Sexual Health Basics: What to Track, What to Ignore, When to See a Clinician
Sexual health is one of those topics most of us sort of learned about, but not in the way we actually need as adults. And because it’s personal, it’s easy to either over-monitor every little change or ignore things that deserve attention.
A helpful middle path is this: learn what’s normal for you, track a few high-value things, ignore the noise, and know the clear “this is worth getting checked” signals. That’s what this guide is for.
What Sexual Health Really Means
Sexual health isn’t just about avoiding infections or preventing pregnancy. It also includes comfort, consent, pleasure, safety, and how your body is functioning over time. Your sexual health can change with stress, sleep, hormones, medications, relationship dynamics, aging, and medical conditions. Changes aren’t automatically “bad,” but some are worth noticing.
What To Track: The Few Things That Actually Help
Tracking doesn’t have to mean logging everything daily. Think “patterns,” not perfection. If you want to keep tabs on sexual health in a way that’s actually useful, these are the most practical things to notice.
1) Any New Or Worsening Pain
Pain with sex is common, but it isn’t something you should just “push through.”
Track things like:
Where it hurts (outside, at the entrance, deeper in the pelvis, testicles, etc.)
When it hurts (during penetration, with certain positions, after sex, with arousal)
How long it lasts
Whether lubrication, slower pace, or different positions change it
Pain can be linked to dryness, pelvic floor muscle tension, infections, skin conditions, endometriosis, prostatitis, injuries, or other treatable issues. The key is: pain that is persistent, worsening, or disruptive deserves medical attention.
2) Bleeding That Doesn’t Fit Your Usual Pattern
If you have periods, it’s useful to know your baseline cycle length and typical flow. Outside of that, track any bleeding that feels “off,” such as:
Bleeding after sex
Bleeding between periods
Bleeding after menopause
Bleeding that is much heavier than usual
Bleeding with pelvic pain, fever, or dizziness
Occasional spotting can happen for benign reasons (like hormonal shifts or missed pills), but bleeding after sex or after menopause is a “check this” sign.
3) Discharge Changes That Come With Symptoms
Vaginal discharge varies a lot across the cycle and can change with arousal, exercise, pregnancy, and hormonal contraception. What’s most useful to track is not the discharge alone, but discharge changes plus symptoms.
Track if discharge changes come with:
Strong or unusual odor
Itching, burning, or irritation
Pain with urination
Pelvic pain
Bleeding
Fever
Those combinations are more likely to suggest an infection or irritation that might need treatment.
If you have a penis, an equivalent “track this” category is:
New discharge from the urethra
Burning with urination
New testicular pain or swelling
New genital sores or rashes
4) Erectile Changes Or Arousal Changes That Persist
An occasional “off day” is normal. What’s worth tracking is a persistent change over weeks to months.
For erections, notice:
Is it a consistent problem or situational
Morning erections are present or absent over time
Any pain, curvature, or changes in firmness
Any new medication, stress, sleep issues, or alcohol use that lines up with the change
For arousal and desire in general, notice:
Does it match big life changes (stress, grief, depression, new relationship dynamics)
Is it distressing to you or your partner, or are you simply less interested right now
Whether pain, dryness, or anxiety is part of the picture
Persistent erectile dysfunction can be an early sign of vascular issues, diabetes, medication side effects, hormonal changes, sleep apnea, or mental health concerns. It’s not just a “sex problem,” it can be a general health clue.
5) Lumps, Sores, Rashes, Or Skin Changes
Track anything new on the genitals, vulva, vagina opening, penis, scrotum, anus, or surrounding skin, especially if it lasts more than two weeks.
Pay attention to:
A new sore, blister, or ulcer
A rash that spreads or doesn’t improve
New warts or bumps
A lump in the testicle or breast/chest tissue
Skin that becomes thickened, white, scaly, or persistently itchy
Some skin changes are harmless (like ingrown hairs), but it’s worth getting persistent or unclear changes checked.
6) Your STI Testing Schedule And Risk Changes
This is the most “high impact” thing to track because it’s concrete and preventive.
Track:
When you last tested and for what (testing panels vary)
Any new partners since last testing
Condom or barrier use consistency
Whether you or partners have symptoms
Whether you might benefit from vaccines (HPV, hepatitis A, hepatitis B) or prevention like PrEP for HIV
Many STIs have no symptoms, so timing your screening to your situation matters more than trying to “spot” an STI by feel.
What To Ignore: Common Things That Sound Scary But Usually Aren’t
Your body is allowed to be a little weird sometimes. Here are things that often cause unnecessary panic.
1) Normal Variation In Desire
Desire is not a constant trait. It’s influenced by sleep, stress, mental load, relationship quality, body image, hormones, and medications. If a dip doesn’t bother you and isn’t paired with other concerning symptoms, it may not be a problem to “fix.”
A helpful question is: does this change feel like a problem for you, or does it feel like a normal response to life right now?
2) Normal Changes In Vaginal Discharge Across The Cycle
Discharge often becomes:
Clear and stretchy around ovulation
Thicker or whiter at other times
A bit more noticeable with arousal
If there’s no itch, burning, strong odor, pain, or fever, it’s frequently just normal physiology.
