Sexual Health

Your Sexual Health Matters—Let's Talk About It

Sexual health is an essential part of overall wellbeing, yet it's often the hardest topic to discuss.

At Ovara Women's Health, we provide comprehensive, judgement-free sexual health care for women at every life stage. Whether you need STI testing, contraception advice, help with sexual concerns, or just honest answers to questions you've been too embarrassed to ask—we're here.

Your sexual health deserves the same attention, expertise, and respect as every other aspect of your health.

What is Sexual Health?

Sexual health is more than the absence of disease—it's about physical, emotional, mental, and social wellbeing related to sexuality.

The World Health Organization defines sexual health as requiring:

• A positive and respectful approach to sexuality and sexual relationships
• The possibility of having pleasurable and safe sexual experiences
• Freedom from coercion, discrimination, and violence
• Access to sexual healthcare information and services

At Ovara, we address all aspects of sexual health:

• STI prevention, testing, and treatment
• Contraception and family planning
• Sexual function concerns (pain, low desire, difficulty with arousal or orgasm)
• Sexual health after pregnancy, surgery, or menopause
• LGBTQIA+ inclusive care
• Sexual trauma and assault support
• Relationship and intimacy concerns
• Vaginal and vulval health

STI Testing & Treatment

Regular STI screening is a normal part of healthcare—nothing to be embarrassed about.

Who Should Get Tested?

Everyone who is sexually active should consider regular STI testing.

Annual testing recommended if you:

• Have a new sexual partner
• Have multiple sexual partners
• Have a partner with multiple partners
• Are not consistently using barrier protection (condoms)
• Are a woman who has sex with women (yes, you still need testing)
• Have symptoms of an STI

More frequent testing (every 3-6 months) if you:

• Have multiple partners
• Have casual or anonymous sexual encounters
• Work in sex industry
• Inject drugs or have partners who do

Testing also recommended:

• Before starting a new sexual relationship (both partners tested)
• During pregnancy (routine screening occurs)
• After unprotected sex with new or casual partner
• After potential exposure to STI
• If your partner has been diagnosed with an STI

Common STIs We Screen For

Most STIs have no symptoms—you can't tell by looking or feeling.

Chlamydia:

• Most common bacterial STI in Australia
• Often has no symptoms (especially in women)
• Can cause: Abnormal discharge, bleeding between periods, pelvic pain (if symptoms present)
• Untreated consequences: Pelvic inflammatory disease (PID), infertility, chronic pelvic pain, ectopic pregnancy
• Testing: Urine test or vaginal swab
• Treatment: Antibiotics (single dose or short course)

Gonorrhoea:

• Bacterial infection often occurring with chlamydia
• Often asymptomatic
• Can cause: Abnormal discharge, painful urination, bleeding between periods
• Can infect: Cervix, throat, rectum
• Untreated consequences: PID, infertility, disseminated infection
• Testing: Urine, vaginal, throat, or rectal swab (depending on sexual practices)
• Treatment: Antibiotics (usually injection plus oral)

Syphilis:

• Bacterial infection with multiple stages
• Cases increasing in Australia
• Symptoms vary by stage: Painless sore (primary), rash (secondary), no symptoms (latent), serious complications (tertiary)
• Testing: Blood test
• Treatment: Antibiotics (penicillin injection)
• Important to test partners and treat early

HIV (Human Immunodeficiency Virus):

• Viral infection affecting immune system
• Early symptoms (if any): Flu-like illness 2-4 weeks after infection
• Can be managed with medication (undetectable = untransmittable)
• Testing: Blood test
• Prevention: Condoms, PrEP (pre-exposure prophylaxis)
• Treatment: Antiretroviral medication (lifelong)

Hepatitis B:

• Viral infection affecting liver
• Spread through blood and sexual contact
• Vaccination available and recommended
• Testing: Blood test
• Treatment: Monitoring and sometimes antiviral medication

Hepatitis C:

• Viral infection affecting liver
• Primarily spread through blood contact, but sexual transmission possible
• Highly treatable with modern medications
• Testing: Blood test
• Treatment: Short course of oral medication (cure rate >95%)

Genital Herpes (HSV):

• Viral infection causing recurrent blisters/sores
• Two types: HSV-1 (typically oral, but can be genital) and HSV-2 (typically genital)
• Very common—many people have it without knowing
• Often asymptomatic or mild symptoms
• No cure, but antiviral medication reduces outbreaks and transmission
• Testing: Swab of active lesion (blood tests less useful)

Genital Warts (HPV):

