Research has shown for years that people tend to make poorer decisions when rushed, scared, pressured or emotionally labile. Choices made during those times may result in financial failures, career disasters, relationship woes, or for example a lifetime of health ailments as a result of acquiring a sexually transmitted infection (STI). In 1973, The Emotions asked a simple question: “What do the Lonely do at Christmas?” From my experience, the answer to that soulful ballad is that unfortunately the lonely forgo safety precautions and have unprotected intercourse.
“The naked penis should never be in the vagina!” is my mantra for which my patients are well familiar. Unless you are with that partner twenty four hours per day, you are not certain about their sexual habits nor do you possess their complete past sexual health history in most cases. Not using barrier protection during sexual encounters can potentially expose you to chlamydia, gonorrhea, HPV (the human papilloma virus), HIV, herpes, hepatitis, and trichomonas.
Numerous times in my career thus far I have had the unfortunate experience of diagnosing someone with one of the aforementioned infections and then witnessing various expressions of anger, sadness and shock. “He said I was the only one. She did not look like someone who had an infection. Is sex the only way I could have been infected? Could I have gotten this from sitting on a dirty toilet?” These are only a few of the many responses I have heard over the years by a diverse demographic of patients.
In the US, chlamydia is the most common sexually transmitted bacterial infection with over a million cases reported to the CDC, Centers for Disease Control, in 2011. About 1 in 15 adolescents between the ages of 14-19 has chlamydia; it can spread via oral, anal or vaginal routes and can be present without the host having any symptoms. Most men however will have some burning with urination and a thick yellowish discharge. In addition, chlamydia can be transmitted even in the absence of ejaculation. Therefore, removing the penis from the vagina, anus, or mouth prior to orgasm does not reduce the risk of transmitting the infection.
STI’s are not exclusively monogamous and can travel in pairs. Chlamydia and gonorrhea are often diagnosed together and both can cause similar symptoms. Sexually active teens, young adults, and African Americans have the highest reported rates of gonorrhea in the US. As with chlamydia, gonorrhea can also be spread from an untreated mother during childbirth and can cause pre-term delivery.
Although chlamydia, gonorrhea and the other bacterial infections can be treated with antibiotics, there are some potential long term sequelae of these diseases such as PID, pelvic inflammatory disease and sterility. In women, sometimes these infections can travel up the genitourinary system, scar the fallopian tubes and eventually result in an inability to become pregnant.
Relationships are more than just the physical act of intercourse. Webster defines intimacy as “belonging to or characterizing one’s deepest nature.” In practice, I see far too many people involved in toxic bonds because of a deep-seeded fear of being alone. I have seen patients who have been given an STI not once but multiple times yet continue to be with their partners because of this unspoken fear. I have had young sexually active teenage girls admit that they do not even enjoy sex yet they continue to allow their bodies to be used like an item at a swap meet.
Deciding to have intercourse and with whom should involve quite a bit of introspection, investigation, and preparation. First, ask yourself am I ready to be involved with this person? Is it too soon after my last relationship? Have I fully grieved the recent death of my spouse? Are both parties seeking the same goal of a committed partnership or is this simply a pleasure mission?
Second, I always recommend that both partners get tested beforehand for STI’s. Go together to the doctor or health department and allow one another to read over the results. Trust no one. Check for yourself. Also, make sure that you are screened for all STI’s. Be specific!
Lastly, be prepared. Carry condoms with you at all times. There should be no “It was the heat of the moment and I forgot.” Read the labels on the condoms for expiration dates and verify that the package is in good condition. Next to abstinence, condoms are the next best protection against STI’s including HIV.
This holiday season don’t let your emotions cause you to make a mistake that could last a lifetime.
Yours in Service,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
