Think about sex day; Valentine’s Day 2014!

Are you thinking about sex? Maybe. Studies tell us that on average you will do 19 times a day if you’re a man, and 10 times a day if you’re a woman!

It’s normal!

What sort of thoughts? The more graphic thoughts I will leave to your imagination but there are numerous reasons why people will think about sex.

Let’s think of some of the less positive thoughts that may cause distress:-

– Sex is always painful

– I’m not getting enough sex

– I love sex but I’m not sure I’m any good

– Have a caught an STI (sexually transmitted infection)? HIV? Other?

– Sex brings back awful memories for me

– Where shall I get condoms/emergency contraception/sexual health checks from?

– Am I big enough?

– Do my genitals look odd? Am I normal? Is that a wart?

– Fears of pregnancy?

– I’m embarrassed to get help or ask advice


Please don’t sit alone worrying about these things. Often the worry is needless and reassurance is all that is required, but if not, help is out there.

If you’re not sure about what to do about your worry then preferably ask a health professional e.g. GP/practice nurse/local sexual health clinic. Book an appointment with us. Another alternative is to do your own research in books or on the internet but please take care that you use reputable sites.

Sex is normal. Thinking about sex is normal. Do it as often as you like. If you have sex make sure you do it safely.

The most important part is to not be shy or embarrassed but to come and ask. Remember we nearly all do it, think about it and worry about it at some time. If we didn’t then none of us would be here of course!

See below for some great helpful websites and resources


Sexual health – Live Well – NHS Choices

FPA – the sexual health charity | FPA

Symptom Checker, Health Information and Medicines Guide | |

Find Sexual health information and support services – NHS Choices


Have a good day!

The unwelcome memento…

Welcome to a new academic year at university!

Many of you will have enjoyed Freshers week or simply seeing your friends back in Bristol again..…perhaps there has been a bit more celebration than study? Alcohol can contribute to risk-taking behaviour that could lead to unwanted pregnancies and sexually transmitted infections.

A survey of 16 – 24-year-olds (Define 2008) found that after drinking alcohol

 •            One in seven have had unsafe sex (i.e. Not using a condom)

•             One in five had sex and later wished they hadn’t

•             One in 10 were unable to remember whether they had sex the night before

•             Many (40%) agreed that they would be more likely to have casual sex

How many of you are nodding in agreement..?

Worryingly, Public Health England (PHE) published data in June that showed that new sexually transmitted infection (STI) diagnoses rose 5% in 2012 to almost half a million….HALF A MILLION!!!!

Although in part due to improvements in data collection, the high STI rates in England suggest too many people are still putting themselves at risk through unsafe sex, especially young adults, and men who have sex with men (MSM). Does this include you?

Chlamydia remained the most commonly diagnosed STI (46%), but considerable numbers of genital warts (16%) and genital herpes (7%) cases were also reported last year. New gonorrhoea diagnoses rose 21%. Those aged under 25 experienced the highest STI rates, contributing 64% chlamydia and 54% of genital warts diagnoses in heterosexuals in 2012.

But “I don’t have any symptoms……so I am ok…..right?”


50% of men and 70-80% of women don’t get symptoms at all with Chlamydia infection.

You have up to a 1 in 10 chance of testing positive to Chlamydia!

 That’s why the National Chlamydia Screening Programme exists- its target is to control Chlamydia and its complications, which can include pelvic inflammatory disease (PID), ectopic pregnancy and infertility in women and epididymitis in men.

The advice is that sexually active under 25 year olds should be screened for Chlamydia EVERY year, and on change of sexual partner. Over the age of 25 you should still seek a test following any change in partner.


So “how can I reduce my chances of picking up an STI?”  Well, you could just stay home and study, but if that isn’t appealing then consider the following options.

