Being in a relationship sometimes involves being sexually active with your partner. This should be your choice and not something that you do because you feel you have to. Your hemophilia does not limit your ability to be intimate with someone else. Having sex can include many different activities, some of which carry almost no physical risks.
You may want to talk with your doctor, nurse, or physiotherapist about sex. But if you’d rather talk with someone who isn’t part of your regular CCT, ask for a referral to an adolescent health specialist.
If you are considering having sex, you should get regular check-ups with your family doctor. These exams will give your doctor a chance to teach you about sexually transmitted infections (STIs) and protecting yourself. Regular exams can also give your doctor more opportunities to check for STIs while they're still in their earliest, most treatable stages. These days, many STI tests are done with a urine sample, so don’t stay away because you are afraid of the examination. If you prefer not to see your family doctor, you can find a local public health clinic in your area where you can get tested confidentially.
Here are a few tips:
- Protect yourself and your partner from sexually transmitted infections (STIs) whenever you engage in any kind of sexual activity. Latex condoms are the best way to protect you against STIs. They can also help prevent pregnancy.
- If you are allergic to latex, you have two condom choices at this time. The newest choice is condoms made from polyisoprene. They are similar to latex condoms and not as pricey as the other choice, which are condoms made from polyethylene. Polyethylene condoms can make funny noises, but they do work.
- Anal sex is the riskiest kind of sex you can have. Condoms with lots of lubrication are essential if you choose to have anal sex. Don’t use an oil-based lubricant like Vaseline with latex condoms—it makes little holes in them.
- Before deciding to have sex with someone, make sure to ask about their sexual history. The more sexual partners they have had, the more likely it is that one of them may have an STI.
- If you are drunk or on drugs, it is difficult to make healthy decisions. Make a deal with a friend to look out for each other at parties or other situations where you might be drinking alcohol or doing drugs.
Can you get a bleed having sex, or engaging in any sexual activity?
Yes, although it is rare. Just like anything else, the more strenuous the activity the more likely it is that you may get a bleed. The signs and symptoms that appear are no different from any other ways you get hurt.
Bleeds to look out for after a sexual activity, include:
- bruising on the surface of the skin
- muscle bleeds in the calf, forearm, upper thigh and hip
- joint bleeds, such as the knees, elbows and ankles
If you develop signs or symptoms of a bleed, treat with factor as you would with any other injury.
If things don’t seem to improve with appropriate levels of factor, call your clinic for advice. You don’t have to explain how you got the injury. All they need to know is the part of your body that is bleeding.
Are some sexual positions less risky than others?
Generally, choice of sexual position does not increase your risk of bleeds. But some positions may be more comfortable if your joints are sore or painful. To feel more comfortable and avoid straining your joints during sexual activity, try:
- lying on your back with your partner on top
- lying side by side
- using pillows for support
Don’t feel embarrassed about discussing sexual positions with your partner. For many couples, discussing sexual preferences is a usual part of conversation – regardless of whether or not they have hemophilia.
Is masturbating safe?
Masturbation is a healthy and natural way to explore your body and sexuality. There is also nothing to be embarrassed about; the majority of boys have had an orgasm from masturbating by the time they reach 18.
It isn’t unusual to get a bit of blood in your ejaculate, or for your urine to be pink when you pee after you have masturbated. You don’t have to worry, as long as your urine is clear the next time. But it’s a different story if you have pain or swelling; if this happens, you should call your health-care provider for advice.
Remember you can get a bleed anywhere that blood flows including your penis. A penile injury may cause:
- external bleeding
- discolored urine
- swelling
- pain
If you have any of these symptoms, call a health-care provider for advice.
Psoas bleeds
There is a chance that you’ll experience a bleed in the muscles located on both sides of your lower spine. These are the psoas muscles. The psoas extends through your pelvic area to your hip joint, allowing you to freely move your hips.
Psoas bleeds usually are not as obvious as other bleeds. If you have trouble straightening your legs when you’re lying down or need your hands to support yourself as you get out bed, go to the emergency room for treatment.
Do you have to be careful when making out?
Yes, you want to be careful when kissing, petting, or having oral sex. Biting, nibbling, or getting a hickie can be more of an issue for people living with hemophilia. As with other injuries, if someone accidently cuts your skin you’ll bleed and may be at risk of infection. Watch out for continual bleeding in the mouth after making out. It is also important to be extra careful if your partner has braces. To avoid the risk of getting cut, ask your partner to remove any sharp jewelry.
Helpful resources on sex and hemophilia
- Sexuality and u is a helpful website about sex that is useful to everyone. It also has information about:
- Puberty
- Contraception
- Sexually transmitted infections (STI)
- Identity and gender orientation
- Sexual health is also discussed on the Health Canada website.
- The Action Canada for Sexual Health & Rights