex. Being ready happens at different times for everyone – don't decide to have sex just because your friends or partner are pressuring you.


You can read this whole page or go straight to the sections to find out more:
 

Sex and the law

The law says it's legal for you to agree – or consent – to sex from the age of 16.If you're under 16, you can get confidential contraceptive and sexual health services, including advice about an unplanned pregnancy. You can get free condoms from some GPs, community contraceptive or young persons' clinics, and Brook services. If you're under 13, the situation is different because the law says you can't consent to any sexual activity at this age. Read Will they tell my parents? to find out more about confidentiality, whatever your age.


Deciding when to have sex
Working out when you're ready to have sex and feeling comfortable about it is one of life's big decisions. You're the only one who can, and should, decide.
Just because you've had sex before, even with the same person, doesn't mean you have to do it again.


How to talk about sex
It's better to have an embarrassing talk about sex than an embarrassing sexual experience before you're ready. There are lots of things to think and talk about, such as:


Are you both ready?

Will you be having sex for the right reasons, and not because of peer pressure or partner pressure?

Do you have contraception sorted?


Sex isn't the only aspect of a relationship, and there are other ways of enjoying each other's company. Discuss what you want and what you don't want to do.
You can do other things you both like, such as talking, meeting each other's family and friends, going to gigs or the cinema, taking part in sport, walking, and listening to music.


The questions to ask yourself about sex
You need to have the confidence to work out how you want to respond if sex comes up and how far to go. Ask yourself if you feel comfortable.
Is it the right time, in the right place, and with the right person? Do you really trust the person, and do you feel the same way about one another?
If you think you might have sex, ask yourself the following questions:


Does it feel right?

Do I love my partner?

Does he/she love me just as much?

Have we talked about using condoms to prevent STIs and HIV, and was the talk OK?

Have we got contraception organised to protect against pregnancy?

Do I feel able to say "no" at any point if I change my mind, and will we both be OK with that?

If you answer yes to all these questions, the time may be right. But if you answer yes to any of the following questions, it might not be:

Do I feel under pressure from anyone, such as my partner or friends?

Could I have any regrets afterwards?

Am I thinking about having sex just to impress my friends or keep up with them?

Am I thinking about having sex just to keep my partner?


Being in a relationship doesn't mean you have to have sex. Even if you've done it once or twice, you still need to make sure your boyfriend or girlfriend is as keen as you are each time.


How do I bring up the subject of safer sex?
When you decide to have sex, there's the possibility of pregnancy, catching a sexually transmitted infection (STI) such as chlamydia, or both. Whoever you're thinking of having sex with, it's important to talk about contraception and condoms before you have sex. Both of you have a responsibility to have this conversation.
Starting a conversation about the different types of contraception could be a good way to start talking about other issues to do with sex, such as how you feel about it and what you do and don't want to do.

You could try saying, "I found out there are 15 different types of contraception … If we were to have sex, which one should we use?".
Researching the options together will help both of you feel more confident and in control of the situation. Find out about the 15 different kinds of contraception. You can get free and confidential advice about sex, contraception and abortion at any time. Visit your local doctor, community contraceptive clinic, sexual health or genitourinary medicine (GUM) clinic, or young persons' clinic.


Using condoms

You need to use condoms to reduce the risk of catching an STI, including HIV, whoever you're having sex with. If you're in a boy/girl couple, you should use an additional form of contraception to prevent an unintended pregnancy.


Choosing the right contraception

There are 15 different kinds of contraception, including the implant, the injection, the combined pill, and the progestogen-only pill.
Most kinds of contraception are used by girls, but both of you have a responsibility to talk about this: a pregnancy will affect both of you.


Lesbian, gay or bisexual sex

If you have lesbian, gay or bisexual sex, it's important to use a condom every time as you can still get or pass on STIs, including HIV. You also need to know about contraception in case you have straight sex as well. Find out more about sexual health for women who have sex with women and men who have sex with men.


Reading the signs they want sex

Many people are surprised when a situation leads to sex, so learn to read the signs. If someone suggests you find a quiet place, makes lots of physical contact, or suddenly tries to charm and flatter you, they might be thinking about sex, even if you're not.

You need to decide whether you want to have sex. Don't let someone else decide for you by just going along with it. Make the decision in advance and stay in control of the situation – especially if you've had alcohol, because you'll be less inhibited. If you're not sure you can stay in control, avoid situations that could lead to sex, such as going to someone's room or somewhere quiet.


