Taking care of our bodies

The vulva refers to the collection of external parts of the female genitals, though not everyone who has a vulva identifies as a woman or as female. The vulva includes the labia majora (outer lips) and labia minora (inner lips), the clitoris, and the urethra and vaginal opening.

Hot Tip: lots of people don’t know that this is called the vulva, and many people use the term “vagina” to refer to everything “down there”!

Vulvas come in all shapes, forms, and colours. Everyone’s genitals are unique, and will look different – some are brownish-black, some are pink, some are hairy, some aren’t, some people’s inner lips are visible or uneven, some aren’t, some people have a hymen, some people don’t.

Labia (lips) – there are two sets of labia, or lips, on a vulva: the labia majora (outer lips) and labia minora (inner lips). The labia are located on the outside of the vaginal opening and look like stretchy fleshy folds that surround and protect the clitoris, the opening of the vagina, and the urethra.

Clitoris – also known as the clit, this is the pleasure centre of the vulva. This is a super dense bundle of nerve endings running both inside and outside the body, ending at the end of the inner labia just above the vaginal opening. The clitoris is very sensitive and can provide pleasure when stimulated. Lots of people think of the clit only refers to the bump that is visible above the vaginal opening, but it actually extends into your body and has two thick legs that run back and down under the skin on each side of the vulva (meaning you can stimulate the clit from within the vagina, too).

Urethra – the urethra is the long inner tube in our body that brings pee from our bladder to the toilet, out the urethral opening. The urethral opening is located just below the clitoris, above the vaginal opening – it looks like a tiny hole (yes, there are two holes down there – the urethral hole and the vagina).

What about the hymen? The hymen is the thin layer of skin that can surround, or partially cover the vaginal opening.

Good to know: Not everyone has one. Some people have one and some people don’t, regardless of whether they have had penetrative sex or not. The hymen can look different from person to person. Some of us will experience our hymen “breaking” when we first experience vaginal penetration or using tampons for the first time, resulting in some bleeding and pain (some people call it “popping their cherry” as it’s associated with losing one’s virginity). However, many people will never experience this, either because their hymen skin is stretchy, breaks without them noticing, or they don’t have any.

Vagina – on one end of the vagina, there is the vaginal opening. That is the hole on the outside of the body that sits in between the urethra (pee hole) and anus. Then, there is an internal tube that runs from the vaginal opening to the cervix. It will beat the very top of the vagina, if you’re standing upright. The vagina is one body part we use for penetrative sex, including sex that can lead to conception (making a baby). It is where menstrual blood leaves the body, and also where babies who are born vaginally exit the body. Many people enjoy vaginal penetration with penises, fingers, sex toys, etc. as it can bring on sexual pleasure. This is also where people insert things like tampons or menstrual cups during periods. Everybody’s vagina is different when it comes to length, width, and “stretchiness”. Length and stretchiness also varies during a person’s menstrual cycle.

G-spot – the scientific name is the Grafenburg spot but most of us know it as the G-spot. It’s a patch of tissue that is a piece of the internal part of the clitoris. It sits a few inches inside the vagina (towards the belly-button). When the G-spot is stimulated (with fingers, sex toys, during penetration, etc.), it can lead to strong sexual arousal, powerful orgasms, and, sometimes, to ejaculation.

Cervix – the cervix is the “neck” of the uterus and looks like a small donut with a small hole in the middle. It controls movement into and out of the uterus. It sits at the very top of the vagina (if you’re standing upright). Some people can touch their cervix with their fingers, while others cannot, depending on the length of their vagina. The cervix thins and stretches open during childbirth, for a baby to leave the uterus and be born. It also lets menstrual blood out and sperm in when a sexual al partner ejaculates into the vagina.

Uterus – a muscular organ that we also call the womb. It’s the part of the reproductive system where a fetus grows during a pregnancy until it is ready for birth. The uterus is about the size of a closed fist and shaped like an upside-down pear. It has thick muscular walls that stretch during pregnancy.

