Sexual Health

We provide all aspects of sexual health: contraception (including implant and intrauterine system - insertion and removal), as well as STI testing and treatment.

We hold a stock of UK oral contraceptive pills and other devices, which are not easily available in Spain.
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SEXUAL HEALTH

At Club de Mar Medical, we are pleased to provide a comprehensive range of sexual health services suited to our highly mobile patient population.
Our services are friendly, discrete and fully confidential.

We offer a full range of contraception and sexually transmitted infection advice, screening and treatment. Our aim is prevention and peace of mind. We are supported by an accredited laboratory and a wide network of secondary care specialists.



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Certain types of the Human Papilloma Virus (HPV) are “high risk” and can lead to the development of cervical abnormalities and possibly cervical cancer.

Most women carry HPV at some time in their life and it causes no symptoms. The body often clears the virus on its own before any problems occur. There is no way of knowing when you caught the virus as it can lay dormant for years. In women 30 years and older, HPV testing is a helpful and more advanced way of assessing your risk for developing cervical abnormalities or cervical cancer along with the traditional smear test. For women under the age of 30, the virus is often present, but does not persist to cause problems, testing for the virus if your smear test is normal, is not recommended. We recommend screening for “high risk” types of HPV only. It is important to remember that having a positive HPV test does not mean you will get cancer, but it increases your risk of the disease so it is important you attend all your cervical screening invitations.

Why have cervical smears?
Around 1000 women die from cervical cancer in England each year*. This is a very sad statistic as cervical cancer can be prevented in many cases. Cervical smears detect changes in the cells of the cervix, the mouth of the womb. These changes often turn out to be nothing, but in some cases, can progress to cervical cancer. In the NHS, it is recommended to have cervical smears every 3 years between the ages of 25 and 50 and every 5 years thereafter. We offer cervical smears to all females aged 20 and above.
What does the test involve?
A cervical smear test takes about five minutes. An instrument is inserted in your vagina to gently hold it open. A nurse or doctor will use a small brush to take a sample of some cells on your cervix. The sample will be sent to a laboratory for examination under a microscope.
We screen the cells themselves for abnormalities and in women above the age of 30, for high risk types of the HPV virus inside the cells. Between the ages of 20 and 30, we screen all smears where the cells appear abnormal for high risk HPV.
How soon can I have this test after unprotected sex?
It is not clear how long an HPV infection takes to develop and therefore, no recommendations about the best time to have the test after having unprotected sex. It is important to have regular cervical smears and to attend when invited.
How do I prepare?
Smears cannot be taken during a menstrual period and the best time to have one is around the middle of your cycle. We recommend that you avoid using spermicides, lubricants, pessaries and ointments for a few days before the test.
How soon will I have a result?
Your result will be back in 5-10 working days. Please call after that time period for your results.
What if I test positive?
It is important to remember that having a positive HPV test does not mean you will get cancer. HPV can your risk of the disease, so it is important you attend all your cervical screening invites. Our Doctor will provide you with a copy of your results to show your GP or Practice Nurse.
If your test is negative:
This is reassuring and indicates a low risk. You should continue to have regular smear tests to monitor any new changes.
If your test is positive:
Your doctor will discuss the results along with the smear results with you. You may need to have very regular smear tests or be referred to a gynaecologist for a further investigation colposcopy. Having a positive test does not mean that you have cervical cancer, but allows us to monitor and investigate further as your risk of cancer is higher.
How can I protect myself against HPV in the future?
HPV is transmitted through intimate skin to skin contact. HPV can be present in all genital areas and it is therefore not possible to prevent catching HPV by wearing condoms. Despite this, condoms are always a good idea as they will help to prevent transmission of a wide range of sexually transmitted infections.
If your test for high risk HPV was negative, you will be eligible for vaccination. We offer vaccination with Gardasil® which protects against the high risk types of HPV and some strains which are associated with genital warts. Gardasil is also available to males. Vaccination is not a substitute for routine cervical screening. * (WHO report – HPV and related cancers - Summary Report Update. September 15, 2010)
A Sexually Transmitted Infection (STI) is an infection passed on between people during sexual activities such as vaginal, anal and oral sex and through sharing sex toys.
There are several viruses, bacteria and fungi which cause a range of infections such as HIV, Hepatitis B, Herpes, Chlamydia, Gonorrhoea and Genital Warts. Some infections such as Genital Warts (HPV) and Herpes (HSV1 and 2) can spread through skin to skin contact as well.
Some sexually transmitted infections can be transmitted through the sharing of needles, tattooing with unsterilized equipment and blood transfusions where the blood has not been properly screened. In the UK, all blood and blood products are screened for HIV, Hepatitis B, Hepatitis C and Syphilis.
Facts
Despite the wealth of public information about STIs and the importance of protection, the rates of STIs remain on the increasing trend. This is partially due to a greater increase in people getting tested as well as more people having more risky sex, with perhaps more than one partner. The highest risk groups remain the 15 to 24 year olds and men who have sex with men.* The most important way to limit the transmission of STIs is by using protection, of which condoms are the best method. It is also important to get tested regularly. *HPA report - Sexually Transmitted Infections in England 2008-2010.

