Frequently Asked Questions About Sexual Health

1. Does a man go through menopause?

Yes, a man goes through menopause, but to a different extent than a woman. Menopause is a term used to describe the end of a woman's fertility. It literally means the end of menstruation. Female menopause is characterized by changes in hormone production. The male testes, unlike the woman's ovaries, do not lose the ability to make hormones. A healthy male may be able to make sperm well into his 80's or longer.

On the other hand, subtle changes in the function of the testes may occur as early as 45-50 years of age, and more dramatically after the age of 70. Because men do not go through a distinct male menopause period, some doctors refer to this as androgen (testosterone) deficiency in the aging male (ADAM). Men typically experience a decline in testosterone production due to aging, but it can also be related to some diseases like diabetes.

Whether waning function of the testicles contributes to such symptoms as fatigue, weakness, depression, decreased sexual desire, or impotence remains uncertain. If testosterone levels are low, replacing that hormone may help relieve them. However, replacing male hormones can worsen prostate cancer and high cholesterol levels. Talk to your doctor to see if hormone treatment is right for you.

2. How often should a woman get a pelvic exam and Pap test?

A Pap test is recommended for women age 21 and older. The American College of Obstetrics and Gynecology recommends routine screening for women ages 21 to 65 years every two years. More frequent Pap tests may be needed if an abnormal test result is found or if you are at high risk of cervical cancer.

Combining a Pap test with a human papillomavirus ( HPV ) test can safely extend the interval between cervical cancer screenings from three years to five years in many women between the ages of 30-65, according to the U.S. Preventive Services Task Force (USPSTF).

Also according to USPSTF guidelines, HPV testing is not recommended for women in their 20s, because people in that age group can have HPV infections that resolve without treatment.

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Women over age 65 can stop getting screened if they’ve had at least three consecutive negative Pap tests or at least two negative HPV tests within the previous 10 years, according to the guidelines. But certain women who have a history of a precancerous abnormality should continue to be screened for at least 20 years.

And women of any age who’ve had a hysterectomy with removal of the cervix and no history of cervical cancer or precancerous abnormalities do not need to be screened, according to the guidelines.

3. What Are the Benefits and Risks of Circumcision?

Circumcision in newborn boys for medical or health reasons is an issue that continues to be debated. In 2012, the American Academy of Pediatrics (AAP) reported that circumcision has potential medical benefits and advantages, as well as risks. The existing scientific evidence is not sufficient to recommend routine circumcision. Therefore, because the procedure is not essential to a child’s current well-being, we recommend that the decision to circumcise is one best made by parents in consultation with their pediatrician, taking into account what is in the best interests of the child, including medical, religious, cultural, and ethnic traditions.

Male circumcision may also make it easier to keep the end of the penis clean, although studies have shown that good hygiene can help prevent certain problems with an uncircumcised penis, including infections and swelling. In addition, using a condom during sex will help prevent sexually transmitted diseases and other infections.

As with most medical procedures, there are risks associated with circumcision. These include:

  • Pain
  • Risk of bleeding and infection at the site of the circumcision
  • Irritation of the glans
  • Increased risk of meatitis (inflammation of the opening of the penis)
  • Risk of injury to the penis

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4. Is vaginal discharge normal?

A woman normally produces a vaginal discharge that usually is described as clear or slightly cloudy, non-irritating, and odor-free. During the normal menstrual cycle, the amount and consistency of discharge can vary. At one time of the month, there may be a small amount of a very thin or watery discharge; and at another time, a more extensive thicker discharge may appear. All of these excretions could be considered normal.

A vaginal discharge that has an odor or that is irritating usually is considered an abnormal discharge. The irritation might be itching or burning, or both. The itching may be present at any time of the day, but it often is most bothersome at night. These symptoms often are made worse by sexual intercourse. It is important to see your gynecologist if there has been a change in the amount, color, or smell of the discharge.

5. Is hormone replacement therapy for menopause bad for women?

There has been much debate by the scientific community regarding hormone replacement therapy, or HRT. In general, hormone treatment is believed to maintain healthy bones after menopause, in addition to relieving menopausal symptoms. But, like all treatments, there may be some harmful side effects, including an increased risk for endometrial (uterine) cancer and breast cancer.