Ovaries – small, almond-sized pouches that hold eggs (ova) and produce hormones such as estrogen, testosterone, and progesterone. The ovaries release one egg per month from either side, though occasionally they will release more than one egg, which can result in either fertilization of the egg – if met with sperm – or menstruation. When people reach menopause, they stop ovulating and releasing eggs, and stop menstruating, which creates hormonal changes in the body.

Fallopian Tubes – two narrow tubes that link up the ovaries and the uterus. The eggs that are released by the ovaries every month travel down those tubes to reach the uterus. Sperm can also travel up the fallopian tube, where it attempts to fertilize the egg. Fertilization happens when a sperm burrows into an egg and they join together.

What happens with the egg? If an egg is fertilized in the fallopian tube, the embryo travels back down to the uterus to attach to the lining. About 50% of fertilized eggs will successfully attach and continue to develop into a pregnancy. If the egg is not fertilized and reaches the uterus, or if the fertilized egg doesn’t attach, eventually they are reabsorbed by the uterine lining and then, the lining is expelled through the vagina as menstrual blood.

It’s important to talk about our sexual organs in ways that respects their many uses. Those parts of our bodies are central to our ability to reproduce, for those who become pregnant or choose to start families, but they can also bring us pleasure during sex or masturbation. The clitoris is a perfect example – this is a part of the body that exists solely to bring pleasurable feelings when stimulated. How cool is that?

Talking openly about the pleasure we can experience through sexual stimulation – of the vagina, clitoris, g-spot, penis, anus, prostate, and more – means we make the space to talk about sex in positive ways. It can help us learn what can make sex more pleasurable for different people and also identify when something doesn’t feel good.

Sex should be consensual and pleasurable for everyone involved. If we are experiencing challenges in feeling sexual pleasure, there are ways we can modify the sex we are having to be more satisfying. We can try to use sex toys, different ways to have our bodies stimulated, or open communication with our partners about the sex we have, for example. Read more about the mechanics of sex.

Vulvas and vaginas can become irritated because of what we do, wear, or the products we use. Vaginal infections can happen because of overgrowth of bacteria, yeast, or fungus.

Everyday habits can make a big difference when it comes to our genital health and comfort. Here are a list of general tips to maintain a healthy vulva and vagina:

