Your Sexual Health Guide When Starting a New Relationship

Embarking on a new relationship is an exciting chapter of life and a phase that nearly all of us will go through. Love is in the air, hormones are raging, and the days (and nights) are sweet and lovely. 

It may be a happy and exciting time, however, you must not forget to always take care of yourself. Aside from looking after your mental health, do remember to take charge of your physical well-being- especially your sexual health!

Why is taking care of your sexual health important?

Sexual health is important because it allows both men and women to express themselves sexually while being free of risk from sexually transmitted diseases and unplanned pregnancies [1]. 

This guide will keep you informed and educated on the key elements of good sexual health. It is vital to be aware of these steps, and then put them into action, when embarking on a new relationship so that you keep both you and your partner safe and healthy. 

Despite practising good sexual health, there are still risks that come with being sexually active. This guide will also inform you of what to do in these cases. 

8 important steps towards maintaining good sexual health 

1. Preventive Sexual Health Screening

Prevention is always better than cure. It is always good practice and social responsibility to take proactive measures to screen for both yourself and your partner(s)’ risk of contracting sexually transmitted infections (STIs). 

Sexually transmitted infections are often indolent. Taking proactive measures to consider a range of preventive sexual health services are good ways to ensure you are always healthy. It is always good to detect early and treat any underlying medical condition promptly. 

Here are the recommended sexual health screening services our clinic offers:

Recommended Screening Sexual Health Services	Male	Female
Chlamydia screening	√	√
Gonorrhea screening	√	√
HIV screening	√	√
Syphilis screening	√	√
Trichomonas screening	√	√
HPV screening	*Consider protection with vaccination	√ *Consider protection with vaccination
Hepatitis screening	√ *Consider protection with vaccination against Hepatitis A and B infections	√ *Consider protection with vaccination against Hepatitis A and B infections
Herpes screening	√ If you have exposure risk or are symptomatic	√ If you have exposure risk or are symptomatic

You are advised to speak to your trusted physician about your concerns, possible symptoms, exposure risk, and the timeline of exposure risk. Based on your individual risk, your doctor will then guide you on the appropriate tests to screen for sexually transmitted infections. 

2. Protection against HIV

In the event of possible exposure to HIV, or risk of becoming infected with HIV, you may wish to consider post-exposure prophylaxis (PEP) medications [2]. PEP medication should be offered within the first 72 hours after a possible exposure to HIV. 

Having said that, every hour counts. PEP has little or insignificant effect in reducing the risk of acquiring HIV infection if taken after 72 hours of possible exposure. You should speak to your doctor before starting PEP. You may consider PEP if you do not have HIV and in the last 72 hours, you have:

• Sexual intercourse with someone with HIV infection
• Sexual intercourse with someone with unknown HIV status
• The condom broke or slipped
• Shared or exposed to contaminated needles or sharps or blade
• Exposed to body fluid, semen, blood through wounds, sores, ulcers with someone of unknown HIV status or known HIV infection
• Assaulted sexually
• Work-related needle stick injury
• Eye-splash injury

Some patients are unsure whether they are required to consider PEP if they have a regular risk of exposure to HIV. You may wish to discuss your concerns further with your doctor, although PEP should only be used during emergency situations. This is because repeated use of PEP may lead to antiviral resistance against HIV infection. In such a situation, your doctor may discuss with you about the PrEP (pre-exposure prophylaxis medication) option to lower the risk of HIV.

3. Immunisation against Sexually Transmitted Infectious Diseases

If you are sexually active, it is a good idea to get vaccinated for certain serious sexually transmitted diseases.

These include: 

• Vaccination against HPV infection

Human papillomavirus (HPV) infection is extremely common. Although in most people, HPV infection resolves spontaneously due to a person’s immune system, some strains/subtypes of HPV can cause cancer such as cervical, throat, penile, anal, vaginal, vulvar cancer, and genital warts. 

HPV vaccination protects against the common subtypes of HPV against genital warts and cancers against the cervix, vulva, anus, penis, and throat. Currently, the high covalent HPV vaccination is recommended for patients up to the age of 45, as the studies show benefits even in older age groups (until age 45). You can find out more regarding HPV vaccination and your eligibility with your doctor. 

• Vaccination against Hepatitis B infection

Hepatitis B is a virus that can cause inflammation and destruction of the liver tissues. Hepatitis B is spread through infected body fluid, blood, or even semen. People who are infected with hepatitis B may be asymptomatic and cause further liver function deterioration over time. 