Alcohol won't help

Many people have sex or lose their virginity when they've been drinking. After a few drinks, you're more likely to lose your judgement, and may do things you wouldn't do normally. You may regret your actions in the morning, and you won't be able to undo what you've done. People are also more likely to have sex without a condom when they're drunk. This can lead to an STI or unintended pregnancy.


Vagina health



Vaginas are designed to help us have and enjoy sex, have periods and have babies. But what's normal and what's not? Find out how vaginas can be different.

Dr Suzy Elneil, consultant in urogynaecology and uroneurology at University College Hospital, London, has worked with a lot of women. "Like people, vaginas are completely individual," she says. "No two are the same." Don't compare yourself to anyone else – what someone else's vagina looks like is normal for them, but won't necessarily be what's normal for you. Yours is unique.

The vagina and vulva
Some of a woman's sexual organs are inside the body, such as the womb, ovaries and vagina, and some are outside.
The external organs are known as the vulva. This includes the opening of the vagina, the inner and outer lips (labia) and the clitoris, which is located at the top of the vagina.
The vagina is a tube about 8cm (3in) long, which leads from the cervix (the neck of the womb) down to the vulva, where it opens between the legs.
The vagina is very elastic, so it can easily stretch around a man's penis or around a baby during labour.
"Vaginas vary in shape, size and colour," says Dr Elneil. "Some are small and ovoid [egg-shaped], some are large and cylindrical, and the colours can vary from light pink to a deep brownish red-pink. The important thing is that the vagina functions normally."
Pelvic floor exercises can help keep your vagina in shape. "These are good for maintaining good pelvic floor tone and can improve sexual function," she adds.
"Normal exercise also helps maintain good vaginal function, as walking and running helps the pelvic floor tone up and helps ensure good general health."
Find out about pelvic floor exercises, including how to do them.

Should I worry about the size of my labia?
Some women worry about the size of their labia (the lips outside the vagina), but there isn't usually any cause for concern. Labia vary from woman to woman, so don't judge yours by anyone else's standards.

"Large labia are only a medical problem if it affects the woman's working, social or sporting life," explains Dr Elneil.
"Size is really not a problem per se for most women. However, for cyclists, the length and size of the labia can affect their ability to sit comfortably on the seat, but this is a rare problem."
If you're worried, talk to your GP.

Vaginal discharge
It's normal to have vaginal discharge (mucus or secretions), and the texture and amount of discharge can vary throughout your menstrual cycle.
If your normal vaginal discharge becomes different – for example, it changes colour or smells – this could be a sign of infection, so see your GP.

Vaginal itching
A healthy vagina shouldn't be itchy. Itching can be a sign of thrush or another infection, but it can also have other causes.
"Itching can be part of a generalised skin problem, such as eczema," Dr Elneil says. "Or it can be a sign of another condition, such as lichen sclerosus.
"All need treatment, so if the itch persists for more than a month, get it checked by a GP or gynaecologist. They need to see the vulva, perineum [between the vagina and anus] and the vagina directly."

Female genital mutilation
Female genital mutilation (FGM) is a procedure where the female genitals are deliberately cut, injured or changed, but there is no medical reason for this to be done. It is illegal in the UK, and is child abuse.

FGM is very painful and can seriously harm the health of women and girls. It can also cause long-term problems with sex, childbirth and mental health. FGM is also known as "female circumcision", or "cutting", and by other terms like sunna, gudniin, halalays, tahur, megrez and khitan. It is carried out for various cultural, religious and social reasons within some families and communities. It is usually carried out on young girls between infancy and the age of 15, most commonly before puberty starts.

In some cases, girls and women may not remember having the FGM at all, especially if it was performed when they were a baby. If you think FGM may have been done to you, or you are worried you or someone else may be at risk, you can get help from a specialist NHS gynaecologist or FGM service – ask your GP, midwife or another healthcare professional about services in your area.


Penis health



Men everywhere worry that their penis is smaller than it should be or that it won't satisfy a lover. But research suggests that most men underestimate the size of their pride and joy.

Man has always placed great importance on the size of his penis. Many cultures associate penis size with masculinity. Throughout the ages, it has come to symbolise qualities such as virility, fertility, strength, ability and courage.

Some men go to extreme lengths to try to increase the size of their penis. Indian mystics known as Sadhus have been known to stretch their penis from an early age by hanging weights on it, while the Topinama tribesmen of Brazil encouraged poisonous snakes to bite their penis to enlarge it.