• While showering or bathing, use your hands and warm water to wash your vulva. Soap can be harsh. If you use soap, make sure it’s gentle and unscented. Pat dry with a clean towel.
• Use white and unscented toilet paper to wipe. Avoid using baby wipes, personal wipes, douches, sprays, bubble baths, perfumes, or other scented hygiene products.
• Wiping from front to back is important because of the closeness of the anus and the urethra. To wipe from back to front can help prevent urinary tract infections. Stool contains a variety of bacteria and while that is natural, some of that bacteria can cause infection if it gets into the urethra.
• Avoid douching. It can upset the balance of bacteria inside of the vagina which can lead to increased risks of yeast infections and bacterial vaginosis. Douching can also cause inflammation that can make it more likely to get an STI. It’s best to let the vagina clean itself which occurs naturally when it makes mucus. Healthy, clean vaginas may have a mild odor – this is totally normal!
• It’s good to wear white, breathable 100% cotton underwear as often as possible. Underwear that are made of other materials like nylon or satin will often have 100% cotton lower area that touches the vulva – this is also good! Keep nylon, girdles, pantyhose, and thongs for special occasions.
• Use gentle laundry detergent. Change underwear regularly and change out of a wet bathing suit or workout clothes promptly.
• Use a menstrual cup or 100% cotton menstrual pads and tampons during menstruation. Wash your hands before and after changing or inserting them. If possible, avoid scented menstrual products and change tampons frequently (at least every 4-8 hours).
• If you use a menstrual cup, it’s important to take good care of it. Before inserting and removing it, wash your cup with warm water and a mild, unscented, water-based (oil-free) soap. Remember to empty and wash your cup at least twice a day, a minimum of every 12 hours. If you are unable to wash your cup after removal (i.e. if you are in a public restroom), use a dry tissue to wipe it down after pouring the contents into the toilet. Then, clean it thoroughly the next time you have a chance. At the end of your cycle, boil your cup in plenty of water for about ten minutes. Boil it again right before starting a new period.
• Starting somewhere between 21 and 25 years old (depending on the recommendations in your home province), you should get regular Pap tests if you are or have been sexually active, regardless of your sexual partner(s) sex. It is recommended to get a Pap test every three years unless your health care provider says otherwise. Up to 90% of cervical cancers are preventable with regular screening tests and appropriate follow-up care.
• Avoid scratching if the vulva is red, swollen, and/or irritated. It can make it worse as we can easily tear the thin skin on the vulva. Instead, you can relieve mild itchiness with a warm bath with oatmeal (after you have made sure you don’t have an infection like yeast or bacterial vaginosis) or by using a cool cloth to relieve unpleasant sensations. See a health care provider if itchiness or irritation persist.
• See a health care provider if there is a bump, sore, itch, or any change in the normal fluids coming out of the vagina or changes in the normal appearance of the skin on your vulva.
• It is important to make STI testing a regular part of your health care routine. It is recommended to get tested before every new partner and then, at least once a year as a part of routine health care. https://www.actioncanadashr.org/campaigns/get-tested-stis-least-once-ye…
• Using an unscented water-based lubricant may be helpful during sex, especially for people who are postmenopausal. It is important to avoid oils or oil-based lubricants like petroleum jelly (Vaseline) with condoms. It can weaken them to the point of breaking.
• Keep an eye on your discharge – everyone will produce different amounts of vaginal discharge, often this is clear or milky white and will change in consistency throughout the menstrual cycle. Know what is normal for your body – a funky odour or different coloured discharge (i.e.: more cloudy, thicker, or more yellow than usual) can indicate an infection. It’s important to see a health care provider if you notice unusual changes with your discharge.
• Always try to pee and/or wash your genitals after having sex. This can wash away some of the normal bacteria that can build up during sex and can stop it from collecting in the urethra and causing a urinary tract infection if the bacteria travels up or a yeast infection.
• If you experience genital pain, either during penetration or generally, seek support from a health care provider.

Everyone’s body is different and that is true for penises, too. Penises vary in size and width. They can be smooth or bumpy, straight or curved, and differ in color and hairiness.

The penis is made up of several parts:

• The shaft or body of the penis (from the top of the penis to where it connects to your lower body)

• The glans, a fancy name for the head or tip of the penis which is sometimes covered by foreskin. This is where the opening of your urethra (pee hole) is, where urine and semen come out.

• The foreskin is a layer of skin that covers the head of the penis. At birth, the foreskin and the glans are lightly joined. The foreskin of adults is typically retractable over the glans. The length of the foreskin determines how much of the glans is covered when the penis is flaccid or erect.

Good to know: The separation of the foreskin from the glans happens around puberty and should not be pulled back prior to that. Many parents of young children believe that pulling back the foreskin is needed to properly clean the head of the penis. It’s important to wait until it happens naturally, as prematurely separating the glans from the foreskin can tear important connective tissue and can cause an infection.

Circumcision: Some people don’t have a foreskin because it was removed through a procedure called circumcision, which is when a doctor surgically removes all or part of the foreskin. It is done for cultural, religious, and, sometimes, medical reasons, and usually happens right after birth. The procedure can also occur later in life for different reasons, including because of phimosis, a medical condition where the foreskin is too tight to be pulled back over the head of the penis.

• The frenulum, which is where the foreskin meets the bottom of the penis. It usually looks like a little V below the head of the penis. Many people who are circumcised will still have a frenulum, and it can be very sensitive to touch.

In addition to its many parts, the penis is also connected to other parts of the genitals:

• The scrotum, which is the sac or pouch of skin that holds the testicles below the penis. The scrotum will change depending on temperature – when it’s cold, it will pull the testicles tighter to the body, and if it’s hot, it will loosen and allow the testicles to hang away from the body to regulate temperature. The muscle that is responsible for moving your scrotum and testicles closer or further away from your body is called the cremaster.
• The testicles (or “balls”) – two ball-like glands that hang in the scrotum. It is common that one testicle to hang lower than the other. Not everyone will have two visible testicles (because of surgery or one testicle that has not descended from inside the body). The testicles produce sperm and hormones including testosterone.

