Being “sexually active” can include penetrative sex, as well as genital-to-genital contact, manual stimulation, and more.
Whether it was your doctor, your parents, or your friends, you’ve likely heard someone talk about being “sexually active.”
If you’re confused by this term, don’t worry. You aren’t the only one!
Although this term is often associated with penis-in-vagina (PIV) penetrative sex, it’s actually way broader than that.
It also includes different forms of manual stimulation, like fingering or handjobs, dry humping or other genital-to-genital contact, rimming or other types of oral sex, and anal penetration.
In other words, while you might not have had some form of penetrative sex, you could very well be sexually active in the eyes of your doctor.
Not technically.
Although masturbation can be considered a sexual act, it usually doesn’t involve skin-to-skin contact with another person.
And if you aren’t getting physical with someone else, you don’t have to be concerned with sexually transmitted infections (STIs) or other transmittable conditions.
Certain sexual activities put you at risk for STIs — and pregnancy, in some cases — so there’s a lot to consider before becoming sexually active.
There are several questions you can ask yourself to help make this decision, such as:
- Am I doing this because I want to, or is it because I feel like I need to in order to fit in or make my partner happy?
- Do I want to be in a committed relationship first, or am I comfortable with having an uncommitted sexual partner?
- Do I have access to condoms and contraceptives?
- Could I have any regrets afterward?
You may find it helpful to talk it over with a close friend or mentor.
If they’re already sexually active, they may be able to share how they realized they were ready, questions they had for their partners, or other tips.
Remember that the decision is ultimately up to you. It all comes down to how you feel and what you’re comfortable with.
Probably not.
If you have a vagina, you may have heard about “breaking your hymen” and how this is a telltale sign of sexual activity. This is a myth.
Some people are born with hymens (a loose piece of tissue around the vaginal opening), some are born with partial hymens, and some are born without hymens.
Although the hymen can be torn during sexual activity (which is where the myth comes from), it can also tear as a result of exercise or other physical activities.
There’s no way to determine what exactly caused the hymen to tear.
The only way that a doctor could tell that you’re sexually active is if you have a pelvic or rectal exam scheduled and have recently had a partner ejaculate inside of you during vaginal or anal sex.
Semen can live inside the body for up to 5 days, so your doctor may see this during your exam.
Sharing intimate details about your sex life can be difficult, especially if you’re worried about being judged or concerned about confidentiality.
But there are several reasons why it’s important to keep your healthcare provider in the loop.
Vaccinations
It’s important to make sure you’re up to date with any necessary vaccines.
For example, the
This vaccine helps protect against some cancers and most genital warts.
You can still get the HPV vaccine if you’re already sexually active, but it’s more effective when done before potential exposure.
Your doctor may also recommend hepatitis A and hepatitis B vaccinations.
STIs
Your doctor will be able to discuss your individual risk for different STIs.
Although many people associate STI risk with penetrative sex, most can be transmitted through any type of contact with bodily fluids.
Others, like the herpes simplex virus, are transmitted through skin-to-skin contact.
Your doctor can explain how you can reduce your risk with condoms and other barrier methods.
If you’re already sexually active, they may recommend testing for STIs while you’re there. This is usually done by taking a blood or urine sample.
Contraceptives
If you or your partner want to avoid pregnancy, talk to your doctor about your options for contraception.
Depending on your needs, they may prescribe one of the following:
- an insertable diaphragm
- a daily pill
- a monthly skin patch
- a monthly vaginal ring
- a three-month injection
- a long-term arm implant or intrauterine device
They can also tell you about your over-the-counter options, including:
- inside condoms (inserted into the vagina)
- outside condoms (worn on the penis)
- a vaginal sponge
- spermicide
Pelvic exams and pap smears
If you aren’t already getting an annual pelvic exam, your doctor may recommend that you start.
You may find it helpful to think of a pelvic exam as a check-up for your reproductive organs and genitalia.
During the exam, your doctor will visually and physically inspect different areas of your pelvic region to look for irritation, sores, or other symptoms that may indicate an underlying condition.
If you have a vagina, they’ll also use a speculum to get a closer look at your uterus, cervix, ovaries, and fallopian tubes.
Your doctor may also suggest getting routine pap smears to screen for cervical cancer. A pap smear is performed during the internal pelvic exam.
Any sexual activity puts you at risk for STIs, even if it was a one-time thing.
It’s also important to remember that some infections, like HPV and chlamydia, don’t cause visible symptoms.
The only way to know whether you were exposed is to get tested.