• Caused by certain strains of Human Papillomavirus
• Appear as small bumps or cauliflower-like growths on genital area
• Different HPV strains than those causing cervical cancer
• Treatment: Topical creams, freezing, or other removal methods
• Prevention: HPV vaccination (Gardasil 9) protects against wart-causing strains

Mycoplasma genitalium:

• Bacterial infection increasingly recognised as cause of cervicitis and PID
• Often asymptomatic
• Can be harder to treat than chlamydia (some antibiotic resistance)
• Testing: Vaginal swab or urine
• Treatment: Specific antibiotics

Trichomoniasis:

• Parasitic infection
• Can cause: Frothy discharge, itching, unpleasant odour (but often no symptoms)
• Testing: Vaginal swab
• Treatment: Oral antibiotics
• Important to treat partners

The Testing Process

What to expect at your sexual health appointment:

Discussion includes:

• Your sexual history (number and gender of partners, types of sexual contact)
• Symptoms if any (discharge, pain, lesions, itching)
• Contraception use and barrier protection practices
• Last STI screening
• Any known exposures or partner diagnoses
• Menstrual and gynaecological history
• Hepatitis and HIV vaccination status

Testing typically involves:

• Urine sample (first pass urine, don't empty bladder beforehand)
• Vaginal swab (self-collected or doctor-collected)
• Blood test (for HIV, syphilis, hepatitis if indicated)
• Throat swab (if you've had oral sex)
• Rectal swab (if you've had anal sex)

You don't need a physical examination unless:

• You have symptoms requiring assessment
• You specifically request one
• Cervical screening is due

Results timeframe:

• Most results available within 3-7 days
• We contact you with results (don't assume no news is good news)
• Positive results discussed confidentially and treatment arranged
• Partner notification support provided if needed

STI Prevention

Reducing your risk of STIs while maintaining a healthy sex life.

Barrier Protection

Condoms (external and internal):

• Most effective way to prevent STI transmission
• Protect against: HIV, gonorrhoea, chlamydia, trichomoniasis, hepatitis B
• Reduce risk of: Herpes, HPV, syphilis (but don't eliminate risk as these can be transmitted from skin not covered by condom)
• Use consistently and correctly
• Compatible with water-based or silicone-based lubricants (not oil-based)
• Available free from sexual health clinics

Dental dams:

• Barrier for oral-vaginal or oral-anal contact
• Reduces STI transmission during oral sex
• Can make from condom if commercial dam unavailable

Vaccination

HPV vaccination (Gardasil 9):

• Protects against HPV strains causing cervical cancer and genital warts
• Free for all Australians up to age 25
• Catch-up program available
• Can still benefit people over 25 (discuss with your GP)
• Safe and effective

Hepatitis B vaccination:

• Part of standard childhood vaccination schedule
• Catch-up vaccination available if not previously vaccinated
• Recommended for all sexually active adults
• Particularly important for certain risk groups

Hepatitis A vaccination:

• Recommended for women who have sex with women
• Recommended if engaging in oral-anal contact
• Protects against liver infection spread through faecal-oral route

PrEP (Pre-Exposure Prophylaxis)

Medication to prevent HIV infection in people at higher risk.

Who should consider PrEP:

• People with HIV-positive partners not on treatment or with detectable viral load
• People who frequently don't use condoms with partners of unknown HIV status
• People who have recently had STIs
• People who have used post-exposure prophylaxis (PEP) multiple times
• People engaging in sex work
• People who inject drugs or have partners who do

How PrEP works:

• Daily medication that prevents HIV from establishing infection
• Highly effective when taken consistently (>99% reduction in HIV risk)
• Does NOT protect against other STIs—condoms still needed
• Requires regular monitoring (kidney function, HIV testing every 3 months)
• Available through sexual health clinics and some GPs

Regular Testing

Even with prevention measures, regular testing is important:

• Condoms reduce but don't eliminate all STI risks
• Many STIs are asymptomatic
• Early detection prevents complications and onward transmission
• Testing is quick, confidential, and usually painless

Sexual Function & Concerns

Sexual problems are common—and most are treatable.

Painful Intercourse (Dyspareunia)

Pain during or after sex is NOT normal and deserves investigation.