Feeling inadequate can really damage a man's self-confidence and affect his social life. It can lead to issues from being unable to use public urinals or shared shower rooms, to avoiding intimate relationships.

Companies around the world have exploited this anxiety, selling pills, penis extenders and other penis enlargement products that promise to "increase the length and girth of your manhood fast, or your money back!"


Measuring your penis

Most men's view about their penis is formed during childhood. Growing up, they may see the penis of an older brother, friend or their father and mentally compare this to their own.

Fears and anxiety about penis size may also arise after taunts from other people during adolescence or following remarks from a sexual partner.

However, men often have the wrong perspective on their penis, says sexual health expert Dr David Delvin. "When you look down at your own organ, it seems shorter than it really is," he says. "In contrast, when you glance around at other guys in changing rooms or showers, you get a sideways view of them. So they usually seem to be longer than you are."

To see your penis as other people would, look at yourself undressed in front of a full-length mirror. The penis looks longer and larger than when observed from above.

At some stage, most boys get out a ruler or a tape measure to find out how long their penis is. Dr Delvin says there's little point in doing this when the penis is limp because the length of a flaccid penis can vary a lot, for example depending on how cold the room is.

To get a precise measurement, do it when you have an erection. It is standard to measure the penis on the top side, from the base to the tip.


Average penis size

There are no average length figures for teenagers because people grow at different rates.

According to a 2015 study of more than 15,000 men, the average dimensions for an adult penis are:


length: 13.12cm (5.16 inches) when erect

circumference: 11.66cm (4.59 inches) when erect


There is large variation in the angle of an erect penis. Some erect penises point straight up, others straight down. Some have a slight bend to the left or right. There is no right shape. If you have a more significant bend in your penis that may cause you pain or difficulty having sex, see your GP. Sometimes, these can be symptoms of Peyronie's disease.

Each penis is unique and boys develop at different ages and rates. During puberty, usually between the ages of 11 and 18, the penis and testicles develop more rapidly, although the penis doesn't stop growing until the age of 21.


Men unsatisfied

Regardless of actual size, many men are still unhappy with the size of their manhood.

A study based on the results of an internet-based survey of more than 50,000 men and women revealed that 45% of men would like a larger penis. The report by Professor Kevan Wylie, a consultant in sexual medicine at the University of Sheffield, concluded that excessive concerns about penis size were higher among men with average-sized penises than men with small ones.


What women think

Professor Wylie's report also found differences between what women and men think. A much higher percentage of women (85%) were satisfied with their partner's penis size than the percentage of men (55%) who were satisfied with their own penis size.

According to Professor Wylie, the issue of attractiveness to women is complex. However, most studies suggest that penis size is much lower down the list of priorities for women than such issues as a man's personality and grooming.

Professor Wylie says: "It may come as a surprise to some young men, but most women have very little interest in the size of their penis and that's been shown in numerous studies over time."

He says research shows that when it comes to sex, women are much more interested in whether you are romantic, tender and sensitive to their needs and desires than your penis size.


If you're still worried

Counselling has proven to be beneficial for men with penis anxiety. Therapy helps patients identify and correct any distorted views about their penis, build self-confidence and overcome fears about sexual relationships.

 

Professor Wylie says: "Therapy allows these men to overcome their anxiety about meeting a potential partner, where before they wouldn't even dare engage because of their fear."


Good sex



If you want to make the most of your sex life, these sex tips are a good way to start.


As long as you're talking and listening to each other, you're well on the way to a healthy sex life. However, even the most contented lovers can have fun trying new things; here are a few ideas.

1. Build anticipation
Agree on a period of time, say one week, when you won’t have orgasms or penetrative sex. At first, allow only kissing and holding each other. Gradually move on to touching and stroking each other, masturbation, oral sex (what is oral sex?) or whatever feels right for you. Avoid orgasm. At the end of the week, allow yourselves the pleasure of orgasm, through any kind of sex you like. This week may help heighten your senses to all the other wonderful feelings you can share when you’re having sex.

2. Massage
Massage can help you have very sensual sex. As part of foreplay, it's a great way to start things off slowly, and relax into the feel of each other’s skin as your arousal intensifies.
However, a simple massage that doesn’t lead to sex can also work wonders for your sex life. A non-sexual massage will familiarise (or refamiliarise) you with your partner’s body, reduce stress and reaffirm the intimacy between you. If you don’t want a massage to lead to sex, discuss this with your partner so you can avoid any misunderstanding. Read more about why it's good to talk about sex.

