Ask Nurse Nettie: the top 10 questions from 2021

Nurse Nettie, our resident sexual health expert, is available throughout the year to answer sexual health and relationship questions from young people across NSW. 

All answers are 100% anonymous (always) but we often spot some common ones coming up time and again. That’s why we’ve decided to take a look at the most common questions from 2021.

Nothing is ever too awkward or intimate for Nettie, so don’t hold back. If something sex-related is weighing heavily on your mind, you can submit your question here. 

Until then, here’s the top 10….

10. Can you get an STI from a hand job?

In short, no — there’s no risk of getting an STI from a hand job, as long as the person isn’t also touching themselves at the same time. If the other person is using their own genital fluid as lubricant for touching you, then there is a small risk of STIs like chlamydia or gonorrhoea. There’s no risk of HIV though.  

If you’re still worried and want to get tested, visit your doctor or any GP and ask for a sexual health check. All you need to do is give a urine sample; it’s quick, easy, and free with a Medicare card.

9. How can I manage premature ejaculation?

Premature ejaculation (PE) is a pretty common problem, so – first up – remember, you’re not alone. Most people with a penis will experience it at some time in their lives. Though it can be frustrating, it’s rarely a cause for medical concern. PE can be more common in younger adults, but can also be the result of anxiety around sex (maybe you have a new partner you’re trying to impress?). Always make sure the people involved are feeling comfortable with the set-up prior to having sex and if anything is concerning you — be open with your communication and speak to your sexual partner about it. You can read more about PE and find some useful tips here.

8. How reliable are condoms as a contraceptive and as protection against STIs? 

Condoms can prevent most STIs and pregnancies when used correctly. In fact, they’re 98% effective at preventing pregnancy when used correctly. 

If you need more detailed help, you can brush up on your skills by reading about the ‘Dos and Don’ts of condoms’. Remember condoms are just one of many tools to look after your sexual health. If a condom breaks, you can get the Emergency Contraceptive Pill without a prescription from any pharmacy and book an STI test at a NSW clinic.

Also, make sure you know the common ways people go wrong with condoms, such as: 

• Not having one when you need it – plan ahead
• Having some penetration (yep, any counts) before the condom is put on
• Damaging condoms with oil based lube or storing them in a hot car which can make them weaker / less reliable 
• Not pinching the tip or rolling fully down (basically not knowing how to put it on properly)

7. Do I need an STI test even if I have no symptoms?

STIs don’t always have symptoms and it’s possible to get them, even if you’ve only ever had oral sex. There are also some STIs that can be asymptomatic, like HPV or chlamydia. That’s why routine testing is so important – every 6-12 months, if you’ve had unprotected sex or if you change partners. The best thing you can do for your sexual health is to be as informed as possible and that means getting tested for STIs regularly. 

6. I’ve lost my libido, how can I get it back?

There are lots of reasons behind a fluctuating sex drive… from experiencing depression, trauma or medical conditions to name just a few. Let’s take a closer look at some of the common reasons and how they can be helped:

• After a trauma, seeing a counsellor is helpful to get back on track
• If you’re in a long-term relationship, it’s normal for your libido to fluctuate. Talking to your partner and working on a solution together with a counsellor can help
• If you think the pill or the IUD have affected your sexual appetite, definitely talk to your doctor about it

The most important thing to remember is that it’s very common to go through phases like this, and you may need to try a few different things to reinvigorate your desire to have sex. So, be patient and kind to yourself.

5. When do I need to get a pap smear/cervical screening?

The pap smear is the old name for a test we now call ‘cervical screening’. Australian guidelines recommend cervical screening should start at age 25 for anyone with a cervix (that’s the bottom part of the uterus at the end of the vagina), who has ever been sexually active. 

Remember though – sexual activity doesn’t just mean vaginal sex with a penis. Other types of sex, like direct genital-to-genital rubbing or sharing sex toys, can also potentially pass on HPV (which is what the cervical screening tests for). The cervical screening test will detect HPV as well as any abnormalities in your cells. This is what makes it different to the original pap smear test, which only screened for abnormal cells.  

What if you’ve never been sexually active? Nearly all cervical cancer (more than 99%) is caused by sexually transmitted HPV, so that’s why you don’t need cervical screening if you’ve never been sexually active before. It’s not, like some rumours may have suggested, because you can’t have a speculum inserted. There’s also a vaccine available to protect you against some strains of HPV. This means if/when you do become sexually active, you will be protected from the most common types of HPV known to cause cervical cancer. However, regular cervical screening is still recommended.

4. My partner can’t climax anymore, is this my fault?

There are many reasons people have difficulty climaxing and it’s unlikely it has anything to do with you. Some of the most common causes are:

1.       Certain medications (antidepressants are a common culprit)
2.       Being intoxicated (alcohol and drugs can have this effect)
3.       Fatigue (being tired can make it hard to climax)
4.       Psychological reasons (stress, anxiety, relationship issues, and depression can all cause a disconnect when it comes to sex)

Of course, if you’ve been together for a while it’s also natural that sexual desire can fluctuate. There’s never harm in experimenting with new things that you’re both interested in, to keep things fresh. 

What’s the best thing to do? Try taking some of the pressure off each other, by letting go of the idea that orgasm has to be the primary goal of sex. It’s okay to give and receive physical and emotional intimacy without having an orgasm every time. Can we get a “hell yeah?!”.

In fact, the more stressed you both feel, that you may not ‘get there’, the more likely it is that you won’t.  

We recommend you try to find a neutral time to talk with one another (not in the bedroom when you’re both feeling vulnerable). If it’s not something you’re able to get to the bottom of on your own, you might consider seeing a counsellor, either together or separately. If there’s any underlying stress or anxiety issues, a psychologist may also help.

3. Is an STI test anonymous?

Yep, an STI test and its results are completely anonymous. STI testing is easily available, and you can find out more about how to make an appointment for an STI test here. If you go through your regular GP, they will keep all your health records on file but won’t share them with other people unless that’s necessary for treatment. 

Your sexual health is your own personal responsibility and no you don’t have to share your STI status with the world either – although your doctor may advise that you’ll need to let recent sexual partners know if you have an STI, so that they can get tested and treated too. Learn more about safe sex here.

2. Is STI testing expensive?

Good news. If you’re eligible for a Medicare card and go to a bulk-billing medical centre or clinic, STI testing is 100% free in NSW. There are lots of other services that provide free testing too and you can find out more about this here.

1. How often should I get an STI test?

We always recommend getting an STI test every 6-12 months, when you change partners or if you show symptoms. We get that it can be a little nerve-wracking to get an STI test (which is why you might have avoided it) but the good news is that it’s super quick and easy and nothing to be ashamed of. 

In fact, being informed about your sexual health and getting regular STI tests is the best way to enjoy your sex life. You get all the fun and none of the worry. Learn more about STI testing and the recommended advice here. 

If you want more info call 1800 451 624 between 9am-5.30pm Monday to Friday to talk with a sexual health nurse. It’s confidential and free if you call from a landline. Nurse Nettie is here if you need anything else — ask away.