Sexual health can be a tricky topic to bring up - which is why we called in the experts. Photo / Getty Images
Sexual health can be a tricky topic to bring up - which is why we called in the experts. Photo / Getty Images
Around 180 people get diagnosed with cervical cancer in New Zealand every year
Roughly 85% of those people have either never been screened or have not had regular screening
Death caused by cervical cancer has decreased by more than 60% since the National Cervical Screening Programme was introduced
OPINION:
It was only a few weeks back that I was engaged in one of my frequently enjoyed kitchen conversations with my friends about sex, love and other mysteries when I was reminded of an appointment I had forgotten to pen to the calendar.
I was seeing my doctor for a sexual health check-up this week.
I announced this to the room and in return received a flurry of confused stares.
“What?”, asked one of my closest friends. My revelation had caught her off guard, her confusion had caught me off mine.
As a 25-year-old who is on oral contraception, has sex occasionally (sometimes regularly) and has a mild case of hypochondria - I thought everyone did.
This is when I made a startling realisation: It’s 2024 and women are still afraid to ask questions about sexual health.
I asked 10 of my closest friends (between the ages of 21 and 26) if they had ever visited a gynaecologist or GP to discuss their sexual health. Of the ten women I spoke to, four said they hadn’t.
So I decided to take it to the professionals and ask how and when we should be monitoring our sexual health.
At what age should I start monitoring my sexual health?
“At your sexual debut”, says Dr Devashana Gupta from Auckland Gynaecologists Group.
Sue Claridge from Auckland Women’s Health Council reiterates this. “Pretty much from puberty. But it’s got to be a staged thing”, emphasising the importance of puberty and period education for girls at a young age.
Dr Danielle Jones, an obstetrician and gynaecologist in Southland, believes that monitoring your sexual health should start with conversations.
“I actually think all the way from preschool we should be teaching kids health”, she says, adding: “And that includes progression through puberty and understanding of development at an age-appropriate level.”
Why are there so many misconceptions about women's sexual health? Photo / 123rf
Why isn’t it common knowledge?
“There’s still a lot of taboos around women’s sexual health and women’s genitalia and sex”, says Claridge.
Sexual health has “historically been a taboo subject”, says Dr Jones. “There’s a lot of unnecessary controversy over sex ed and talking about all of the things that fall under that umbrella, particularly for women and AFAB (assigned female at birth) people.”
But if speaking about sexual health is still accompanied by a cloud of embarrassment and shame, how can women and AFAB people get access to the information and care they need?
While monitoring your sexual health comes with a long list of benefits, a big one is keeping informed about your body and its processes.
“The lack of education makes it really hard sometimes for people to know when something is not normal”, says Dr Jones. “Sometimes we don’t know what we don’t know.”
What’s helpful, she says, is “just having that open line of communication, either with a sexual health clinic or GP or both.”
Claridge agrees, saying: “What women really need to know is how their body works.
“There’s a lot of mythology and misinformation so it’s really important that girls from a young age know what to expect, understand what’s normal, and what they need to do for themselves.”
Dr Gupta says, “If you’ve never been sexually active, obviously doing a STI or sexual transfer infection screen is not necessary but if you are in between relationships, then it is important to get one done just so that you can tell your new partner that you are clear of infections and vice versa.”
Dr Jones adds: “Everybody who is sexually active should have STI testing every year unless they are in a long-term, monogamous relationship, and sometimes even then.”
Contraception
Another important reason to keep in the know regarding your sexual health is to get advice on contraception, which Dr Gupta says is “crucial”.
Conversations and prescriptions for contraceptives are freely available to young girls, says Dr Gupta, adding that a lot of advice doesn’t need parental consent.
“While we do encourage parents to be involved, if there is a situation where they think they aren’t able to get their parents involved, they are able to get the appropriate medical advice, medications or any contraception that they would need”, says Dr Gupta.
She adds: “If I feel like they will have intercourse and they’ll have unprotected intercourse, have an unwanted pregnancy or an STI, we can give that advice. We can give that prescription.”