3. The senses
Good sex can embrace all the senses, not just touch. Scented oil for a massage (don't get oil on a latex condom as this can damage it), music and candles for soft lighting can all be erotic, as well as listening to your partner’s breathing and the sounds that they make. Taste each other as you kiss. If you both want to, you could mix food and sex – feed each other something delicious and juicy, such as strawberries.

4. Whisper
Whether it’s sweet nothings or your sexy intentions, whispering things to each other can add an extra thrill. It doesn’t have to be during foreplay or sex. A sexy phone call leave both of you looking forward to the event for hours or days.
This works with texts and emails too, but make sure you send them to the right person, and remember that your employer has the right to access your work email.

5. Masturbation
Masturbation, by yourself or with your partner, can be a bonus for your sex life. Exploring your own body and sexual responses means that you can share this knowledge with your partner. Masturbating your partner can help you learn more about what turns them on. It can also be a useful option if one of you doesn’t feel like full penetrative sex, or if you have different levels of desire. Talk about this with your partner.

6. Sex toys
If you and your partner both feel comfortable, using sex toys can be an arousing thing to do together. Some people use vibrators (and more) as an enjoyable part of their sex life. If you’ve never thought about using sex toys before, how do you feel about trying them? You can buy them online or in sex shops. Find out more: are sex toys safe?

7. Read a book
There are many books that have exercises and ideas to help you achieve a fulfilling sex life, whatever your age, gender, sexual orientation or taste. If you’ve never thought about buying a book about sex, why not do it now? You might wish you’d done it years ago.

8. Share fantasies and desires
Everyone has unique fantasies, tastes and preferences when it comes to sex. From earlobes to ankles, hairline to hips, pirates to picnics, don’t be afraid to talk about them. If you and your partner know about each other’s turn-ons, you can make the most of them.

9. Keep it clean
We’re talking about your general hygiene. You don’t have to keep yourself super-scrubbed: a certain amount of sweat is fine, as long as it isn’t overwhelming. But be respectful towards your partner, and wash every day to prevent nasty smells and tastes. For specifics, read more about keeping your vagina clean and how to wash a penis.

10. Relax
Sex with a loving partner can be one of the most beautiful and intense experiences in life. Sometimes the best sex happens when you’re not worrying about making it exciting or orgasmic. Relax with your partner, and great sex may find you.


Fertility



Conception is when a woman's egg is fertilised by a man's sperm, and then implants itself into the woman's womb. Most couples don't have a problem getting pregnant.

For most couples, regular unprotected sex is all it takes to conceive a child. If you’re trying for a baby or thinking of doing so in the future, knowing the basic facts about fertility can be helpful.

The monthly cycle
Every month, hormonal changes in a woman’s body cause the ovaries to release a single egg. This egg passes into the fallopian tubes, which link the ovaries to the uterus (womb).
At the same time, the lining of the womb thickens. This is to prepare it for the possibility of receiving a fertilised egg. If fertilisation does not occur, the womb lining will break down and will be shed through the vagina. This is a woman’s period. The period is made up of the womb lining and a small amount of blood.

Women of childbearing age have a period approximately every 28 days, although the length of the cycle can vary and between 24 and 35 days is common. If a woman has unprotected sex with a man around the time of her egg being released, sperm from her partner may fertilise her egg while it is in the fallopian tube. The fertilised egg will then travel to the womb and become embedded in its lining, where it will start to grow.
 

How conception happens
An egg can be fertilised by sperm during the 12 to 24 hours after it has been released from the ovaries. Sperm can survive in the fallopian tubes for up to seven days, so fertilisation can occur even if sperm entered the fallopian tubes before an egg was released.

During conception, a single sperm from a man penetrates the egg of a woman. The sperm carries the father’s genes, while the mother’s genes are contained in the egg. Once the egg has been fertilised by a single sperm, no more sperm can enter.

The fertilised egg, called a zygote, continues to move down the fallopian tubes, until it reaches the womb. Here, it will implant itself into the lining of the womb (about 6-10 days after ovulation), where it begins to grow. Until eight weeks after conception, the implanted zygote is called an embryo. After this it is called a foetus.

For most women, the first sign that they are pregnant is a missed period. A few days after that missed period, a urine test can confirm the pregnancy. Urine tests for pregnancy are available through your GP or family planning clinic. You can buy a test to do at home at your local pharmacy or supermarket.