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You Asked It: What Does “Sexually Active” Mean?

My doctor asked me if I was sexually active, and I didn’t know how to respond. What does that mean?

Great question! The phrase “sexually active” is a bit vague, and you’re definitely not the first person to be confused by it.

Many people think that being sexually active means that they’ve had penis-in-vagina (PIV) sex. But being sexually active can include a variety of sex acts, including oral sex, anal sex, and manual sex (giving or receiving a hand job, or fingering someone else or being fingered).

Medical providers ask you about being sexually active in order to figure out your risk level for sexually transmitted infections (STIs) and pregnancy. They want to know if they should test you for STIs, talk about birth control (including condoms), or give you a Pap smear (if you have a uterus and are over 21 years old). Remember: PIV, anal and oral sex put you at the highest risk for STIs, but some (like HPV and herpes) can also be spread by manual sex. PIV sex also puts you (or your partner) at risk of getting pregnant.

If you’ve had manual, oral, PIV or anal sex, you should tell your healthcare provider that you’re sexually active. If you want, you can explain up front exactly what you mean, such as, “Yes, but I’ve only had oral sex.” You should also tell your healthcare provider if you’re not sexually active now, but might be soon. If you’ve had sex, but not recently, clarify this with your medical provider.

They’ll probably ask some follow-up questions. This is also your chance to ask any questions you have about birth control options, STI risk and testing, and sexual health in general.

It may feel awkward to talk about sex at first, but it’s important to communicate openly and honestly with your health care provider. Remember: They want you to be the healthiest version of yourself, and that includes being informed about sex.

Even though masturbation counts as a sex act, it carries no risk of STIs or pregnancy (assuming that you’re not in contact with someone else’s bodily fluids). So if you touch yourself for pleasure, but haven’t been sexual with someone else, you don’t need to tell your healthcare provider.

Talking about sex can be especially nerve-wracking if you’re lesbian, gay, bi, or queer. It may be hard to come out to your medical provider, but it’s still a good idea if you feel comfortable. This information helps your health care provider figure out your STI risk, and whether they should talk to you about birth control.

If you’re 10-22 years old and live near NYC, you can make a free, confidential appointment at Mount Sinai Adolescent Health Center to talk about any sexual health questions or concerns you have. Our care is non-judgmental, trauma-sensitive, and LGBTQ-inclusive.

ABOUT YOU ASKED IT

You’ve got questions.  We’ve got answers. At the Mount Sinai Adolescent Health Center, we answer a lot of questions. Topics range from nutrition to pregnancy prevention, and everything in between. Now, we’re bringing these questions back to you with our new weekly advice column, You Asked It. Got a question? Holler at us in the comments, send us a message on FacebookTwitter or Instagram, or email us at teenhealthcareorg@gmail.com. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.

Missed a “You Asked It” post? Click on “You Asked it” under Topics.

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12 thoughts on “You Asked It: What Does “Sexually Active” Mean?

  1. I had sex 2 years ago and used a condom (first time) and never had it again. Can I say that I’m sexually inactive since it’s been 2 years to my doctor and never got tested for anything. It was oral,vaginal and anal sex. Please answer…

    1. Hi Lori– Thanks so much for your question! Unfortunately, we can’t give any medical advice, only general information for education purposes. We recommend talking to your medical provider about your concerns. We know it can be hard to talk about sex with your doctor, but it’s a really important part of being healthy. You can also submit your question to us anonymously on our Health Squad app. One of our adolescent medicine specialists can respond to you there. You can download the Health Squad app for free for iPhone via the app store or for android via Google Play. Good luck!

  2. “if you touch yourself for pleasure, but haven’t been sexual with someone else” – does this category needs to undergo pap smear as well?

    1. Hi Hero–Thanks so much for your question! Please keep in mind that we cannot give medical advice, only general information for educational purposes. Please talk to your health care provider to learn if and when you need a Pap smear. In general, whether someone masturbates (meaning touches themselves for pleasure) will NOT change a provider’s recommendations on when someone needs a Pap smear. We talk a bit more about when Pap smears and pelvic exams are needed (and what to expect!) here: https://teenhealthcare.org/blog/what-to-expect-at-your-first-gynecological-exam-step-by-step/

  3. What do doctores consider sexually active as in do you consider if the last time you had sex a month ago would that be sexually active ?

    1. Hi Jessica– Thanks for your question! If you’ve had sex before (even once!), you’re generally considered sexually active. Think of the sexually active question as the beginning of a conversation, not just a yes or no question. In this case, it would be best to tell the doctor that you had sex a month ago, but not since. They’ll probably have follow up questions about the use of barrier methods and birth control, and about STI/STD testing. All of this information helps them give you the best care possible, and it’s a great opportunity to ask any questions you have. We hope this helps!

  4. I have never had of any symptom or sign of UTI but my wife have been always in and out of the hospital due to the fact that she has a urinary track infection,how is this possible?

    1. Hi Dickens—Thanks for reaching out! There are a lot of reasons that someone may get recurring or chronic urinary tract infections. Women/people with vaginas are particularly prone to UTIs because the urethra is close to the rectum and because their urethras are shorter. This makes it easier for bacteria to get into the bladder. Using spermicides, douches, certain antibiotics and other factors can sometimes make people with vaginas more likely to get UTIs. While having sex can increase the chances of getting a UTI, sex is far from the only reason people get UTIs. Your wife should talk with a healthcare provider. They should be able to help her figure out what’s going on and the best way to treat it. Please keep in mind that we cannot provide medical advice, only information for educational purposes.

    1. Great question! Your doctor doesn’t necessarily need to know about romance and kissing, but getting semen on or near your genitals (including your anus) is important information for your doctor to have. That’s because having semen come into contact with your genitals could spread a sexually transmitted infection. If your health care provider asks whether you’re sexually active, you could say, “Yes. I haven’t had penetrative sex, but semen has touched my genitals,” or something similar. Please keep in mind that we cannot give medical advice, only general information for educational purposes. We hope this helps!

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