You may not be “active” right now, but your past encounters still have an effect on your overall health.
Some conditions, like genital herpes, can lay dormant for months or even years after you were initially exposed before making their presence known.
Others might not ever show symptoms and — if left untreated — may lead to infertility and other long-term complications.
Telling your doctor the truth about your sexual history is crucial. This includes:
- the number of partners you’ve had
- the specific activities you’ve engaged in, such as oral sex
- how consistently you’ve used condoms or other barrier methods
- whether you’ve experienced pelvic pain, bleeding, or other unusual symptoms
This information allows your doctor to provide the most complete care possible.
If they don’t know that you’re sexually active — or what that entails for you — they won’t necessarily screen for the following underlying conditions or provide you with the resources you need to help reduce your risk.
HPV
As many as
HPV refers to a group of viruses. More than 100 types of HPV exist, and at least 40 are spread through sexual contact.
Certain types of HPV are asymptomatic and will eventually clear on their own. Others may lead to genital, anal, or oral warts, as well as certain cancers.
Regular pap smears are the only way to screen for HPV and detect other abnormal cells.
Other STIs
The CDC estimates that, in the United States alone, more than 20 million new infections occur every year.
Many STIs are asymptomatic. This means they don’t present any symptoms, so you could have an infection without knowing it. That’s why STI screenings are so important.
When symptoms are present, they may include:
- rash
- blisters
- itching
- unusual discharge
- burning during urination
- pain during intercourse
- fever
Pelvic inflammatory disease
Pelvic inflammatory disease (PID) occurs when sexually transmitted bacteria spreads from your vagina to your uterus, fallopian tubes, or ovaries.
It usually occurs a result of untreated chlamydia or gonorrhea.
PID, like the infections that typically cause it, is often asymptomatic. When symptoms are present, they may include:
- pain in your lower abdomen and pelvis
- unusual discharge
- painful or difficult urination
- pain or bleeding during intercourse
- spotting between menstrual periods
- fever
- chills
Left untreated, PID can cause chronic pelvic pain and tubo-ovarian abscesses. It can also lead to infertility.
HIV
HIV is a virus that affects the immune system. It’s usually transmitted through genital or rectal fluids during sexual activity.
Symptoms are more common within the first two to eight weeks of exposure. They may include:
- swollen glands
- fever
- headaches
- muscle soreness
If left untreated, HIV can increase your risk of certain cancers and other life-threatening complications.
Certain cancers
If left untreated, hepatitis B and hepatitis C can result in liver cancer.
High-risk strains of HPV can lead to the following cancers:
- oral
- cervical
- vaginal
- vulvar
- anal
HIV can also increase your risk of certain cancers, especially if it’s undetected or untreated. This includes:
- Kaposi sarcoma
- lymphoma
- cervical
- anal
It depends. If you tell your doctor in private that you’re sexually active, they have a responsibility to protect your confidentiality.
But things can get a little more complicated when it comes to actually providing — rather than just discussing — different sexual health services.
According to the American Academy of Family Physicians, all jurisdictions in the United States allow doctors to diagnose and treat STIs in minors without parental consent.
Whether minors require parental consent when requesting the following services varies from jurisdiction to jurisdiction:
- contraception
- pregnancy tests
- abortion
- prenatal care
- child delivery services
If you’re concerned about your confidentiality, ask your doctor about what they’re required to disclose before discussing your sexual health.
If your doctor isn’t able to provide the care you need without parental involvement, know that you do have other options for medical care.
If you’re uncomfortable going to your doctor — or if you don’t have access to a primary care doctor or gynecologist — you have a few alternatives.
Some contraceptives are available over-the-counter at your local pharmacy. Your options here are all non-hormonal:
- condoms (external and internal)
- spermicides (foams, suppositories, gels, creams, and films)
- sponges
Several oral emergency contraceptives, such as Plan B, are also available without a prescription.
These can be taken up to five days after unprotected sex to help reduce your risk of pregnancy.
You can also go to your local women’s health clinic or county health department to receive care at a reduced or no cost.
This includes:
- birth control
- Pap smears
- STI testing
- pregnancy testing
Deciding when to become sexually active is up to you and only you.
And although your sex life isn’t anyone else’s business, it’s important to be straight up with your doctor.
They can give you the information you need to make informed decisions about your sexual and reproductive health.
Whether that means discussing what exactly is considered “sexual activity,” how to reduce your risk of STIs, or something else entirely depends on where you are in the moment.
Your provider is there to support you in whatever way you need.