Urethra – the urethra is the long inner tube in our body that brings pee from the bladder out through the penis to the toilet. Usually, the pee hole is on the tip of the head, but some people’s urethra is on the underside of the penis’ shaft because of a condition called hypospadia.

Prostate – the prostate is an internal gland that is found in between the bladder and penis, just in front of the rectum. It is roughly the size of a golf ball and creates the fluid that helps the sperm move. It is sensitive to the touch, and many people find it pleasurable to stimulate the prostate through the anus.

Root – the root of the penis is the part of the penis that is tucked up inside the pelvis and attached to the pubic bone.

Epididymis – the tube where the sperm matures and sits prior to ejaculation. The epididymis connects each testicle to its vas deferens (the tube that carries the sperm out during an ejaculation).

Vas Deferens – the narrow long tube that carries sperm from the epididymis to the seminal vesicles where it is then turned into semen before it is ejaculated.

Seminal Vesicles – the two small organs located below your bladder that produce semen.

Semen – the milky fluid that sperm moves around in, which comes out during ejaculation.

Cowper’s glands – located under the prostate and attached to your urethra, these glands produce pre-ejaculate (also known as pre-cum) which helps get your urethra ready for ejaculation by lubricating the urethra and making it easier for semen to move around and get pushed out during orgasm.

The penis has a sexual function – this external organ is full of nerve endings and can bring great pleasure when stimulated. An erection is the stiffening and rising of the penis. It generally happens when someone gets sexually excited but can also happen in non-sexual situations (for more information, read this section on arousal non-concordance).

The penis isn’t the only body part with a sexual function. Touch and stimulation of the scrotum or the insertion of a finger in the inguinal canal (which is the tube in which testicles get pulled into when it’s cold) can bring a lot of pleasure. Many people also find anal stimulation to be extremely pleasurable. That’s because we can reach and stimulate the prostate that way and because the anus is full of nerve endings, so it’s very sensitive to touch. Anal stimulation can be done with different things – sex toys, mouth and tongue, fingers, or a penis. The prostate is regularly referred to as “the other G-spot” because of how pleasurable it can feel when touched. For more on this, read our sections on anuses.

Everyday habits can make a big difference in our level of genital health and comfort! This section offers general tips for maintaining a healthy penis and testicles. 

Gently wash your penis every day. Carefully pull back and clean under the foreskin (if you have a foreskin), as well as the tip of your penis (the glans) using only water or a very gentle soap. There is no need to scrub this sensitive area.

• After cleaning, gently pat dry the tip of your penis, under the foreskin and the rest of your penis. Replace the foreskin (if you have one) over the glans before putting on underwear.
• You can take good care of the delicate skin on the penis by using lubricants during masturbation and penetrative sex and by wearing underwear made with natural fibers that are not too tight.
• Use gentle laundry detergent. Change underwear regularly and change out of a wet bathing suit or workout clothes promptly.
• It is important to wash your hands before touching your penis. Especially if you have been handling anything that might irritate your penis like chemicals, hot peppers (seriously!), or heat rub for muscle pain.
• At the age of 15, it’s recommended to start doing a monthly self-exam of the testicles. It’s a good way to become familiar with their shape and feel to be able to detect any unusual lumps. Testicular cancer is more easily treatable when caught early.
• See a health care provider if there is any discharge coming out of your penis, if it hurts to pee, or if you find a bump, sore, or itch. It is important to make STI testing a regular part of your health care routine – not just when you have symptoms, as many STIs don’t have symptoms.
• If there is any swelling or pain in your scrotum, see a health care provider.
• If you are in pain after trauma to the penis, it is important to follow-up with a health care provider. A firm bump into a hard surface, like a partner’s pelvic bones, can cause an injury to the penis.
• Erections are an important part of what keeps penises healthy. Most people have erections during their sleep for that purpose. Some people who have suffered trauma to the nerves or blood vessel damage, for example, damage that can be caused by diabetes, are physically unable to get erections. A device like a vacuum pump, which makes the penis swell with blood, can help maintain a healthy penis if you have difficulties becoming erect. If you suffer from erectile dysfunction due to health issues like depression or anxiety, or due to the side effects of medication, seeking support about these issues is important. Your sexual health matters and is closely linked to mental health and wellness.
• The most important ways to reduce the risk of penile cancer is to practice good genital hygiene (cleaning under the foreskin if you are not circumcised), getting the HPV vaccine (which works best if given before the person starts having sex), having protected sex to avoid HPV infection, and not smoking.

