Sexual Health is a state of physical, emotional, mental and social wellbeing in relation to sexuality and sexual relationships, not merely the absence of sexually transmitted infections or sexual dysfunction. It encompasses the ability to have consensual and satisfying sexual experiences, make informed decisions about sexual activity and reproduction, access appropriate healthcare and experience sexuality without coercion, discrimination or violence. Sexual health includes contraception, fertility, pregnancy, sexually transmitted infections, sexual function, relationships, consent and relevant aspects of reproductive health. The concept therefore extends beyond disease treatment and includes prevention, education, rights, communication and access to appropriate services.
Sexually transmitted infections, commonly called STIs, are infections that can be transmitted through sexual contact, although some can also be transmitted through routes that are not sexual. Examples include chlamydia, gonorrhoea, syphilis, genital herpes, human papillomavirus, HIV and hepatitis B. Some infections can be asymptomatic, meaning a person can transmit an infection without knowing that they have it. Testing therefore depends on exposure history, symptoms, anatomy, vaccination status and individual risk rather than relying solely on the presence of symptoms. Different infections require different diagnostic methods and treatment, and antibiotic treatment is not effective against viral infections such as HIV or herpes.
STI prevention involves several complementary measures. Barrier methods such as condoms can reduce transmission of many infections when used correctly, although they do not provide complete protection against infections transmitted through uncovered skin. Vaccination can prevent particular infections, notably HPV and hepatitis B. Testing and treatment reduce the duration of infection and, for some infections, can reduce onward transmission.
HIV pre-exposure prophylaxis, or PrEP, is medication taken by people without HIV to substantially reduce the risk of acquiring HIV when used appropriately, while post-exposure prophylaxis, or PEP, is used after a potential HIV exposure and needs to be started promptly according to clinical guidance. Prevention strategies should be selected according to actual exposure circumstances rather than assuming one measure is sufficient.
Contraception is a major component of sexual and reproductive health and includes methods designed to prevent pregnancy. These include condoms, combined hormonal contraception, progestogen-only methods, intrauterine devices and implants, with effectiveness varying according to method and correct use. Some methods also provide non-contraceptive benefits or have specific medical contraindications. Emergency contraception is intended to reduce the risk of pregnancy after unprotected or inadequately protected sex and differs from abortion medication because it acts before an established pregnancy. Contraception and STI prevention are also distinct: most contraceptive methods do not protect against STIs, while condoms can provide both contraceptive and infection-prevention benefits.
Consent is a fundamental element of healthy sexual activity. Sexual consent means agreeing to a particular sexual activity freely and without coercion, and consent can be withdrawn. A person must have the relevant legal and practical capacity to consent, and circumstances involving threats, coercion, exploitation or incapacity raise serious ethical and legal concerns. Consent to one activity does not automatically constitute consent to another, and previous sexual activity or an existing relationship does not eliminate the need for consent. Sexual-health education therefore includes communication, boundaries, respect and recognition of coercive behaviour rather than concentrating solely on biological aspects of sex.
Sexual function can be affected by biological, psychological, relational and medication-related factors. Common concerns include erectile difficulties, premature or delayed ejaculation, reduced sexual desire, difficulties with arousal, orgasmic difficulties and pain during sex. In people with vulvas, conditions such as genitourinary disorders, hormonal changes, pelvic-floor dysfunction and endometriosis can contribute to pain or sexual difficulties, while in people with penises cardiovascular disease, diabetes, neurological disorders and medication can contribute to erectile dysfunction. Assessment should consider physical health, medication, psychological factors, relationships and the person's own description of the problem. Sexual dysfunction should not automatically be attributed to psychological causes or ageing without appropriate assessment.
Sexual health services commonly provide confidential testing, diagnosis, treatment, contraception, vaccination, pregnancy-related advice and counselling or referral. Confidentiality is particularly important because concerns about privacy can discourage people from seeking care. Services may use different testing approaches depending on the infection and exposure site, including urine, blood, genital swabs, throat swabs or rectal swabs where clinically appropriate. A negative result is meaningful only in relation to the test used, the timing of testing and the exposure being assessed; some infections have window periods during which testing may not yet detect infection. Partner notification and treatment can be important for particular infections to reduce reinfection and onward transmission.
Sexual health also intersects with fertility, pregnancy, menopause, gender and relationship health, although these areas are not identical concepts. Fertility concerns can involve sperm production, ovulation, reproductive anatomy, age and numerous medical conditions. Pregnancy introduces additional considerations concerning STI screening, medication, vaccination and contraception planning after birth. Menopause can involve hormonal changes affecting sexual desire, vaginal or vulvovaginal symptoms and comfort, while other medical conditions can affect sexual function at any age. A comprehensive sexual-health approach therefore recognises that sexuality changes across the lifespan and is influenced by physical health, relationships, psychological wellbeing, social circumstances and access to appropriate information and healthcare.