Cervical screening
Cervical screening - or a pap smear - is used to identify abnormal cells in the cervix that could potentially become cancerous. Knowing when, where and why you need to get a pap smear is important for a number of reasons.
Early diagnosis of cervical cancer not only gives patients a better chance at a cure but can prevent it from forming altogether, says Claridge.
Interestingly, pap smears are the only type of screening that “can actually prevent invasive cancer”, she says, by detecting changes in the cervix early - another reason why monitoring your sexual health is crucial.
A simple change in how doctors go about cervical screening hopes to see more people coming in the door for check-ups and reduce the “fear” aspect that often accompanies getting a pap smear. Photo / 123rf
When should I get a pap smear?
New Zealand’s cervical smear guidelines have seen an update recently, with the Ministry of Health changing the recommended check-up age from 21 to 25.
What’s more, a simple change in how doctors go about cervical screening hopes to see more people coming in the door for check-ups and reduce the “fear” aspect that often accompanies getting a pap smear.
Dr Gupta says, “We used to start with the cervical smear, or pap smear as it’s known by most people in the lab world. But now that’s moved to the HPV self-test swab. So that’s going to make it a lot more available.”
Reflecting on why people don’t get screened, Dr Gupta thinks it’s because of the uncomfortable pap smear process. “It’s not a nice speculum exam”, she says. “But the fact that you can now just self-administer and do a swab, which gets sent to you in your home when you do it in your own privacy, it’s going to make it much more widely utilised.”
Should I see a gynaecologist or a general practitioner?
Your “first port of call” when monitoring your sexual health, says Dr Gupta, should be to pop into your general practitioner’s (GP) office.
According to Auckland Women’s Gynaecology, GPs have a range of knowledge and can provide help and assistance when it comes to:
regular check-ups
prescribing contraceptive pills
performing cervical smears
checking for STIs
However, despite their “across the board” wisdom, certain conditions could use some specialist advice. This is when you get a GP referral to a gynaecologist, who can help with problems such as:
fibroids
endometriosis
polyps
ovarian cysts
vulval skin conditions
gynaecological cancers
Gynaecologists also perform a range of surgeries, such as:
hysteroscopies
insertion of IUDs
laparoscopies
removal of endometriosis
removal of ovarian cysts
removal of fibroids
hysterectomies.
Should you have a gynaecologist? When should you visit a doctor? The answers should be general knowledge. Photo / Getty Images
Of course, just going by my kitchen conversation around the subject, there are many misconceptions about visiting a gynaecologist.
“I think it’s a particularly American thing to have a gynaecologist”, says Claridge. “The only way you’re going to see a gynaecologist here is either if you have some life-threatening gynaecological disease like endometrial cancer or ovarian cancer or something like that, or if you have sufficient money to pay for a specialist.
“When we talk about women looking after their sexual health, I wouldn’t necessarily be recommending that they see a gynaecologist on a regular basis unless they have got private health cover and a lot of money.”
The unknown can be scary
The biggest misconception for Dr Gupta? “That it’s scary.”
“Cervical screening is important”, she iterates. “It’s been a scary topic of sorts and, you know, people have avoided it.
“So I think we do need to put it out there and increase awareness that it’s easy enough to do now.”
Dr Gupta adds: “Please just contact your GP and they’ll send you a swab and you can do it at home without having to worry about going to see anyone or paying to see anyone.”
A larger problem
Dr Jones sheds light on a larger problem, pointing out that there are misconceptions across the board - and they’re dangerous.
From general education around hormonal contraception, how to use it and whether it is safe, to what a normal period looks and feels like, the blurry information around sexual health is the most concerning factor.
Dr Jones says: “The education is just not where it needs to be and this perpetuates that kind of taboo cycle”, adding: “It also prevents people from getting care.”
Megan Watts is a lifestyle multimedia journalist and has been working for the NZ Herald since 2022. Her writing passions include pop culture deep dives, backstage band chats and doing things for the plot.
