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Sex: questions you may ask
Sex is not compulsory.
Whenever you decide to have sex with someone it should be your choice and most people would see sex as the natural progression of a loving relationship. Although the majority of sexual relationships are heterosexual (man/ woman), some people find they are attracted to people of the same sex. And that’s OK too. A gay or lesbian relationship can be as fulfilling and loving (and as permanent) as any other. Unfortunately, some people make stupid jokes about homosexuals - difficult though it is, just ignore them...and hope that they soon mature! Remember that if you are at a party and have had a few drinks your judgement could be affected and you could end up having sex with someone and regretting it later. If you have not made a considered decision to have sex you could also be unprepared and risk pregnancy or a sexually transmitted disease. Make sure you always use effective contraception.

What kind of contraception should I use?
There are many methods of contraception available, some safer than others. Whatever you choose, it is important to use an effective contraception method. Using a condom with or without a spermicidal barrier cream is a way of protecting yourself against a sexually transmitted disease including AIDS/HIV and is an effective method of contraception. If you, or your partner, have spina bifida you should ideally be using latex free condoms, eg “Avanti” which are made by Durex and available from most chemists or Family Planning Clinics. There are many myths concerning

Sex: questions you may ask
contraception and they are not to be believed. Remember – you can get pregnant the first time. • pain and/or bleeding during intercourse • bleeding after sex and/or between periods Be aware that some STIs show no symptoms at all. Most STIs can be completely cured if they are diagnosed early enough. Usually a short course of antibiotics will clear them up. But if you have an STI and ignore it there is a risk that you can cause permanent damage to your health and fertility. If you do not wish to speak to your GP about this, you could go to one of the NHS drop in centres, or your nearest Family Planning Clinic. There is a low cost Family Planning Association helpline number available Monday to Friday 9 am to 6 pm – 0845 122 8690.

Sexually transmitted infections (STIs)
STIs are passed on through bodily fluids, like saliva, blood and sexual fluids (eg sperm). You catch an STI by having sex or oral sex with someone who’s infected. The best way to avoid STIs is by using a condom when having sex and this includes oral sex. If you think you have acquired an STI you should seek medical advice immediately. These are some STIs you may have heard of: chlamydia, genital herpes, AIDS, HIV, pubic lice, syphilis and gonorrhoea (sometimes referred to as the “clap”) Common symptoms of STIs: • pain or burning when you pass urine • itches, rashes, lumps or blisters around the genitals or anus

Sex and Continence
To prevent any “accidents” during intercourse make sure your bladder and bowel are empty beforehand. If you use clean intermittent catheterisation, do so prior to intercourse – this can sometimes interfere with the spontaneity of the moment but does reduce the risk of any embarrassing situations!

If you have an indwelling catheter, you can still have penetrative sex. If you are male you should be wearing a condom anyway, and so the condom will go over the catheter. Make sure you empty your bag first and use a spigot or bung in the end of the catheter tube where the bag is usually attached. If you are female, again empty the bag and place a spigot or bung where the bag usually goes. Then tape the catheter to the inside part of your thigh – this will keep it out of the way. If you are able to catheterise yourself you can just remove the catheter and then replace it with a new one when you have finished.

to the general population and is only available on prescription. Many pregnancies are unplanned and accidental pregnancies do occur, so if your have started having sex speak to your GP about folic acid. Further reading: Sex and spina bifida a leaflet for men Sex and spina bifida a leaflet for women

Useful contacts
www.fpa.org.uk www.teenagehealthfreak.org www.tht.org.uk www.embarrassingproblems.com Sexwise: 0800 282930 NHS Direct: 0845 4647 FPA: 0845 3101334

Remember Folic acid!
It is recommended that all women of child bearing age take a daily supplement of folic acid to reduce the risk of having a baby with a neural tube defect (NTD) eg spina bifida. If you or your partner have spina bifida your chances of having a baby with a NTD are increased. To reduce this risk, it is recommended that women in this higher risk group take a daily 5mg supplement of folic acid for at least one month prior to conception, and until the 12th week of pregnancy. This is a higher dose than that which is recommended

Help us
Shine relies on people’s generosity and support so we can help our clients who depend on us for help and advice - people with hydrocephalus, spina bifida, their families and carers. To donate to Shine please visit www.shinecharity.org.uk or call 01733 421329. This information has been produced by Shine’s medical advisers and approved by Shine’s Medical Advisory Committee of senior medical professionals. Shine - Registered charity no.249338 To see our full range of information sheets and to find out how to donate to Shine please visit www.shinecharity.org.uk

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