Sexual Health can easily be misinterpreted as something ‘dirty’ and something ‘no one talks about’ and that is the biggest issue. People have no where to go with their most intimate problems – problems that you cannot talk to just anyone about.
Sexual health is also so much more than it seems. We treat a vast array of problems including STD’s, HIV, Contraception and insertion of Mirena’s, Pap smears, Painful intercourse, Low libido, Menopause, Low Testosterone levels, Erectile dysfunction, Premature ejaculation and much more.
Read a bit more about each of these topics and the services that Well Family Practice offers and do not hesitate to contact the practice to make an appointment. We treat your most intimate problem with the utmost confidentiality and care.
We offer screening and treatment for all STDs.
A few Facts on STDs
- You can have an STD without having any symptoms
- If you have had unprotected intercourse once, you can have anything from HIV, to syphilis, gonorrhoea, chlamydia, herpes, HPV or any other STD under the sun!
- Having an STD increases your chances of contracting HIV
- STDs are the most common cause of infertility in women
We insert the Mirena at affordable rates.
The Mirena is a form of contraception. It is a device that is inserted into your uterus to prevent pregnancy. It contains a hormone called levonorgestrel than is released into the womb on a daily basis for up to five years. It prevents pregnancy by thickening the cervical mucous to make it impossible for sperm to enter the womb. The Mirena can be inserted at any age, as long as you have had three menstrual cycles. It can be done even if you have not had children yet and directly after the birth of your baby, since it does not interfere with breastfeeding. The Mirena is also not affected by the use of antibiotics or any other medication and can be used in most chronic diseases.
Although it lasts for five years, you can remove it at any point – it is very easy to remove. Most ladies will bleed much less when they are using the Mirena, due to the effect on the lining of the womb. Some even stop bleeding completely and this is absolutely normal and not dangerous.
We think the Mirena is the contraceptive that is the least likely to interfere with your sex life, but each person is different and we will have a thorough discussion about the pro’s and con’s in your specific situation. See www.Mirena.com for more info.
The Mirena must be inserted while you are menstruating. If you are certain when your period is going to start, please make the appointment for day two of your menstruation. If you are not sure, please phone us on the first day of your cycle and we will see where we can make a plan for you. Conscious sedation is offered during the procedure. A Dormicum injection will help you to relax, but still be awake. You will have no recollection of the procedure, which makes it much less traumatic. You will be asked to insert a Voltaren (or equivalent) anal suppository an hour before the procedure for pain relief.
You are welcome to have your partner or any other person present with you in the rooms. If all of these measures are taken, it is usually not a traumatic experience at all. You are not allowed to eat for 6 hours prior to the procedure and will not be allowed to drive up to 8 hours after the procedure . You can drink clear fluids up to 2 hours before the procedure. Please arrange for somebody to take you home.
The Mirena can be inserted without conscious sedation, especially if you have already had children. It can also be done as soon as 6 weeks after the delivery of your baby.
To remove the Mirena or any other IUD: This procedure can be done during a normal consultation, and is not painful at all under normal circumstances. You can phone our rooms to make a standard appointment if you want to have the Mirena removed. Please note: If you want to fall pregnant, arrange a consultation to make sure you have all the necessary immunisations and blood tests done before you remove your Mirena.
We offer pap smears at very affordable rates.
The Papanicolaou test (also called Pap smear) is a screening test used to detect potentially pre-cancerous and cancerous cells in the cervix (lower portion of the uterus). All sexually active females need to do regular Pap smears and if you are not sexually active by the age of 25, you should start anyway. We see many women who are terrified of pap smears and who are still virgins. We know exactly how to deal with such patients and will try our best to make it a positive experience for you, rather than a traumatic one.
What to expect:
During the consultation with the doctor, all concerns will be discussed. You will then be able to undress in privacy and put on an examination gown. The physical examination will include a breast examination, general examination and finally a genital and internal examination. This will take only about ten minutes. When a Pap smear is taken, a speculum is used to open the vaginal canal and to allow the collection of cells from the outer opening of the cervix with a small brush. This is not painful if your muscles are relaxed. The cells are sent to the laboratory to be examined under a microscope. The test aims to detect potentially pre-cancerous changes which are usually caused by sexually transmitted human papilloma virus (HPV). The test may also detect infections and other abnormalities in the cervix, but is not a screening test for sexually transmitted infections.
After the examination you will discuss the findings and management plan with the doctor. During this consultation you can discuss contraceptive issues as well as concerns regarding sexually transmitted infections and immunisations against cancer and sexually transmitted infections. You will be asked to complete a separate form for the laboratory and hand in your pap smear at Lancet laboratory which is on the way out of our building.
We specialise in the treatment of patients with painful intercourse and chronic pelvic pain. We have treated many patients who have never been able to have sex due to the severity of the pain as well as patients whose lives are affected by pelvic or perineal pain on a daily basis. You should not have to just “live with it”. Painful intercourse has an effect on you and can put a strain on a relationship. If you are not able to use a tampon or find it extremely painful, we can also help you. Painful intercourse (dyspareunia) can occur for a variety of reasons and the most important thing we want you to know is that we believe you that it hurts – it is not in your head!
