First things first. In order to answer that question, we need to know: What is a sexual health physician?  A sexual health physician is a medical doctor who specialises in the management of sex-related problems. So basically anything and everything that involves sex and your health.   

The aim is to have safe, disease free and pleasurable sex.

To achieve that we need to break things up in different areas of sexual health. The first involves sexually transmitted infections (STI) and diseases, including HIV.

Your doctor will help test for and treat STIs and HIV, as well as discuss STI and HIV prevention strategies with you.

HIV prevention strategies that you should definitely know about is pre-exposure prophylaxis (PrEP) and post exposure prophylaxis (PEP).

The next area of sexual health is related to relationship and sexual problems, things like low libido, sexual pain or erectile dysfunction.

The third area of sexual health relates to family planning or contraception.

So how do you know you need a sexual health physician?

If you are having sex (any type of sex with any gender) you should consider seeing a sexual health physician.  

What can I expect during the consultation?

Seeing a sexual health physician might sound scary but let me break it down so that you know what to expect.

History taking

Your sexual health physician will start by just talking and taking a full medical and sexual history.

I know it is not easy talking about your intimate and private issues, but it is important as a doctor to get a full picture.

If you suspect that you might have sexual transmitted infection your doctor will ask about the symptoms that you are experiencing, the number of sexual partners you have, the type of sex you are having, whether you use protection etc. This will help to understand your risks and what infections to consider.

If you are struggling with a sexual problem, such as erectile dysfunction, premature ejaculation, low libido, orgasmic problems or painful sex, your doctor will ask about the specific problem in detail.

Questions can include: How long have you been struggling with this? Are you taking any chronic medication? What is your obstetric and gynaecological history? What contraceptives are you using? How is this problem affecting your relationship?

Examination

Depending on your presenting problem, it is likely that your doctor will need to do a quick general examination followed by a genital examination. Again, the examination will be focused on what your specific complaint is.

If you are worried about a possible STI your doctor will do a genital examination and do some tests.

The tests might involve:

• Taking a urine sample
• Taking blood for STI testing
• Taking a vaginal swab or doing a pap smear when indicated

Testing for chlamydia, gonorrhoea and trichomoniasis usually requires a urine sample or a vaginal swab for woman. And testing for HIV, hepatitis B & C and syphilis will need a blood sample.

Women struggling with painful sex will also need an examination. A genital and pelvic examination will shed some light on where the pain is originating from which will help guide the management.

I know how intimidating it can be to see a sexual health doctor. I understand that it is not easy discussing your sexual practices and sexual problems.

By seeing a sexual health doctor you will:

• Know whether you have an STI
• Have information on safe sexual practices
• Know about HIV prevention options
• Have all your vaccines up to date
• Be on the the right contraceptive for you
• Know that your sexual problems can be managed
• Know that you can have safe and pleasurable sex going forward.

Author:

Dr Jireh Serfontein (SASHA Member)

Medical Doctor and Sexual Health Physician

MBChB(UP), DipHIVMan(CMSA), MMed HIV & Sexual Health (Aus)

Instagram: @dr_jireh

Website: www.drjirehserfontein.co.za

Email: jireh.serfontein@mysexualhealth.co.za

Phone: +27(0) 12 816 8240