What we learned from our #AskSH24 twitter chat

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Last night we hosted our first Twitter chat to help give everyone, even those who aren’t using the SH:24 service, a chance to access the expertise of our marvellous clinical team. As well as sharing the answers for those who missed it, we wanted to share what we learned too.

Dr Paula Baraitser and SH:24 lead nurse Adam Black sat down with us for an hour to answer questions from our twitter audience, people who’d submitted questions via our blog and people who’d privately DM’d us, as it turned out...

An hour really isn’t a long time

Comprehensive but reassuring answers to sexual and reproductive health questions take time to craft. Even with two very experienced professionals answering the questions, checking for tone, formulating approaches to trickier questions and sourcing any helpful signposting links is not a 140 character job. We used the twitter thread function so that we weren’t limited by the character count. During the hour we managed to answer 8 questions -  each answer took around 7 and half minutes to draft. Next time we’ll look at how we can split our resources to answer more questions but it was great to apply our collective wisdom for this first chat. We’ll also look at how we can get more questions in advance so that we can pre-draft response for quicker delivery on the day.

Social media can be used for sexual and reproductive health advice

We were chuffed to see other twitter users adding on advice we’d given

We’ve known for a while that while some people are very happy to talk about personal sexual health on social media, others would rather use the more private channels the platforms offer. Last night we had a few public questions but the rest came from private messages through our social channels, blog and email. We were chuffed to see other twitter users adding on advice we’d given - for example when we recommended a period tracking app to a young person who’d experienced problems in the past, one Twitter user joined in and mentioned her personal favourite tracking app - Clue #socialgoals. Our new Health Foundation-funded ‘Changing Contraceptive Conversations’ project will explore the possibilities of this further through a private social network that combines peer and clinician-driven conversations - giving users the benefit of the lived experience of their peers alongside medical expertise to help them make more informed choices.

Parents need answers too

Last year’s commitment from the government to make Relationships and Sex Education (RSE) statutory in schools was met with huge praise from campaigners who known that current solutions are inadequate. Often parents, who may not have had good RSE education when they were younger, can need a bit of support when talking to their children about aspects of sexual and reproductive health. We had two questions from concerned parents about their teenager’s reproductive and genital health - it’s really great that parents asked these questions and are talking to their teenagers about sexual health.

The sexual and reproductive health Q & A

Here are the questions and answers as they appeared on Twitter:

Q: I am a gay sexworker and as such receive anal penetration every day. Is there a long term issue I need to consider regarding my health in this respect?

A: We don't anticipate that frequent anal sex will cause long-term issues if the sphincter is relaxed on penetration and appropriate amount of lubricant is used. If there are any breaks in the skin, redness or sores around the entrance to the anus then we advise you don't have sex. If there's any pain, discomfort or discharge from the anus or rectum then we advise you don't have sex and attend your local sexual health clinic for a check-up. We recommend using condoms and water-based lubricant (re-applied as required) when having anal sex to reduce risk of sexual infections. If you need to attend a clinic you can find one through @SXTHealthCIC https://sxt.org.uk/ 

Q: My daughter is now 17. She has had painful periods since about 13 and got worse as for older , last year was the worst, she would throw up all day for first day. Like her own period made her sick. Doctors put her on pill which we swapped once to another brand as made her depressed. Doctor hesitant to suggest was endometriosis as she is so young. She hasn't thrown up since. At the moment we are ok but worried about future. Should we go private? Any suggestions would be appreciated. Thank you

A: Periods often get better over time. It sounds like it's not a problem for your daughter at the moment however, a chat with a gynaecologist could ensure you know all of the options for treatment. This could be arranged through your GP. She might like to use a period tracking app to document and keep track of symptoms so she can better communicate with a health professional in future.

Q: When I need to use the toilet (#2) I get terrible "cramp" like pains in my ovary/womb area. Drs have said to try use the toilet more but it doesn't help. Any ideas?

A: There can be many things that cause abdominal pain. If you think about the organs in that area, pain could come from your bowel, your bladder or your reproductive system. An assessment of these organs would require an examination therefore a visit to a clinic is a good idea. Keeping a diary of your symptoms including what makes it better and what makes it worse could be helpful to the consultation.

The copper IUD http://bit.ly/2w0ybx1 is the only 'semi-permanent' non-hormonal form of contraception. There are other non-hormonal methods like the diaphragm and the condom. As with all methods of contraception, it's about matching your personal preferences with the pros & cons of that particular method. You can read about all methods on our website, we feel that contraceptive decision making is a process, you might need to try several methods before you find the right one for you. Here's our information pages for more ideas http://bit.ly/2x9LV8U

Q: My partner and I have been passing thrush backward and forward for months! We keep thinking it's cleared up but it keeps coming back. How can we make it stop??

A: Thrush is not sexually transmitted it's very common, many people carry it without symptoms. Some people are more sensitive to it and in those people it can cause itching and discharge. There are thrush creams that you can buy over the counter that could bring relief. Oral treatments and pessaries are also available. They are all effective and can be used to manage symptoms.

Q: I’m not sure if I need to go to a clinic or not. I’m peeing all the time and it burns, but when I googled it it sounded like cystitis or something. Shall I get it checked out?

If you are urinating a lot and it is burning it could be cystitis, especially if you are female. In men, it could be caused by an irritation or bacterial infection of the urethra (tube inside penis). For both it could also be a sign of a sexual infection like chlamydia. If you visit your local sexual health clinic http://www.sxt.org.uk they can check for cystitis, urethritis and sexual infections and offer treatment (if you need it). More information on cystitis: http://bit.ly/2ipixIL

Q: I have never had an orgasm from penetrative sex & it is starting to affect me & my partner. A lot of my friends say it must be a problem with me so how can I fix it?

You’re not alone. Different people have orgasms from different types of sex and many women do not orgasm from penetrative sex. Communicating with your partner about different ways to have sex is a good place to start. It’s helpful not to think of your orgasm as the end goal in a sexual encounter. However if it’s something that bothering you and you’d like to discuss it most sexual health services offer a psychosexual counselling service specifically designed to provide support. You can get a referral from your GP or from your sexual health service.

Thanks so much to all of the brilliant people who asked questions and of course, to Dr Paula Baraitser and Adam Black for your time and expertise - we're lucky to have you. If you have any questions for #AskSH24 or would just like to be kept up-to-date about future #AskSH24 chats fill in the form below or follow us on Twitter, Facebook or Instagram.

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