Types of pain:

• Superficial pain (at vaginal opening or during initial penetration)
• Deep pain (during deep penetration or certain positions)
• Pain after sex

Common causes:

Vaginal dryness:

• Most common after menopause but can occur at any age
• Can be caused by: Low oestrogen (menopause, breastfeeding), medications, insufficient arousal
• Treatment: Lubricants, vaginal moisturisers, local oestrogen therapy, addressing arousal issues

Vulvodynia:

• Chronic vulval pain without identified cause
• Burning, stinging, rawness sensation
• Can be provoked (triggered by touch/penetration) or unprovoked
• Treatment: Pelvic floor physiotherapy, topical treatments, medication, psychological support

Vaginismus:

• Involuntary tightening of vaginal muscles preventing penetration
• Can be lifelong or acquired after previously pain-free sex
• Often involves anxiety and fear of pain
• Treatment: Pelvic floor physiotherapy, dilator therapy, psychological support, addressing underlying fears

Endometriosis:

• Deep pain during intercourse, especially certain positions
• Often accompanies other endometriosis symptoms (painful periods, pelvic pain)
• Treatment: Pain management, hormonal treatment, sometimes surgery

Pelvic floor dysfunction:

• Overactive or tight pelvic floor muscles
• Can cause pain with penetration and other pelvic symptoms
• Treatment: Pelvic floor physiotherapy (strengthening is NOT always the answer—sometimes release and relaxation needed)

Infections:

• Thrush (candida), bacterial vaginosis, STIs can cause painful sex
• Usually accompanied by other symptoms (discharge, odour, itching)
• Treatment: Specific treatment for identified infection

Skin conditions:

• Lichen sclerosus, lichen planus affect vulval skin
• Cause pain, itching, skin changes
• Treatment: Topical medications, ongoing management

Psychological factors:

• Past sexual trauma
• Anxiety about sex or pain
• Relationship difficulties
• Body image concerns
• Can contribute to or result from physical pain—often both physical and psychological factors involved

Our approach:

• Thorough assessment to identify cause
• Physical examination if appropriate
• Referral for specialist assessment if needed (pelvic floor physio, gynaecologist, sexual health psychologist)
• Treatment of underlying conditions
• Multidisciplinary approach when needed

Low Sexual Desire (Low Libido)

Reduced interest in sex is one of the most common sexual concerns women report.

Important to know:

• Sexual desire exists on a spectrum—no "normal" amount
• Problem only if it's causing YOU distress
• Many factors affect desire—rarely just one cause
• Responsive desire (arousal leading to desire) is normal for many women

Common causes:

Hormonal:

• Menopause and perimenopause (low oestrogen)
• Postpartum period (especially if breastfeeding)
• Hormonal contraception (affects some women)
• Thyroid problems
• High prolactin

Medications:

• Antidepressants (particularly SSRIs)
• Blood pressure medications
• Some contraceptives
• Others—ask about all medications

Physical health:

• Chronic illness
• Chronic pain
• Fatigue and exhaustion
• Sleep deprivation
• Painful sex (understandably reduces desire)

Mental health:

• Depression and anxiety
• Stress (work, financial, family)
• Body image concerns
• Past sexual trauma

Relationship factors:

• Relationship conflict
• Communication difficulties
• Loss of emotional intimacy
• Mismatched expectations about sex
• Routine/monotony
• Partner sexual problems

Life stage:

• New parents (exhaustion, touched out, body changes)
• Caring responsibilities
• Career demands
• Life transitions

What we can help with:

• Identify contributing factors (often multiple)
• Address hormonal causes (testosterone, oestrogen therapy may help some women)
• Review medications that may be contributing
• Treat underlying health or mental health conditions
• Discuss relationship and psychological factors
• Referral to sex therapist or psychologist if appropriate
• Realistic expectations—no magic pill, but improvement possible

Difficulty with Arousal or Orgasm

Challenges with arousal or reaching orgasm are common and often treatable.

Arousal difficulties:

• Reduced physical response (lubrication, swelling, sensitivity)
• Can be hormonal (especially after menopause)
• Can relate to medications, health conditions, or insufficient stimulation
• Often improves with treating underlying cause and addressing psychological factors

Orgasm difficulties:

• Never having experienced orgasm (primary anorgasmia)
• Previously able to orgasm but now can't (secondary anorgasmia)
• Can orgasm with masturbation but not with partner (situational)

Contributing factors:

• Lack of knowledge about own body and what works
• Insufficient stimulation (many women need clitoral stimulation)
• Anxiety about performance or body
• Past trauma
• Medications (antidepressants, blood pressure medications)
• Hormonal changes
• Relationship factors
• Medical conditions affecting nerves or blood flow

What helps:

• Education about female sexual response and anatomy
• Exploration (solo and with partner if applicable)
• Communication with partner about needs
• Addressing psychological barriers
• Treating underlying medical/hormonal causes
• Sex therapy if needed
• Patience and removing performance pressure

Vaginal & Vulval Health

Common conditions affecting vaginal and vulval health.