Trans and nonbinary folks have unique health needs, and unique contexts in which they navigate these health needs. That said, those of us who are trans also have many of the exact same health needs as cisgender people – things like Pap smears, STI tests, and breast/chest examinations.

More often than not though, navigating these routine parts of sexual health care can be difficult. This can be because health care professionals may not have the training to know how to be trans-affirming and inclusive in their practice. To trans folks, it can feel like you have to be the one educating your health care provider on things like using the correct pronouns, or explaining what you need to be healthy, like routine tests that are offered to cis people or for physicals go a certain way. Sometimes it becomes so overwhelming that people can avoid health care providers all together.

While many of the health concerns of trans folks are the same as those of cisgender folks, there are some unique health needs that trans folk may have. The following tips are meant to offer some information on some of them. Remember though, there is no single way of being trans – while some folks will access gender affirming surgeries, or some people will bind their chest, tuck, take hormones, etc. others wont. Everyone has their unique way of understanding and living their gender, and no one is “more” or “less” trans whether or not they choose to (and are able to) bind, take hormones, or access gender-affirming surgeries.

Chest binding is using different things – compression undergarments, layered t-shirts, bandages, sports bras, or commercial binders – to flatten the appearance of the chest. Often times, people will use chest binding to feel more like themselves, especially when the appearance of breasts is causing gender dysphoria or negative feelings.

There are safe and not-so-safe ways to bind. While there are things to be careful about when binding, including back pain, overheating, shortness of breath, itching, and bruising, it’s important to remember the many positive emotional impacts of it. Check out this study on the health impacts of binding to get to know more.

While there is little medical guidance around how often or how to bind, it is often suggested to bind for around eight hours a day maximum. That said, not everyone has the option to remove their binder, especially if they feel dysphoria once it is removed.

Hormone therapy is using synthetic hormones to change the appearance of the body, and also to change how someone feels in their body. This helps people look and feel in a way that is more in line with their gender.

With the support of a health care provider, those assigned male at birth who wish to transition might start taking anti-androgens such as spironolactone, as well as estrogen which can cause breast development, slow the growth of body hair, and redistribute body weight.

Those assigned female at birth might use testosterone to cause a deepening of voice, the redistribution of body weight, increase their muscle mass/strength, and see facial hair and body hair grow thicker and fuller, among other physical effects.

Hormones are usually taken orally (by mouth), by injection, or through applying a skin patch, cream, gel, or spray. The combination of medications that a person goes on will be different from person-to-person, depending on medical advice, our different bodies and, most importantly, what people’s goals are with using hormones.

The impacts of hormones will also be different if someone is taking them before or after experiencing puberty because of the physical changes that happen during puberty.

There are lots of different types of gender affirming surgeries, sometimes referred to as sex re-assignment surgeries. This decision to have surgery or not is unique to each person. It often depends on what feels the most right when it comes to the way we want to express our gender.

The choices we have are also impacted by whether or not we have access to surgeries that can cost a lot of money or if there are doctors near us who are knowledgeable and skilled in trans-specific health care. Someone having a gender affirming surgery may undergo one or multiple of the following procedures, depending on access and what changes they wish to make to their body:

Hot tip: Not every trans person will decide to have surgery. Many people are not wanting any changes to their bodies. Others may wish to have surgery, but can’t afford it, since not all surgeries are covered by provincial health care.