As many as one in five women has pain during intercourse. If you are one of them, we would like to help you. We are aware that talking about sex and the examination might be terrifying. Please remember that we see patients with this condition on a daily basis and are therefore very understanding. Depending on the diagnosis, referral to a physiotherapists, sexologist and/or psychologist might be necessary and follow-ups will be done until you have pain-free intercourse.
HIV Treatment
We follow a patient-centered approach. We realise that being HIV positive can affect every aspect of your life and we are there to help you address it. We also realise that you should be able to live a life free from concerns about your health and we are here to help you to live a normal, fulfilling life, despite your diagnosis. Some of our patients go on to study more degrees, they get married, have children, they travel to interesting countries and excel in their careers. HIV can be managed like any other chronic disease. We can do HIV testing for you and also offer advanced HIV Counselling.
Fertility Services for HIV positive and Sero-discordant Couples:
If you want to fall pregnant, but you or your partner is HIV positive, we can help with the right advice and treatment to make the process as safe as possible for both partners and the baby. If all precautions are taken, the chances that the baby is HIV positive is less than 1%.
If you are a new patient, please make sure you come to see us with your latest CD4 result. If you do not have a CD4 count, please inform us when you make the booking. We will send you a form named “Blood Tests Required” that will explain all the tests that you would need to do, which would include a CD4 count. Please also bring any reports you might have from other doctors and any previous results you have available. Thereafter you have to be seen two to four times a year, depending on your clinical condition. If you are unwell in any way between your appointments, please phone for an appointment.
If it is an emergency and we are unable to help you, or it is after hours, please go directly to the Emergency Unit of your nearest hospital. You will be seen by one of the doctors in the emergency department. It is our intention to keep you out of hospital! Please consult with us if you are not feeling well, don’t wait too long! If you are admitted to hospital, please inform us as soon as possible in order for us to communicate with the doctors taking care of you in hospital.
Please make sure you never run out of medication, especially your ARVs. If your prescription is due to expire make sure you ask for a new one at least two weeks in advance. It is advisable to always have a week or two of extra supply in case of an emergency. Please inform your doctor if you are travelling to another country or a Malaria area. In general, travelling is safe as long as you have all your immunisations and you are taking Malaria Prophylaxis when visiting malaria areas. If your CD4 count is too low it might be a problem. Taking medication when you are in different time zones can also be problematic therefore discuss it with your doctor in advance.
Low libido is a very common problem, but it is often difficult to determine the cause. It is usually caused by various factors – problems from your past, current psychological issues, relationship issues, medication, hormonal imbalances as well as medical and gynaecological conditions like painful intercourse. During the consultation all of these aspects will be explored and addressed. You are welcome to bring your partner. A follow-up will be scheduled for a week or two later to discuss the results and the response to treatment. If the cause of the problem is found to be mainly psychological or relational, you will be referred to one of the other team members as well. It is advisable to do a testosterone level before your consultation. In men, this should be done before 11h00 in the morning. In females, if you still have regular menstruation, the testosterone can be done alone and at any point during your cycle.
Many men suffer from low testosterone levels, which can have an effect not only on their sex lives, but also their general health and quality of life. Doing a blood test and completing a questionnaire about the typical symptoms of testosterone deficiency will help the doctor to make the diagnosis. Testosterone deficiency affects your heart, muscles, bones, the fat around your belly and your sexual functioning among other things. It is necessary to look into all of these aspects if you suffer from low testosterone. This is a treatable condition with very little risk. The most important point is not to give treatment to somebody with prostate cancer or heart failure in which case it can be very harmful. You will be thoroughly examined before treatment starts.
Erectile dysfunction (ED) is defined as the inability to attain or maintain an erection that is strong enough for satisfactory sexual intercourse. Medical causes of erectile dysfunction include heart disease, high blood pressure, diabetes, neurological problems, hormonal insufficiencies (hypogonadism) and drug side effects. Psychological problems can also result in erectile dysfunction, especially feelings of inadequacy and performance anxiety. You will be asked to complete various questionnaires before you see the doctor. During the consultation the extent of the problem will be discussed as well as possible causes, further investigations necessary and a treatment plan. Treatment will be offered according to your specific needs. You can be sure that we will offer you the best treatment we can to get as much as possible of your function back and hopefully get you to a point where you can function without medication eventually.
Contraception (family planning, birth control or prevention) is one of the most powerful public health tools for any country. Providing women with access to safe and effective contraception is a critical element of women’s health. Enabling women to make choices about their fertility is empowering and offers women better economic and social opportunities. Birth spacing also improves the opportunities for children to thrive physically and emotionally. We will discuss all contraceptive methods available and decide which method will suite you best. You do need to see a doctor every year about your contraceptive choice because there are certain things that need to be monitored.
Please do not hesitate to ask any questions beforehand. We want to make this a comfortable experience for you and will help as much as we can.
Also see www.mysexualhealth.co.za for more info