Tests.
We offer testing for a wide range of sexually transmitted infections (STI). Our tests are analysed by our fully accredited specialist laboratory and we guarantee a result within 2-5 working days. During your visit, you will be seen by one of our experienced Health and Wellbeing Doctors who will discuss your tests. One of our team of doctors will be in touch to discuss your results.
HPV Vaccination
The Human Papilloma Virus (HPV) is a very common virus which spreads through intimate skin to skin contact.
There are many different types of the virus, some can cause warts and certain types are “high risk” and can lead to the development of cervical abnormalities and possibly cervical cancer. Most people carry HPV at some time in their life and it causes no symptoms. The body often clears the virus on its own before any problems occur. There is no way of knowing when you caught the virus as it can lay dormant for years.
We offer a vaccine called Gardasil® which protects against the main high risk types (16, 18) as well as 2 common low risk types (6, 11) which have been associated with genital warts. Who can have HPV vaccination?
Everyone* between the ages of 18 and 45 (males and females) can have the vaccination. Safety in pregnancy has not been established and we therefore do not recommend vaccination during pregnancy.
Gardasil is for preventative use only and has no effect on active HPV infections. Gardasil has not been shown to have a therapeutic effect and is therefore not indicated for treatment of cervical cancer, genital warts or other established HPV-related conditions.
Vaccination is not a substitute for routine cervical screening. Since no vaccine is 100% effective and Gardasil will not provide protection against every HPV type or against existing HPV infections, routine cervical screening remains critically important. Vaccination will also not protect you against any other sexually transmitted infections.
What will happen?
You will receive 3 injections over a 6 month period (0, 2 and 6 months). The injection is into the upper arm or buttock.
How do we make sex safer?
By having safer sex we aim to reduce the transmission of sexually transmitted infections and unplanned pregnancy.
Barrier methods - especially condoms remain the most effective method of reducing the risk of catching STIs. Common barrier methods include male and female condoms, dental dams and gloves. Sex toys can also be covered with condoms and it is important to change condoms or wash devices before it is used by another partner. Oil based lubricants and oils used during foreplay and sex can break down some condoms and reduce their protective properties. Non-penetrative activities such as mutual masturbation, kissing, hugging and massage carry a reduced, but not zero risk of catching or transmitting an STI and causing pregnancy.
At risk groups may benefit from vaccination to protect against Hepatitis B and in some cases Hepatitis A (such as sex workers, men who have sex with men and individuals who frequently change sexual partners).
HPV vaccination may also protect against certain strains of the virus linked to genital warts and cervical abnormalities. The vaccination is most successful when given before someone becomes sexually active.
You can reduce your risk of catching an STI if you have sex with fewer partners.
Regular testing for STIs reduces the incidence of infection. It is important to be tested before starting a sexual relationship with someone new and to encourage all parties to be tested. Risky sexual behaviour such as unprotected sex is more likely to occur under the influence of alcohol or drugs and it is important to be prepared if you expect to be in such a position so that you can protect yourself and others.
Preventing pregnancy
Contraception such as the birth control pill, vasectomy, tubal ligation, implants and contraceptive coils offer good protection against unplanned pregnancy. Diaphragms, contraceptive foams and gels, sponges and other methods such as the rhythm method and early withdrawal are less safe. None of the above methods of contraception offer any protection against catching STIs and condoms should still be used.