• Chest Construction

The removal of breast tissue to create a flatter chest.

• Breast Reconstruction

Surgery to create, enlarge, or shape the breasts.

• Vaginoplasty

The surgical grafting of parts of the penis and scrotum skin to create a vaginal cavity, as well as the grafting of the glans to create a sensitive clitoris.

• Hysterectomy

The removal of the uterus.

• Phalloplasty

The surgical construction of a penis, usually using skin from the forearm. There are different types of phalloplasty.

• Scrotoplasty

Refers to the creation of a scrotum using the labia majora.

• Orchiectomy

The surgical removal of one or both of the testicles.

• Scrotectomy

The removal of the entire scrotum or a portion of it.

For more on gender affirming surgeries, visit this website.

We usually learn about how to have safer sex in super limited ways. For example, sex ed classes usually only talk about straight relationships or penis-in-vagina penetrative sex between cis people. Trans folks are often invisible in conversations around safer sex. That leaves many of us with little to no sources of information we can trust to take care of ourselves and our partners.

Safer sex, as well as the ways STIs can be transmitted, depends on anatomy and on the anatomy of our partner(s) – not gender. Practicing safer sex will look different depending on your body and depending on whether you have a vagina or a penis (people can use all sorts of words to describe their genitals – those are the anatomical terms) and what kind of sex you are having with your partners. Condoms can be used to cover penises, dental dams can be used to cover vulvas and vaginas prior to oral sex, and gloves can be used during anal sex.

Regular STI testing is important for everyone. At the clinic, you will be asked questions about what type of sex you are having as well as the partner(s) you have. This will determine the type of testing you will receive. Sometimes, healthcare providers aren’t familiar with all the ways trans folks are having sex, so you may need to do some advocating at the clinic for the types of tests that meet your needs.

The anus, also known as the butt hole, the asshole, etc., is the external opening of the rectum. It is located behind the vagina or the scrotum. Around the anus are two rings of muscle that control the exit of stools (or poop) from the body, which is its main job. These rings are the internal anal sphincter and the external anal sphincter. Both sphincters tighten and relax the hole for defecation (pooping). We have control over the outer sphincter while the inner one clenches or relaxes involuntarily.

The rectum is the final straight portion of the large intestine, connected to the anal canal.

Pleasure

The anus has a high concentration of nerve endings which can make anal stimulation (using fingers or toys, oral-to-anal sex, or penetration) very pleasurable. That is true for people of all genders and sexualities. In addition to nerve endings, pleasure from anal penetration can also be attributed to the fact that the rectum shares a wall with the prostate for those of us who have a penis and the vagina/G-Spot/the internal parts of the clitoris for those of us with vulvas, which makes indirect stimulation possible. Pleasure from anal penetration is also tied to the tightness of the muscles which can make for an enjoyable pressure on the penis, if it is a penis that is penetrating the anus (you can also use fingers and sex toys).

Taking Care of Your Anus

Everyday habits can make a big difference in our level of health and comfort. This section is full of tips to maintain good anal health and play safely! These tips are particularly important for those who enjoy any type of anal play or anal sex.

