Challenging myths about . . . sexual health

A doctor sets the record straight on some of the most common sexual health misconceptions

'When used correctly every time you have sex, male condoms are proven to be up to 98% effective while female condoms are approximately 95% effective in preventing pregnancy.' Illustration: SV Sunny
'When used correctly every time you have sex, male condoms are proven to be up to 98% effective while female condoms are approximately 95% effective in preventing pregnancy.' Illustration: SV Sunny
A series about debunking myths
A series about debunking myths

Myths, perpetuated by pop culture, tell us that a broken hymen means a person has had sex before, that pulling out protects against pregnancy and STIs, and that two condoms are better than one. All of which are fabricated tales twisting and confusing our understanding of our sexual health.

The many myths surrounding our sexual health and wellbeing have complicated even some of the most basic ideas. For instance, the hymen is a misunderstood body part that naturally thins over time and not everyone with a vagina has one. Stretching or tearing of the hymen can happen many ways and is not indicative of whether someone has engaged in sexual activity or not. The “pulling out method” is not advised for birth control or protection against STIs as sperm can still be released from the penis well before ejaculation occurs and, when used correctly, one condom will do the job.

There are many misconceptions surrounding sexual health that we assume to be true. We may not question something we have repeatedly heard and likely believe, leading us to make decisions that do not necessarily serve us well. With so much unreliable information travelling through social media, Debunking the Myths, a sexual health education programme for teenagers, aims to bust the myths generated by false sources on the science behind our sexual health. Continually expanding on the programme’s themes, the workshops debunk misconceptions on topics including the anatomy of the vulva, periods, contraception and STIs and the HPV vaccine.

Debunking the Myths complements the Relationships and Sexuality Education curriculum for secondary schools – responding to the need of teachers and students for a trustworthy source of information on sexual health, and also creating a bridge between students and experts, providing a safe space for an open discussion on the science behind sexual health.

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Dr Zara Molphy, the project co-lead on the Debunking the Myths programme developed by the RCSI Rotunda Hospital Research Department to discuss and debunk a number of myths associated with women’s health, sets the record straight on some of the most common sexual health misconceptions.

1) Myth - Condoms mean safe sex

Safe sex means caring for your sexual health and that of your partners, lowering your combined risk of sexually transmitted infections, and being conscious of the choices you both make surrounding sexual health and wellbeing.

“Safe sex should incorporate consent, appropriate contraceptive and prophylactic use,” says Dr Molphy. “Enthusiastic consent is the most vital part of a healthy sexual relationship, even if you are having casual sex.”

Dr Molphy outlines that when used correctly and consistently, heterosexual use of condoms, external (male) and internal (female) condoms act as a physical “barrier” contraceptive. “Not only can they prevent pregnancy,” she says, “but they can also protect against sexually transmitted infections (STIs). When used correctly every time you have sex, male condoms are proven to be up to 98% effective while female condoms are approximately 95% effective in preventing pregnancy. However, a number of factors can make condoms less effective including incorrect sizing/shape of condom, incorrect condom application, condom usage after expiration date, use of a damaged/torn condom, use with the wrong lubricant/lotions, use of multiple condoms.”

For further protection, Dr Molphy advises a second contraceptive such as the pill, intrauterine system , implant, patch, vaginal ring, or diaphragm which can also be used. “If you have had unprotected sex,” she says, “or your contraception method has failed and do not wish to get pregnant, a number of emergency contraceptive options are available”.

For gay and bisexual men pre-exposure prophylactics can be used to prevent the spread of HIV/AIDS, advises Dr Molphy. “However,” she says, “they do not prevent the spread of other STIs therefore, it is vital to use condoms while having casual sex. Notably, condoms do not prevent against the spread of HPV (which can cause cervical, mouth and anal cancers and genital warts) so it is important for both men and women to get vaccinated.”

2) Myth - You’ll know if you or your partner have an STI because of symptoms

A prevailing and perpetuating myth is that an STI is obvious, and you can easily tell if a blind date, or potential partner has an STI. However, STI symptoms are not always noticeable and just because you are not showing signs or symptoms of an STI does not mean you don’t need an STI test.

“Many STIs like HIV, HPV, neurosyphilis, chlamydia and trichomoniasis show no signs or symptoms and can be passed readily to sexual partners,” says Dr Molphy. “The only way to be sure whether you have an STI or not, is to get tested by your GP or sexual health clinic. It is also possible to obtain a free STI testing kit from sh24.ie. A timely STI diagnosis and treatment is important to avoid potentially life-threatening health problems for you and your sexual partner(s).”

3) Myth - STIs don’t cause infertility

There are many unsubstantiated myths surrounding STIs and one of the more harmful myths concerns the idea that STIs don’t cause infertility. STIs are responsible for more cases of infertility than we may realise. Considering infections can fly under the radar and go untreated for years, the damaging effects can be permanent.

“If left undiagnosed and untreated, a number of STIs can result in both male and female infertility,” advises Dr Molphy. “For example, chlamydia can result in irrevocable damage in the fallopian tubes in women, and in men can lead to DNA fragmentation and malformed and immobile sperm. In women, untreated gonorrhoea can cause pelvic inflammatory disease (PID), while in men it can cause inflammation of the epididymis.”

Left untreated, STIs have the potential to greatly impact fertility and without regular testing, the issue may only be discovered when attempting to conceive.

“Significantly,” says Dr Molphy, “the Centre for Disease Control in the United States recommends annual chlamydia and gonorrhoea screening for: sexually active women younger than 25 years, older women with risk factors such as new or multiple sex partners, or a sex partner who has an STI, and all sexually active gay, bisexual, and other men who have sex with men.”

Myths Series

  1. Ageing
  2. ADHD
  3. Grief
  4. Sexual health
  5. Loneliness
  6. Introverts
  7. Imposter syndrome
  8. Mental health
  9. Rage in motherhood
  10. Therapy
  11. PTSD
  12. Food safety
  13. Endometriosis
  14. Pregnancy
  15. Frozen shoulder
  16. Thyroid gland
  17. Eating disorders
  18. Chronic pain
  19. Pelvic floor
  20. OCD
  21. Happiness
  22. Physiotherapy
Geraldine Walsh

Geraldine Walsh

Geraldine Walsh, a contributor to The Irish Times, writes about health and family