GENERAL HEALTH AND SEASONAL

I had unprotected sex – what should I do?

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If you’ve had unprotected sex, taking action now can protect your health today and in the future.
If you’ve had unprotected sex, taking action now can protect your health today and in the future. Dr Samuel Menon, Lead GP at Livi, shares the key steps to take

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Whether your method of protection failed or you didn’t use anything, don’t panic – unprotected sex happens.

‘If you’ve had unprotected sex, there’s always the possibility of pregnancy and sexually transmitted infections (STIs). Although this can be a scary situation, there are help and options available,’ says Dr Samuel Menon, Lead GP at Livi.

Here are some steps you can take to avoid unwanted pregnancy and look after your sexual health.

First of all, what exactly counts as unprotected sex?

When they’re used the right way, condoms and other barrier methods play a key role in protecting you against pregnancy and STIs. Unprotected sex usually means sex without any form of contraception or condom, but sometimes a condom may break or come off during sex, or it might not have been used correctly or forgotten altogether.

What to do straight after unprotected sex

Empty your bladder

Though it won’t protect you from contracting an STI, peeing after sex can help to reduce your risk of getting a urinary tract infection (UTI). Although UTIs can occur in both sexes, women are 30 times more likely to get a UTI than men.

‘Peeing helps flush out bacteria before it’s able to get into the urethra and other parts of the urinary system,’ says Dr Menon. ‘This is particularly important for women who are more susceptible to UTIs after sex.’

What to do the next day

Consider emergency contraception

If you’re not using any form of hormonal contraception and an unplanned pregnancy is a concern, you can take emergency contraception. There are 2 types of emergency contraception:

The emergency contraceptive pill, often known as the morning-after pill The copper intrauterine device (also called the IUD or coil)

There are 2 kinds of the morning-after pill, which work by stopping or delaying the release of an egg (ovulation). Levonelle should be taken within 72 hours (3 days) of sex, and ellaOne should be taken within 120 hours (5 days) of sex to prevent pregnancy. ‘The effectiveness of the emergency pill depends on how soon after unprotected sex you take it,’ says Dr Menon.

‘The IUD is the most effective way to prevent pregnancy, and it’s also the most effective form of long-term contraception,’ advises Dr Menon. ‘It must be inserted by a health professional within 5 days of unprotected sex, and like all emergency contraceptives, it is more effective the sooner you have it.’

Right now, only the copper IUD is available for emergency contraception. But when it comes to long-term contraception, you can choose either the copper or hormonal IUD.

You can get emergency contraceptives free from some doctor’s surgeries and sexual health clinics. The emergency contraceptive pill is also available from some pharmacies.

Speak to your doctor about HIV exposure

‘If you’re concerned that you may have been exposed to HIV, contact a doctor or sexual health clinic as soon as possible because you may be suitable for post-exposure prophylaxis (PEP), a short course of medicine that can dramatically reduce the chance of HIV infecting your body after you’ve been exposed to it,’ says Dr Menon.

For PEP to work, it must be started within 72 hours – and it works best if taken within 24 hours. It’s estimated to reduce the chance of HIV infection by at least 80%.

Take stock of how you’re feeling mentally

Make time to check in with yourself, because it’s normal to experience a wide range of emotions after unprotected sex. Share how you’re feeling with a trusted friend or member of the family. They can listen to you, offer support and help you think your options through. Or arrange an appointment with a doctor, who’ll be able to offer advice on counselling or recommendations for organisations that can help.

What to do 2 weeks to 1 month later

Take a pregnancy test

The only way to know if you’re pregnant is to take a pregnancy test. The earliest sign of pregnancy is often a missed period. You may also experience tender, swollen breasts, feel sick and experience mood swings.

‘Taking a test at least 3 weeks (21 days) from the last time you had unprotected sex or on the first day of your missed period will give you the most accurate result,’ says Dr Menon.

You can buy a reliable home pregnancy test from a pharmacy and most supermarkets, or get a free test and confidential advice from a doctor or sexual health clinic.

Get tested for STIs

Look out for signs of an STI ‘If you develop symptoms of an STI, get yourself tested immediately,’ says Dr Menon. Symptoms and signs of an STI include:

  • Unusual discharge from the vagina, penis or anus
  • Pain during sex
  • Pain when ejaculating or peeing
  • Lower tummy pain
  • Unusual vaginal bleeding
  • Blisters, sores or warts around your vagina, penis or anus

Whether you’ve experienced symptoms or not, it’s best to get tested after unprotected sex because some STIs produce no symptoms at all.

Waiting 2 weeks after unprotected sex to take an STI test will provide more accurate results. This is because all STIs have a window period.

The most common STIs with a window period of 2 weeks include:

Chlamydia

Look out for an unusual discharge from the vagina or penis, and vaginal bleeding after sex and between periods, pain when peeing and pelvic pain in women. If left untreated, chlamydia can lead to pelvic inflammatory disease (PID), which can cause infertility. Screening is done through a urine or swab test.

Gonorrhoea

Symptoms include pain when peeing and green or yellow discharge from the vagina or penis. Less commonly, it can affect the eyes and throat. Testing is done through a urine or swab test.

‘Virtually all STIs are treatable,’ says Dr Menon. If you’re feeling nervous about getting tested, ask a friend to go with you. Free STI testing is available at sexual health clinics.

What to do 2 to 6 months later

Get another STI test

‘There are some STIs that take longer to detect. During this period, it’s important not to have unprotected sex with anyone,’ says Dr Menon.

Common STIs that are tested for at a later stage include:

Syphilis

You can be tested for syphilis after 3 months. Symptoms may include painless sores or ulcers on the vagina, penis, anus or mouth, followed by a rash and flu-like symptoms. If left untreated, syphilis can cause long-term health problems. A blood test can diagnose syphilis.

HIV

You can be tested for HIV after 45 days. Although there are often no or minimal symptoms in the first few years, the infection weakens the immune system and can lead to more serious conditions, including tuberculosis and cancers such as lymphomas. Testing is done by taking a blood or saliva sample.

How can I protect myself next time?

If you’re sexually active, there are some steps you can take to protect your sexual health and prevent pregnancy:

  • Always have a supply of condoms or barrier methods available
  • Check the expiration date on the condom wrapper or box
  • Take good care of your condoms: keep them away from heat and light, and don't open them with anything sharp, such as scissors or teeth
  • Choose condom-friendly lubricants – oil-based lubricants can damage the latex of the condom, causing it to rip
  • Consider the right size of condom to avoid slippage or breakage. If you’re not sure about the size, try a variety pack
  • Clean sex toys after every use. If you’re sharing toys with different partners, cover them with a new condom each time because they can pass on STIs and infections
  • Think about regular STI testing

What should I do if I’ve been sexually assaulted?

If you’ve been sexually assaulted, it’s important to remember that it isn’t your fault. If you’re in immediate danger, you should call the police.

Sexual assault includes being physically forced or emotionally manipulated into any sexual act without your consent. This includes a partner deliberately removing or damaging a condom during sex without telling you.

You can report sexual assault to the police by dialling 999 or 101 or by visiting your local police station. You can also report it online. Alternatively, confidential medical and emotional support is available at sexual assault referral centres (SARCs).

This article has been medically reviewed by Dr Samuel Menon, Lead GP at Livi.

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