• Wear looser and breathable clothing, including light, white cotton underwear. This helps prevent itchiness and irritation.
• Use gentle and non-allergenic laundry detergent, especially when washing underwear.
• Use softer, white, non-perfumed toilet paper or wipes, or wash with water after defecating.
• After exercising, dry yourself well and change underwear to avoid getting your skin irritated because of sweat.
• Avoid sitting for long periods, take breaks to stretch and walk around.
• Healthy bowel movements can minimize straining which is associated with damages to the skin (e.g. fissures) or the swelling of hemorrhoids. You can help prevent and treat constipation by having a high-fiber diet and drinking lots of water. Some people also like to use a low stool to prop up their feet when they poop to help the body strain less. Treating diarrhea promptly also reduces anal strain.
• The risk for anal cancer is something to be aware of for people who have anal sex. The major risk factor for anal cancer is infection with HPV. Routine anal Pap smears to detect the early changes on the cells inside the anal canal are an important prevention tool.
• Unprotected anal sex carries a higher risk of passing on STBBIs because the skin in that area is delicate and little tears may provide an entry for infection. Using condoms and lots of lube during anal penetration reduces the risk of tears caused by friction.
• While cleaning out before anal play may not be necessary, some people find that it makes them feel more comfortable.
• Toys: Make sure that any toys used for anal sex can be cleaned or are covered with a condom as the skin inside of the anal canal is very delicate and porous. Anything that goes into the anus needs to be smooth. Ridges on toys designed for the vagina can cause irritation or pain. Finally, it is essential that anything that is inserted into the anus has a wide base. Toys with no base can be sucked in and lost much more easily than you might think, and that can result in a trip to the emergency room.
• Two important things to keep in mind for anal play are relaxation and lubrication. Taking your time is crucial with anal play, so it’s important to not rush anal penetration.
• We can’t control the internal muscle but the more relaxed you are, the more relaxed this muscle will be. Using numbing cream is not recommended. While using them might make the anus less sensitive, they won’t help to relax the muscles. Instead, it becomes more difficult to notice pain or discomfort which can result in irritation or damage to this sensitive area. It is safer to start by stimulating the outside of the anus to help the muscles relax.
• Unlike the vagina, the rectum doesn’t make enough lubrication for sex. Everyone needs lube for anal sex. Thicker lubricants work better for anal play – and we recommend silicone-based ones as they don’t dry out.

The throat is the muscular tube that runs from the back of your nose down into your neck. It contains blood vessels, various muscles, the windpipe, and the esophagus.

Sexually transmitted Infections (STIs) can be passed on during unprotected oral sex. When you get an STI in your throat, you can get a sore throat, tonsillitis, oral lesions, or cold sores. But often, there are no symptoms. It is important to ask for a throat swab too when you get tested for STIs.

HPV is one type of infection that can lead to lesions in the throat that can eventually develop into cancers if they are not detected in time. It’s tricky because, unlike Pap tests which can monitor possible lesions on the cervix caused by HPV infections, doctors don’t routinely offer throat swabs.

If or when you choose to have oral sex, you can use a latex barrier like a condom or a dental dam to prevent STIs transmitted by skin-to-skin contact or by fluid transmission. If you don’t use a barrier, you can make sure to ask for regular throat swabs at the doctor. Here are some tips:

• Use a non-lubricated or a flavored condom on a penis or sex toy
• If you are going down on a vulva, or for oral-anal stimulation (rimming), you can use a dental dam, plastic food wrap, or you can DIY your own dam by cutting a condom lengthwise.
• Avoid food products like whipped cream or chocolate sauce with the condom or dental dam. They may be oil-based which can break down latex and they are also full of sugar, and can potentially lead to yeast infections.
• Ask for throat swabs as part of your routine sexual health check-up.

Sexual Health – Taking Care of Your Oral Health!

Oral health has a big impact on risk of exposure to STIs during oral sex. Here are some tips and tricks:

• If you have gum disease (like gingivitis), cuts, or sores in your mouth, or you’ve had recent dental work, you are more at risk of being exposed to STIs when having oral sex, so using barriers is advised.
• Avoid brushing your teeth or flossing right before or right after oral sex as it can irritate your gums or create small cuts that might increase your exposure to an infection.
• If you have a new oral piercing (lip, tongue, etc.), avoid oral sex for six weeks so it can completely heal. Before then, the piercing is an open wound that can provide an easy entry point for bacteria or viruses.
• Maintain good oral health by regularly brushing your teeth with a brush that has soft bristles and is replaced every three months, by flossing, and by regularly visiting the dentist.

Different things like physiological events (e.g. pregnancy, birth, etc.), injuries, medical conditions, infections, medications and surgeries can impact the ways we connect with our bodies or express our sexuality. In certain situations, these conditions or injuries might make some body parts to feel numb, might cause a loss of sensations or might restrict sexual function. In some cases, it can cause people to feel pain in the pelvic and genital areas during sex. Painful sex is more common than it should be, so it can be helpful to understand some of the main causes of pain and discomfort during sex. If this is your experience, a trusted health care provider can help you find ways to get back to feeling comfortable and pain-free.