Thrush (Vaginal Candidiasis)

Fungal infection causing itching, discharge, and discomfort.

Symptoms:

• Itching and irritation
• Thick white discharge (cottage cheese-like)
• Redness and swelling
• Pain during sex
• Stinging when urinating

Triggers:

• Antibiotics
• Pregnancy
• Diabetes (poor glucose control)
• Weakened immune system
• Hormonal changes
• Tight clothing, synthetic underwear

Treatment:

• Antifungal cream or pessary
• Oral antifungal tablet (single dose or short course)
• Usually clears within days

Recurrent thrush (4+ episodes per year):

• Needs investigation for underlying causes
• May need longer treatment course
• Consider diabetes screening
• Discuss triggers and prevention strategies

Prevention:

• Wear cotton underwear
• Avoid tight pants
• Don't douche (disrupts normal vaginal bacteria)
• Wipe front to back
• Change out of wet swimming costumes promptly

Bacterial Vaginosis (BV)

Imbalance in normal vaginal bacteria.

Symptoms:

• Thin, grey, or white discharge
• Fishy odour (especially after sex)
• Mild itching or irritation
• Some women have no symptoms

Not an STI but can be triggered by:

• Sexual activity
• Douching
• Using scented products
• Having an IUD (in some women)

Treatment:

• Antibiotic cream or tablets
• Symptoms usually resolve quickly
• High recurrence rate (many women get it repeatedly)

Recurrent BV:

• Longer treatment courses
• Maintenance treatment may be needed
• Probiotics (some evidence they help)
• Avoid douching and scented products

Urinary Tract Infections (UTIs)

Bacterial infection of bladder or urethra—very common in women.

Symptoms:

• Frequent urge to urinate
• Burning pain when urinating
• Passing only small amounts of urine
• Cloudy, dark, or strong-smelling urine
• Pelvic pain or pressure
• Sometimes blood in urine

Treatment:

• Antibiotics (usually short course)
• Symptoms improve within 1-2 days
• Drink plenty of water

Prevention strategies:

• Empty bladder after sex
• Wipe front to back
• Don't hold urine for long periods
• Stay well hydrated
• Some women benefit from cranberry products or supplements
• Vaginal oestrogen for postmenopausal women (reduces recurrence)

Recurrent UTIs (3+ per year):

• Investigation for underlying causes
• Consider preventive antibiotics (low dose, long-term or after sex)
• Assess for contributing factors (incomplete bladder emptying, prolapse, post-menopause changes)

Genitourinary Syndrome of Menopause (GSM)

Collection of symptoms affecting genital and urinary health after menopause.

Caused by:

• Declining oestrogen levels
• Affects vaginal and vulval tissues, bladder, and urethra

Symptoms:

• Vaginal dryness
• Painful intercourse
• Burning or irritation
• Vaginal tightness
• Recurrent UTIs
• Urgency and frequency of urination
• Reduced lubrication with arousal

Important to know:

• Affects up to 50% of postmenopausal women
• Doesn't improve on its own (unlike hot flushes which eventually resolve)
• Progressive if untreated
• Very treatable

Treatment:

• Vaginal oestrogen (cream, tablet, or ring)—highly effective and safe
• Vaginal moisturisers and lubricants
• Vaginal laser therapy (newer option, limited evidence)
• Systemic HRT helps some symptoms but doesn't fully treat vaginal changes
• Don't suffer in silence—treatment works

LGBTQIA+ Sexual Health

Sexual health care that respects and affirms all identities and relationships.

Women Who Have Sex With Women (WSW)

Common myth: Women who only have sex with women don't need sexual health care.

Reality: WSW still need:

• Regular STI screening (yes, STIs transmit between women)
• Cervical screening (HPV transmitted sexually between women)
• Contraception counselling if having sex with men or planning pregnancy
• HPV vaccination
• Sexual health discussions

STIs that transmit between women:

• HPV (most important—causes cervical cancer and genital warts)
• Herpes
• Bacterial vaginosis (can be shared)
• Trichomoniasis
• Syphilis (less common but possible)

Barrier protection for WSW:

• Dental dams for oral sex
• Gloves for manual sex (especially if cuts/abrasions on hands)
• Don't share sex toys (or use barrier and clean between partners)

We provide:

• Appropriate screening based on actual sexual practices
• Respectful, knowledgeable care
• Understanding of unique health needs

Sexual Health After Life Events

Sexual Health After Pregnancy

Pregnancy and birth change your body—and your sexual health needs.

