I work in a sexual health clinic...ama

[Hereandthereandeverywhere]

Go for it! Nothing is too much

Candida auris? Ooh, exciting! Well, not exciting I guess, But interesting all the same and worrying! I work in microbiology and spend a bit of time doing microscopy in my local SRH too so I know exactly some of the stories you get!!!

If someone has HPV (that I understand is supposed to go away on their own after a while), is it worthwhile getting the HPV vaccine once they are all-clear? Is it straight-forward to access?

I understand having HPV is very common and most adults get it at some point?

If OP is who she says she is, then she will be non judgemental about cheaters and johns (as she should be in this work), but women who object to being called cis and lies about sex being "assigned" will receive accusations ("YOU are the problem) and be labelled "vultures". And of course she's "joining the trans debate" by making a point about using offensive and inaccurate terms after being asked to stop. As ever, seems there's only one class of people for whom respect and non judgement are optional.

Reassuring.

Not the point of the post.
The post has been derailed and may have actually been of help to some people.

Been told?! Wtf

Just a note that the site you linked to groups HSV-1 and HSV-2 together, giving a combined number. My numbers up-thread were more accurate, for anyone interested, or this site has accurate percentages.

Also, HSV-2 is more likely to result in outbreaks in the much more painful location of the genitals, and result in more frequent outbreaks, while HSV-1 has fewer outbreaks on average, but if it affects the eye (very rare) it could put a person's sight at risk.

As the two variants have different effects, your link lumping them together isn't helpful.

Except for all of OP's misinformation?

Please remember that sexual health staff treat every single person they see with dignity, whether you like the language they use or not.

Treating people with dignity isn't referring to them as cis women. I'd be furious if you said that to me. I'm not a subset.

@Hereandthereandeverywhere

Name changed for this but curious: had a smear and all of a sudden I have tested positive for HPV. Been with my partner for over 6 years and last smear was normal (3ish years ago, done privately). I am 45, peri and on HRT now if this matters at all. Partner faithful as well do unsure how this happened.

How worried should I be about the HPV diagnosis? Do you see this a lot in women of my age and what advice would you give? What can I do to clear this infection? I am worried about the cancer risk. TIA 🙏

Can people get tested / treated without having to answer any questions about their sex lives?

I feel it's really important to challenge anyone , least of all people who purport to be in healthcare or legal professional roles when they pretend to not see any risk from men who identify as women. This is as you only need to see the stats for sexual assaults that take place on wards to know that safeguarding vulnerable women should be a priority and the risk of all types of men being considered . Also when we have rape cases where women have been compelled to call their rapist a she in court, it is not in our best interests to be accepting any language that denies that trans women are men, and mostly are men who retain their very male genitalia

can't you people ever talk about anything without making it about transgender issues

You can't clear HPV by doing anything. Your immune system will most likely clear the infection on its own if you eat healthily and look after yourself. It's also quite normal for HPV to lie dormant for many years before flaring up, and in most cases it's nothing to worry about.

What did your GP/medic say about the results though, when you had the smear? Really, they're the only ones who can advise you properly, as they will know the type of HPV you tested positive for, and how high or low risk it is.

I'm trying to talk about the fact that the OP seems to have half her facts wrong, never mind the transgender problem. Is that alright?

If your health provider respects your declared pronouns you won’t have anything to be furious about.

Of course! We don't interrogate people. It is absolutely okay to decline questioning. We ask questions so we know where/what to test for and to offer safer sex advice, but we would hate for people not to test because they didn't want to answer questions.

Hi OP, it’s good of you to do an AMA on the topic of sexual health. As an older divorced woman (happy to refer to myself as cis) who was dating again I was diagnosed with HIV at a sexual health clinic almost 9 years ago. I was also diagnosed with vaginal atrophy/Genitourinary Syndrome of Menopause and came to realise that with lower estrogen levels causing thinner weaker genital tissue and microtears this can make women more susceptible to contracting infection.

It can be quite anxiety provoking in going to a sexual health clinic as many of us don’t realise they are for everyone not just the younger generation and how lovely they are there, although they can differ in what services they offer. As an example I also had my Mirena coil removed there a couple of years later, but they were unable to install a new one, at that point used as part of HRT, without a GP referral to the attached menopause clinic which would then have taken a few months.

It might be helpful for members to know that postal STI tests can be searched for online (we’ve just had HIV testing week with these widely available) with the result often showing our local SH clinic. Also helpful to know that some tests might give a false positive and should be followed up with a sample taken from the arm at a clinic.

Although going to a clinic and being examined (some clinics have a room where you can self swab) and having to answer all the questions might seem intrusive they can sometimes do a more thorough job in testing. For example they added in a Trichomoniasis test with me, though no strange discharge. The one thing, looking back, was they asked at 2 stages if I really wanted the HIV test, saying how low risk I was. I felt it would have been so easy to say no. I hope that they don’t do that now?

My other questions:
For anyone diagnosed with HIV is peer support offered, and if so at what stage? Do you have access in signposting local charities offering this service and are you aware of other support services offered to women living with HIV eg when pregnant or in menopause?

Regarding PrEP – are you discussing this with women you see at your clinic who you feel would benefit, and if so do you mention both daily and on demand/event based dosing? Are any women, beside sex workers who are likely more aware, asking for PrEP?

Sure, when it's not actually relevant. In this case, it is. Among other things too.

Also, I did ask OP a few questions earlier. Is she concerned that her misplaced judgement and accusations regarding women who object to being called "cis" will put women off accessing the service, and also how she knows that sex workers (who, to be clear, I don't judge) are so safe to have sex with and take time off when recovering from infections; is there some sort of regulation going on?

She's not answered but she has seen fit to "make it about transgender issues", directly and indirectly.

I suppose I do have another question: should people be taking medical advice from an anonymous and unverified internet source?

"As long as they don't say it to your face, it's fine."

Hm. 🤔 I'm not sure you'd say that to anyone but women, frankly.

Any ladies in your clinic that have 'damaged' themselves from using odd objects? You read stories of over use of clit pumps or sticking too big toys up their urethras etc 😳

For men this seems to be a given, but women be too adventurous seems to be a rarity ...

Do you ever have a case of a very repeat visitor where you actually think "I wish I could put you on a permanent sex ban because you never learn, never change your behaviour and continue to put your sexual health and that of others at risk, you selfish twat"?

Do you see women with Cytolitic Vaginosis or vulvodynia? And for vulvodynia do you try to find root cause or just prescribe neuropathic meds? (I have the latter and gynaecology are so unhelpful I'm wondering whether to go to sexual health clinic).

Thank you. HIV peer support, I think, is offered at the point of diagnosis. The HIV care is slightly separate from the sexual health clinic. We are lucky here in that we have specialised HIV clinics and groups for women, parents, breastfeeding mothers etc. And PrEP is now offered to everyone. The government changed their guidelines at the end of last year from GBMSM to anyone who would benefit. We are seeing an uptake in women, which is brilliant!

All the time!! We have specialist clinics and offer psychosexual counselling to help with the root course, so definitely worth speaking to your clinic. Sorry you've had a naff time!

Do vulva usually change as we age. I’m in my fifties and mine seems a lot more lumpy inside and I’m not sure if I should get it checked or not?
im not sexually active but I’m worried it could be cancerous.