Vaccination against hepatitis B is the best way to protect your liver against hepatitis B. In Singapore, hepatitis B vaccination is part of our childhood immunisation schedule. However, we may have lost immunity over time and may require a top-up booster. Speak to your doctor for further understanding of the need for vaccination, and the schedule of the vaccinations.

• Vaccination against Hepatitis A

Hepatitis A virus can lead to liver tissue inflammation and damage. Hepatitis A can be passed on through kissing and salivary transfer. Though most people recover from hepatitis A infection without liver harm, some may have severe liver inflammation. 

Currently, there is no treatment for hepatitis A and the management goal is mainly supportive. Vaccination against Hepatitis A is effective and safe. Do speak to your doctor to understand hepatitis A vaccination further.

4. Lifestyle tips for reducing the risk of contracting STD

If you have just started a new relationship and are unsure how to protect yourself from STDs, it is a good idea to discuss with your doctor about lifestyle tips to protect yourself.

Lifestyle tips often include:

• Using barrier contraception at all times to reduce chances of contracting STD
• Abstaining from sex
• Engaging in lower-risk sexual activities such as kissing, touching, and massaging
• Getting regular STI screening/tests
• Limiting sexual partners
• Consider pre-exposure prophylaxis (PrEP) if you may be at risk of becoming HIV infected by your partner, or even post-exposure prophylaxis (PEP) if you think you have been exposed to HIV during sex. 

5. Paying attention to your body 

One of the major steps in taking care of your body is paying attention to the signs and symptoms of your body. 

If you are sexually active, take note of any abnormal physical symptoms such as a fever, sore throat, new rash, ulcers, lumps or bumps, swelling, or growth over the genitalia region. You may also want to look for any abnormal urinary symptoms. If you have any unexplained symptoms, consult your doctor.

6. Reviewing your need for contraception

Both men and women should be aware of contraception. If you are in a new relationship, you should discuss the method of contraception with your partner before starting sexual activities. For men, the options are more limited. They include wearing condoms and a vasectomy (surgical male control).

Women have more options when it comes to contraception. However, this does not mean that only women need to use contraception during sexual activities. It is generally recommended that both partners use forms of contraception for the best protection against unwanted pregnancies and sexually-transmitted infections and diseases.

Contraception options for women include: 

• Emergency contraception

The morning after pill/plan B is an available option if you have unprotected sex. Emergency contraception is used to avoid pregnancy in a person who has not had adequate contraception during intercourse. 

You are advised to take the pill as soon as possible (within 72h or 120h after intercourse – depending on the type of medication). Your doctor will guide you on the medication, potential side effects, and efficacy of the medication. 

• Long-term contraception

You can speak to your healthcare providers for information and advice on which are the most suitable contraceptive options for you.  

Long-acting contraception includes implants such as IUD, Mirena, Implanon, while short-term methods include injection, birth control pills, contraceptive patch, and barrier contraception. In some ladies who have completed family planning, permanent contraception option with ligation can be discussed. 

7. General health screenings

When life is already busy, and we add a new relationship to the mix, we tend to put our health on the back burner. You may want to take a breather to revisit your daily eating habits and exercise routine. It is good practice to be proactive and always take charge of your physical health, especially when committing to a new partner. 

General health screening allows a person to understand and screen for asymptomatic chronic conditions such as diabetes, hypertension, elevated cholesterol, and cancer. These conditions are common and you don’t want to wait until major health adversaries take their toll on you.

For ladies, regular pap smears for screening of cervical cancer if you are or were in a sexual relationship, should also be considered.

8. Taking care of your mental health

Starting and maintaining a relationship often has its ups and downs. It is a journey to understand yourself and others. It is about growing, learning your own shortfalls, and your partner(s) shortfalls, and attempting to make the best out of the relationship. 

Sometimes, heartbreaks may occur. Looking after your mental health is important so you can avoid indulging in self-pity and instead, empower yourself with your strengths and surrounding resources. 

Ensure you have strong social support- good friends and family to support you along the journey. If you are struggling with your mental health, or having suicidal ideation, you can always reach out to healthcare professionals to help you through the rough patch.

The bottom line is that while starting a new relationship is a beautiful and exciting chapter in your life, you must always remember to be safe and take care of yourself.  Remember that you are always in charge of your sexual health and well-being. If you have any concerns at all, you can discuss them with your trusted healthcare provider. 

References

1. What is Sexual Health? Retrieved from The National Coalition of Sexual Health: (http://www.nationalcoalitionforsexualhealth.org)

2. 14 September 2022. Guide to Sexual Health Services. Retrieved from NHS UK: (https://www.nhs.uk/nhs-services/sexual-health-services/guide-to-sexual-health-services/)