Common concerns:

• When is it safe to have sex again? (Usually 4-6 weeks, when you feel ready)
• Vaginal dryness (especially if breastfeeding—low oestrogen)
• Painful sex (scar tissue from tears or episiotomy, pelvic floor changes)
• Low libido (hormones, exhaustion, touched out, body changes)
• Fear of pain or further damage
• Body image concerns

What helps:

• Time and patience
• Pelvic floor physiotherapy if pain or concerns
• Lubricants and vaginal moisturisers
• Communication with partner
• Contraception discussion (yes, you can get pregnant while breastfeeding)
• Professional support if issues persist

Sexual Health and Menopause

Menopause changes sexual function—but sex doesn't have to end.

Common changes:

• Reduced lubrication
• Vaginal tightness or shortening
• Painful intercourse
• Reduced libido
• Reduced sensitivity
• Longer time to arousal
• Difficulty with orgasm

What helps:

• Vaginal oestrogen (highly effective, very safe)
• Lubricants and moisturisers
• Systemic HRT (helps some aspects, not sufficient alone for vaginal changes)
• Continued sexual activity (helps maintain vaginal health)
• Communication with partner about changes
• Addressing relationship factors

Important: These changes are treatable. You don't have to accept painful or unsatisfying sex as inevitable.

Sexual Health After Cancer

Cancer treatment can significantly affect sexual function.

Effects of cancer treatment:

• Vaginal dryness and atrophy (chemotherapy, hormonal treatment)
• Premature menopause (some treatments)
• Painful sex
• Reduced sensation
• Body image changes (scars, hair loss, weight changes, surgical changes)
• Fatigue
• Anxiety and fear

Our role:

• Address physical symptoms (dryness, pain)
• Discuss treatment options that are safe after cancer
• Coordinate with oncology team
• Referral to specialist sexual health services if needed
• Support for emotional and relationship impact

Sexual Trauma & Assault Support

We provide trauma-informed care and support for survivors of sexual assault.

If Recent Assault (Within 7 Days)

Please attend hospital emergency department or sexual assault service immediately if:

• Assault occurred within past 7 days
• You need emergency contraception
• You need post-exposure prophylaxis (PEP) for HIV
• You need forensic evidence collection
• You need immediate medical attention

Sexual assault crisis services (24/7):

• State-based sexual assault services with medical and counselling support

Longer-Term Support

We can help with:

• STI screening and treatment
• Contraception and pregnancy testing
• Treatment of physical injuries or ongoing symptoms
• Referral to specialised counselling services
• Addressing sexual function concerns related to trauma
• Ongoing health monitoring and support

Trauma-informed care means:

• You are in control of your healthcare
• We ask permission before examinations
• We explain everything before we do it
• You can have a support person present
• You can stop at any time
• We believe you
• We don't judge
• We work at your pace

Sexual Health FAQ

"Do I need STI testing if I'm in a monogamous relationship?"

If you and your partner were both tested before the relationship and neither has had other partners, ongoing testing isn't necessary. However, if you weren't both tested at the start, consider getting tested together now (many STIs can be asymptomatic for years).

"Can I get STIs from oral sex?"

Yes. Chlamydia, gonorrhoea, syphilis, herpes, and HPV can all be transmitted through oral sex. Throat infections are often asymptomatic.

"Do I need STI testing if I only have sex with women?"

Yes. STIs transmit between women, including HPV (which causes cervical cancer). You still need cervical screening and sexual health care.

"Is it normal to not want sex after having a baby?"

Very common. Hormones, exhaustion, physical changes, and being "touched out" all affect desire. Most women's desire returns over time, but seek help if painful sex or other concerns persist.

"Can I use coconut oil as lubricant?"

Oil-based lubricants (including coconut oil) damage latex condoms and can increase infection risk. Use water-based or silicone-based lubricants instead.

"How do I bring up sexual concerns with my partner?"

Start conversation outside bedroom, when you're not about to have sex. Focus on how you feel and what you'd like, rather than criticising. Consider couples therapy if communication is difficult.

"Is vaginal dryness after menopause permanent?"

It persists without treatment, but it's very treatable with vaginal oestrogen, moisturisers, and lubricants. You don't have to accept it.

"Will my GP tell my parents I've had an STI test?" (For young people)

No. Sexual health care is confidential if you're old enough to understand the treatment (usually applies to teenagers). We won't share information with parents without your permission unless there are serious safety concerns.

Book Your Sexual Health Appointment

Your sexual health deserves expert, respectful care.

Our Ovara specialists provide comprehensive, judgement-free sexual health services across 110+ clinics in Australia. We're here to listen, assess, treat, and support—whatever your sexual health concern.

Book online or call your nearest Family Doctor clinic to see an Ovara women's health specialist.

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