Hormone replacement therapy isn't right for everyone. Talk to your doctor to determine if hormone treatment is right for you.

6. Can a woman get pregnant while breastfeeding?

Yes. Even though breastfeeding may suppress or delay menstruation, you can still get pregnant. Ovulation will occur before you start having menstrual periods again, so follow your doctor's recommendation on the appropriate birth control method to use.

7. Can a hysterectomy cause sexual problems for a woman?

Some women may experience changes in sexual function after a hysterectomy (surgical removal of the uterus). These changes may comprise a loss of desire, decreased vaginal lubrication, and genital sensation. Furthermore, surgery can damage nerves and blood vessels considered critical to a woman's sexual functioning.

8. Can a person with syphilis spread the disease?

Yes. Syphilis is a sexually transmitted disease. A person with syphilis can spread the infection during the first two stages of the disease. If you come in contact with an open sore (first stage) or skin rash (second stage), you can pick up the bacteria that cause the infection. If the bacteria enter your body through an opening such as the penis, anus, vagina, mouth, or broken skin, you can get syphilis.

If a person has had syphilis for more than two years, it's unlikely that he or she can spread the disease. Don't take a chance. Use a lubricated condom during sex.

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9. How do people get HIV?

A person gets HIV when an infected person's body fluids (blood, semen, fluids from the vagina, or breast milk) enter his or her bloodstream. The virus can enter the blood through linings in the mouth, anus, or sex organs (the penis and vagina), or through broken skin.

Both men and women can spread HIV. A person with HIV can feel okay and still transmit the virus to others. Pregnant women with HIV also can pass the virus to their babies.

Common ways people get HIV:

  • Sharing a needle to take drugs
  • Having unprotected sex with an infected person

You cannot get HIV from:

  • Touching or hugging someone who has HIV/AIDS
  • Public bathrooms or swimming pools
  • Sharing cups, utensils, or telephones with someone who has HIV/AIDS
  • Bug bites

10. Is it OK to use Vaseline as a lubricant with a latex condom?

No. Use only water-based lubricants, such as K-Y Jelly, with condoms. Oil-based lubricants, like Vaseline, can weaken the condom and cause it to break.

11. What should a woman do if she forgets her birth control pills?

If you forget to take a birth control pill, take it as soon as you remember. If you don't remember until the next day, go ahead and take two pills that day. If you forget to take your pills for two days, take two pills the day you remember and two pills the next day. You will then be back on schedule. If you miss more than two pills, call your health care provider for instructions. Those instructions may be to take one pill daily until Sunday and then start a new pack or to discard the rest of the pill pack and start over with a new pack that same day.

Any time you forget to take a pill, you must use another form of birth control until you finish the pill pack. When you forget to take a birth control pill, you increase the chance of releasing an egg from your ovary. However, if you forget to take any of the last seven out of the 28 day pills, you will not raise your chance of pregnancy, because these pills contain only inactive ingredients. If you miss your period and have forgotten to take one or more pills, get a pregnancy test. If you miss two periods even though you have taken all your pills on schedule, you should get a pregnancy test.

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12. Can a woman get pregnant using the withdrawal method of birth control?

Pulling out before the man ejaculates, known as the withdrawal method, is not a foolproof method for birth control. Some ejaculate (fluid that contains sperm) may be released before the man actually climaxes. In addition, some men may not have the willpower or be able to withdraw in time.

WebMD Medical Reference Reviewed by Carol DerSarkissian on January 26, 2017

Sources

SOURCES: 
The National Institutes of Health. American Cancer Society. The Center for Disease Control. American Academy of Family Physicians. Thomas P. Newsman, MD, MPH, "Circumcision: Again," PEDIATRICS Vol. 108 No. 2 August 2001, pp. 522-524. University of California School of Medicine Department of Urology. American College of Surgeons. The Cleveland Clinic. Contraception.net. U.S. Preventive Services Task Force.

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