Anal sex
Anal sex remains the most risky of sexual activities. The skin and lining of the anus and rectum are delicate and easily torn, allowing bacteria and viruses including the Human Immunodeficiency Virus (HIV) to pass between those engaging in unprotected anal sex. There is also less natural lubrication which makes condoms more likely to break.
To reduce the risk of infection:
Make sure the anal area is clean and the bowel is empty If any pain occurs at any point, stop and withdraw A condom is always the best method to reduce the risk of infection and should be used to cover sex toys as well There is no evidence that stronger or thicker condoms are better or safer for anal sex.
Use generous amounts of a water based lubricant.
If a man has performed anal sex on his partner, it is important that he cleans his penis before penetrating the vagina or mouth of his partner. Bacteria from the rectum are easily transferred to the partner causing infections.
Anal to oral contact (“rimming”) can transmit infections including Hepatitis A as well as other infections caused by bacteria present in the bowel. A dental dam can help to reduce the risk.
Oral sex
Oral sex carries less risk of transmitting STIs than unprotected vaginal and anal sex, with the person receiving oral sex at the lowest risk (except for Herpes).
Oral sex includes activities such as cunnilingus (stimulation of the female genitals), fellatio (stimulation of the male genitals) and “rimming” (stimulating the anus). The most commonly transmitted infections during oral sex are Herpes, Gonorrhoea and syphilis. Transmission of chlamydia, HIV, Hepatitis A, Hepatitis B, Hepatitis C, Genital warts and Pubic lice is also possible, but rare.
To reduce the risk of infection:
Avoid oral sex if you or a partner have an STI, have sores, blisters, warts or rashes around the genitals, anus or mouth, have inflamed piercings in the mouth or genitals or have a throat infection.
Use condoms and dental dams.
Avoid brushing or flossing your teeth before or after giving someone oral sex.
Sex toys.
If you and your partner use a sex toy, it is a good idea to cover it with a condom. Replace the condom each time the toy is shared between you and your partner. Some toys are made of materials which can trap and hold bacteria and viruses. It is very important that all sex toys are thoroughly washed and disinfected prior and after use by each person. It’s a good idea to use cleaners that are specifically made for cleaning sex toys. Sex toys made out of glass and other non-porous materials are more easily cleaned and sterilised between uses than some other materials. Some sex toys such as whips, needles, restraints and other similar devices can draw blood and allow transmission of certain infections.
Condoms.
When used correctly, condoms offer nearly complete protection (98%) against pregnancy and certain sexually transmitted infections. There is no evidence that stronger or thicker condoms are better for anal sex, but extra lubrication is recommended to reduce the risk of the condom breaking. Female condoms offer nearly the same protection as male condoms against infection and approximately 95% protection against pregnancy.
The condom should be put on when the penis is erect and before it comes into contact with the vagina, mouth or anus.
Condom packaging should be kite marked (a mark of safety and quality) and within date. Use male condoms that easily fit the erect penis – tight condoms are more likely to tear.
Examine the packaging and condom itself for tears before use. There is no evidence that stronger or thicker condoms are better or safer for anal sex. Polyurethane condoms are an alternative for latex allergy sufferers. Condoms should be discarded after sex and not reused. Condoms should be stored where they cannot be damaged by strong heat, sharp objects, light or damp.
More information can be found on the Family Planning Association (FPA) website: www.fpa.org.uk.