 Recalling that many people with infections are unaware of their status, as they don’t have any symptoms (and therefore cant warn you), the best advice is therefore to  –

  • Reduce the number of sexual partners  you have
  • Avoiding overlapping sexual relationships
  • Always use a condom when having sex with casual and new partners
  • Get tested regularly if you’re in one of the higher risk groups (eg MSM)
  • Get screened for chlamydia every year (if aged under 25) and on change of sexual partner.


You can access testing through the Students’ Health Service- see the contraception and sexual health section on our website for more details. You can also pick up a self-testing kit for Chlamydia (and it also tests for Gonorrhoea too) in the practice- they are on the windowsills along the corridors and in the waiting room.

So make sure it’s a memorable start to the new academic year…for all the right reasons and that your not left with an unwelcome memento of that big night out!

Anything Goes

Just returned from a backpacking trip? I bet you have brought back lots of souvenirs, mementos, memories, photos, a lovely tan…? What about Chlamydia, Genital Warts, Herpes, or even HIV?

Yes that innocent looking, healthy, gorgeous person you had unprotected sex with may look like they are clean or may have reassured you they have no infections but how do you know? Some sexually transmitted infections (STIs) have no symptoms… (50% of men and 70-80% of women don’t get symptoms at all with Chlamydia infection), so if some people who have an STI don’t know they are infected- how do you know?

Sun, sea and sex can go hand in hand together with perhaps an increased alcohol intake- ‘beer goggles’ can cause misjudgements about people we sleep with abroad. Inhibitions are lowered and an ‘anything goes’ attitude is created. So you may have also brought back more than you expected from your trip in the form of an STI.

STIs are infections that are spread primarily through person-to-person sexual contact. Blood borne viruses e.g. HIV, Hepatitis B can also be transmitted from mother to child during pregnancy and childbirth, and through blood products.

Common infections include:

  • Gonorrhoea
  • Chlamydia
  • Syphilis
  • Chancroid
  • Human immunodeficiency virus (causes AIDS)
  • Herpes simplex virus 1 and type 2 (causes genital herpes)
  • Human papillomavirus (causes genital warts and certain other subtypes lead to cervical cancer in women)
  • Hepatitis B virus (causes hepatitis and chronic cases may lead to cancer of the liver)
  • Trichomonas

World Health Organisation stats:

  • 499 million new infections of curable sexually transmitted (syphilis, gonorrhoea, chlamydia and trichomoniasis) infections occur yearly. throughout the world with the largest proportion in the region of south and south-east Asia, followed by sub Saharan Africa, and Latin American and the Caribbean, in adults aged 15-49 years
  • Sexually transmitted infections are an important cause of infertility in men and women.
  • Drug resistance, especially for gonorrhoea, is a major threat to STI control globally.
  • STIs can increase the risk of HIV acquisition three-fold or more
  • Untreated gonococcal and chlamydial infections in women will result in pelvic inflammatory disease in up to 40% of cases. One in four of these will result in infertility
  • Herpes simplex virus type 2 infection is the leading cause of genital ulcer disease in developing countries. Data from sub-Saharan Africa show that 30% to 80% of women and 10% to 50% of men are infected. Among women in Central and South America, prevalence ranges from 20% to 40%. In the developing Asian countries, prevalence in the general population ranges from 10% to 30%. In the United States of America, the prevalence of the HSV 2 infection among 14–49-year-olds is 19%
  • Hepatitis B virus results in an estimated 350 million cases of chronic hepatitis and at least one million deaths each year from liver cirrhosis and liver cancer.

Condoms Condoms Condoms!

Think about your sexual health (and contraception) before you go, especially if you are visiting one of the higher risk countries on your travels, and always insist on using a condom! Using a condom greatly reduces your risk for an STI or unwanted pregnancy.


Take a supply of UK kite mark condoms, which you can obtain here at SHS, and take care with latex condoms as these can be damaged with oil based lubricants- Vaseline, sun screen etc… Take an adequate supply of contraception or emergency contraception as these may not be easily obtained in certain countries.

