The Doctor is In (Take 2)

Talking sex with your doctor isn’t always easy. Whether you are afraid she or he will judge you,  you just don’t feel comfortable sharing the intimate details of your life between the sheets, or you can’t think straight with a speculum between your legs, many people get tight lipped in the doctor’s office. But that doesn’t mean you don’t have questions.

We took the embarrassment (and speculum!) factor out of the equation and asked you, the CollegeCandy readers, to submit the questions you had regarding STDs and sexual health to our new pal, OB/GYN Dr. Lissa Rankin. Check out the first batch of questions she answered and get the rest of the info below:

1. If you have a high risk strain of HPV and so does your current partner, will my chances of it progressing to cervical cancer increase if we do not use a condom, and just use birth control? I am positive he is also monogamous.

Bummer about the HPV, but rest assured, you’re so not alone. As many as 80% of sexually active young people will test positive for HPV, even in the absence of symptoms.  If you and your partner already have a high risk strain of HPV and you’re both completely monogamous, using a condom probably won’t help you unless there are other strains of HPV or other STDs that the two of you have not already transmitted to each other.  Whether or not your high risk HPV leads to precancerous changes of the cervix, or worse, cervical cancer, has much more to do with how well your immune system functions.  The best thing you can do to avoid cervical cancer once you have high risk HPV is to eat a whole foods, healthy diet, exercise regularly, get enough sleep, take a multivitamin, manage your stress in healthy ways, and generally take good care of your body – all things that strengthen your immune system.  If you have access to an integrative medicine physician or a naturopathic doctor, there are herbal formulas that can help your body naturally fight the HPV. 

2. I would like to get a general STD test. However, I’m on a budget. I don’t want to spend money on a test because my mom will probably find out, and if I use my insurance my mom will probably find out! What can I do?
You can call your local public health clinic. Most offer free, anonymous STD testing, so your mother never needs to know (although, as a Mom myself, I highly encourage you to talk to your mom if you have a good relationship. You might be surprised how much we moms want to help, if we can get over our own embarrassment. Sometimes we need a good kick in the pants from our kids.)  Also, if you don’t have access to a public health clinic, donate blood. They won’t test for everything (like gonorrhea, chlamydia, or HPV), but it’s free, and you will be screened automatically for all blood-borne STD’s, such as HIV, hepatitis B & C, and syphilis.  If anything comes back abnormal, they will contact you to let you know.

3. What are the options for testing and the costs? Can you get anonymously tested?
There are many STDs, such as gonorrhea, chlamydia, syphilis, hepatitis B and C, HIV, herpes, HPV, trichomonas, and pubic lice (crabs).  For most of them, you can be tested, through blood tests, urine or cervical testing, or visual inspection, depending on the type of STD.  Costs vary depending on the facility and your insurance coverage.  If you have health insurance, testing is covered much of the time.  If not, you can usually get free, anonymous testing at your local public health clinic.  But remember that peace of mind (and good health) is money well spent.

4. Is it okay to lie to your doctor with the famous “How many partners have you had” question?
As one of those doctors, I’m reluctant to say, “Sure, go ahead!  Lie to your doctors!”  After all, we’re here to be your friend, confidante, health-partner, and advisor – not a judge or the morality police.  That said, let me try to answer your question very honestly.  What we’re really looking for is a sense of how much risk you’ve assumed in your sexual life.  If you tell me you’ve had 101 partners by the time you’re 19, I’m gonna assume you haven’t been uber-careful, and I’m going to look very carefully for the kinds of health issues that accompany high risk behaviors.  (Not to mention, I’m going to worry about your self-esteem and wonder why you might be needing so much external validation, when the only place you can really find it is within).

On the other hand, if you tell me that you’ve only had one or two partners, it changes how I will care for you.  And if you’re nineteen and you’ve never had intercourse, it makes a big difference. I probably won’t even subject you to a pap smear yet, since, unless you’re having problems, you really don’t need one until you’re either 21 or sexually-active, whichever comes first.

But whether you’ve had 6 or 8 partners?  Whether you’ve had 23 or 31 partners?  To be honest, it really isn’t that important.  So if you’ve only told your boyfriend about 4 of your partners and there’s this one other you don’t want to admit to your doctor in front of him, go ahead and lie.  (Yikes, I can’t believe I just said that!)  But keep it in the ballpark.  That way we can optimize the kind of health care we provide for you.  But don’t bother wracking your brain to make sure you get the number exactly right.

Why Everyone Should Get Tested
Why Everyone Should Get Tested
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