Since all of our bodies are different and we will all experience different injuries, illnesses, conditions, and experiences in life, let’s take a look at some of the more common conditions that can impact the way we express our sexuality, starting with incontinence and erectile challenges. These are only a couple of examples of challenges people can experience. It is to show how many of those issues are often the result or reveal underlying medical conditions that need treatment and how important it is to seek the support we need to have them addressed.

If you experience physical challenges that undermined your sexual function and your enjoyment of your body and of sex, please find a health care provider you trust to discuss it with them.

Pelvic floor issues and incontinence

Pelvic floor issues are common and can usually be treated. The pelvic floor is a layer of muscles that supports the bladder and bowel control, sexual function, and serves as the “home” for the pelvic organs, including the urinary bladder, rectum, uterus and vagina, keeping them in the correct position.

Common pelvic floor issues are urinary problems, loss of pelvic organ support or pelvic organ prolapse, and bowel dysfunction. Childbirth is one of the main causes of pelvic floor dysfunction, and the risk for dysfunction increases with the more children someone has.

Pelvic organ prolapse happens when a pelvic organ—like the bladder or rectum—drops (prolapses) from its normal place in the lower belly and pushes against the walls of the vagina or bulges out of the anus. This can happen when the muscles that hold your pelvic organs in place get weak or stretched. Some of the symptoms people feel are a feeling of pressure or like something is falling out, having trouble emptying their bladder or passing stools and lower back ache.

A high number of people will experience stress incontinence and/or organ prolapse in their lifetime. The issue is that many people will wait a very long before talking to a health care provider out of embarrassment, losing quality of life in the meantime.

Incontinence, the loss of bladder control or leaking of urine, can happen anytime in life, and is more common as we grow older. It is very common for people who have been pregnant or given birth at one point in their life. Over 45% of cis women will experience incontinence at one point in their lives. Pelvic floor conditions (which can be a result of surgery, pregnancy and childbirth, and other medical conditions) can also cause lower back pain, pelvic pain, and pain during sex. All of this impacts the sex we are having – for instance, extra pressure on the bladder during sex can cause us to lose urine. We might feel worried, embarrassed, or in pain, all of which can lower our desire to have sex. Many people who experience incontinence see their libido go down because of it.

If you suffer from incontinence, know you are not alone, it’s very common. Talk to your health care provider about it as they can help diagnose the type of incontinence or the possible underlying condition causing it and then specialists like pelvic floor physiotherapists, gynecologists, urologists and sometimes, surgeons can help manage symptoms, recommend therapies or treat it.

Erectile dysfunction and other male sexual dysfunctions

Erectile dysfunction (ED) means being unable to get or keep an erection firm enough to have sex. Having trouble getting an erection from time to time isn’t necessarily a cause for concern – this can be completely normal, and many people will experience it if they feel stressed. But if it does become an ongoing challenge, it can cause stress, affect self-confidence, and contribute to relationship problems if it causes tensions. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and is a risk factor for heart disease. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.

Other types of male sexual dysfunction include premature ejaculation, delayed or absent ejaculation, anorgasmia (which means being unable to achieve orgasm after plenty of stimulation) a and lack of interest in sex.

You should talk to your healthcare provider if you have any of these symptoms, especially if they’ve lasted for two or more months. They can determine if your sexual disorder is caused by an underlying condition that requires treatment.

àThere are many possible causes for ED, and they can include both emotional and physical disorders. Some common causes are:

• cardiovascular disease
• diabetes
• hypertension
• hyperlipidemia
• damage from cancer or surgery
• injuries
• obesity or being overweight
• increased age
• stress
• anxiety
• relationship problems
• drug use
• alcohol use
• smoking

ED can be caused by only one of these factors or several of them. While we may feel awkward about bringing this up in the doctor’s office, it is important to talk about it as it can be a symptom of a condition that needs medical attention.