Watch your alcohol and drug intake too, as an increased consumption of these may lead you to having unprotected sex. Think about having a hepatitis B vaccination course before you travel.

Remember it takes only one episode of unprotected sex to leave you with an STI, unwanted pregnancy or HIV.

If you have had unprotected sex whilst away- book into SHS or your local sexual health clinic for a full STI screen.

Remember that some STIs don’t have any symptoms so it’s always worth having a check up on your return.

If you do develop any symptoms don’t worry, just book an appointment to get yourself checked out.


Contraception; your options!

Dear students, and in particular those new to the university and Bristol.

Welcome! You have picked a great city and it’s an exciting time for you all. Parties, Fresher’s week, new friends, often your first time away from home and a new course to get stuck into.

First let me introduce myself. I am Dr Tim Percival; lead GP for contraception at the Students’ Health Service (SHS). I felt it was a good time to get the message out to you all regarding your choices, what we can offer and trying to correct some of the common misconceptions regarding contraception.

We have comprehensive facilities to manage the vast majority of all contraception and sexual health issues from:-

  • Choosing the right contraception and sorting subsequent problems
  • Diagnosis and treatment of sexually transmitted infections (STI’s)
  • Taking cervical smears (if over 25 years)
  • Providing condoms and pregnancy tests free of charge
  • Generally helping you with any symptoms and problems ‘down below’.

We pride ourselves on being approachable and friendly, and we take confidentiality very seriously. So please just come and talk to us!

It is commonly thought that the contraceptive pill and condoms are the ‘usual and only’ options.Condoms are good protection from STIs and are a relatively safe method of contraception but ONLY IF USED CONSISTENTLY AND CORRECTLY.

The pill is a very good option too, especially for those that like good control of their periods. It is a misconception that the pill makes everyone put on weight and become very ‘hormonal’…this is unusual. It is also not a problem to continue the pill long term if you’re fit and healthy.

Longer Acting Reversible Contraceptives (or LARC’s) are becoming very popular for good reason. They give you the benefit of highly reliable contraception that is not prone to ‘user failure’ i.e. ‘had a few heavy nights and forgot my pill’! They are also statistically better at preventing pregnancy. The options are:-

  • Contraceptive implant called nexplanon,
  • Contraceptive injection or depo
  • Intrauterine devices i.e. the copper or hormone coils.

Let’s take each of these in turn and try and dispel some common misconceptions!


  • Injected into inner upper arm where can’t be seen and releases hormone slowly
  • Lasts 3 years
  • Generally a simple insertion and removal with at most mild pain from small anaesthetic injection similar to vaccination
  • Very highly effective
  • Low risk hormonal side effects


  • Injected invisibly into upper buttock and hormone released slowly
  • Lasts 3 months
  • Mild pain from injection similar to vaccination
  • Very highly effective


  • 2 types 1) copper (IUD) and 2) Mirena (Hormone IUS).
  • Copper IUD lasts 10 years, has no hormones but can make periods slightly heavier so good for any of you with lighter periods
  • Mirena IUS lasts 5 years, has very small amounts of hormone that works locally in the womb to lighten periods so good for those with heavier periods
  • Both very highly effective
  • Can be fitted even if not had children!
  • Can be fitted at Students’ Health
  • Do not make you infertile in the long term (only when device in place!!)
  • Usually mild-moderate period like cramps during fitting. Usually not significant pain during insertion as commonly believed


Please remember that none of the above methods protect you against STIs so make sure you also use a condom unless:-

  • with a regular partner,
  • AND you have both had comprehensive STI screening
  • AND you are using an alternative contraceptive method e.g. pill/coil/implant etc.

 If you do have unprotected sex then please see us ASAP for emergency contraception. If we are not open chemists, A+E departments and sexual health clinics can also supply this for you. If you do get pregnant and don’t want to be please try not to panic and see us for advice on your options.

Hope this is helpful. Look forward to meeting some of you. EnjoyBristol!

Dr Tim Percival

GP Students’ Health Service