3) Occasional Performance Variability
Erections, lubrication, orgasm timing, and overall responsiveness can vary from one day to the next. Alcohol, fatigue, anxiety, and pressure to “perform” can easily cause changes.
What matters is whether it’s persistent, distressing, or paired with pain or other symptoms.
4) Queefs, Sounds, And Other Unsexy Normal Human Things
Air can get trapped and released during sex, especially with certain positions. Bodies make noises. This is normal, even if it feels awkward.
5) One-Off Irritation After Shaving, Friction, Or New Products
Mild irritation after:
Shaving or waxing
Lots of friction
Tight clothing
New soaps, scented wipes, lubricants, condoms, or laundry detergent
…is common. If it improves quickly with gentle care, it’s often just irritation. If it worsens, spreads, becomes very painful, or doesn’t improve, that’s different.
When To See A Clinician: Clear Signs To Take Seriously
If you remember nothing else, remember this: persistent, severe, or fast-worsening symptoms deserve evaluation. Here are the big ones.
Go Soon, Not Later, If You Have Any Of These
Pain with sex that persists, worsens, or makes sex hard to tolerate
Bleeding after sex, bleeding after menopause, or heavy bleeding that soaks through pads quickly
New pelvic pain, testicular pain, or swelling that doesn’t resolve
Burning with urination plus fever, back pain, pelvic pain, or discharge
New genital sores, blisters, ulcers, or a rash that doesn’t improve
Strong odor with itching or burning, especially if symptoms are new
A new lump in a testicle or breast/chest tissue, or a testicle that feels heavier or different
Erectile dysfunction that persists for several weeks, especially with other health risks (diabetes, high blood pressure, smoking) or if it’s sudden
Exposure to an STI (or a partner tells you they tested positive), even if you feel fine
Seek Urgent Care If You Have Any Of These
Severe testicular pain, especially if it starts suddenly (this can be an emergency)
Fever plus pelvic pain or severe abdominal pain
Signs of an allergic reaction after condoms or lubricants (swelling, hives, trouble breathing)
Heavy bleeding with dizziness, fainting, or shortness of breath
Severe pain with urination plus fever and flank or back pain
If something feels alarming in your gut, it’s okay to get checked even if it turns out to be nothing. Peace of mind is a valid reason.
STI Testing Basics: A Practical, No-Shame Guide
People often assume STI testing is one standard test. It’s not. Different infections require different samples.
Common testing methods include:
Urine tests for chlamydia and gonorrhea (site-specific swabs may still be needed depending on sexual practices)
Blood tests for HIV and syphilis
Swabs for throat or rectum if those are exposure sites
Swabs of sores if present
When to test depends on your situation, but these are common times to consider it:
Before starting sex with a new partner, ideally both of you test
After unprotected sex with a new or non-monogamous partner
If you or a partner has symptoms
If a partner tests positive
Periodically if you have multiple partners or are in a non-monogamous arrangement
If you’re not sure what tests you need, tell the clinician what kinds of sex you have (oral, vaginal/front hole, anal) and what body parts are involved. That detail helps them test the right sites. It can feel awkward, but clinicians hear it all day.
Contraception And Pregnancy Prevention: What’s Worth Tracking
If pregnancy is possible in your body or with your partner, it helps to track:
Whether your contraception method is being used consistently and correctly
Missed pills, late shots, or a patch or ring schedule issue
Any medication interactions (some anti-seizure meds and certain antibiotics can affect hormonal contraception)
Emergency contraception needs after unprotected sex or contraception failure
If you have a uterus and a period, it’s also useful to track your cycle enough to recognize major changes, but you don’t need to obsess over daily fluctuations.
Comfort And Pleasure Count As Health
This is the part many “sexual health” articles forget: comfort and pleasure are not bonus features. They are part of health.
It can be worth talking to a clinician if:
Sex is consistently painful
You can’t get aroused or orgasm, and it bothers you
Anxiety or past experiences make intimacy feel hard
You’re having persistent dryness, irritation, or tearing
Depending on the cause, solutions might include pelvic floor physical therapy, changing products, addressing hormonal factors, adjusting medications, counseling, or treating underlying conditions.
How To Talk To A Clinician Without Feeling Weird
If you’ve ever avoided care because you didn’t know how to say the words, try this simple script:
“I’m noticing a change in my sexual health, and I want to make sure it’s not something serious.”
“Here’s what’s been happening, how long it’s been going on, and what makes it better or worse.”
“I’d like STI testing that matches my sexual practices.”
“I’m not sure what’s normal here, and I’d like guidance.”
You don’t have to give a perfect story. A timeline and your main concern is enough.
A Friendly Checklist You Can Use
If you want the quick version, this is a good rule of thumb.
Track:
Pain, bleeding outside your normal pattern, concerning discharge plus symptoms, new skin changes, persistent erection or arousal changes, and your STI testing dates
Ignore:
Normal desire fluctuations, normal discharge changes without symptoms, occasional performance variability, and minor short-lived irritation from friction or grooming
See a clinician:
For persistent or worsening symptoms, bleeding after sex or after menopause, new sores or rashes that don’t improve, significant pelvic or testicular pain, or STI exposure
Bottom Line
Sexual health is mostly about knowing your baseline and not dismissing changes that persist or interfere with your life. You don’t need to track everything. Track the things that signal a real change, ignore normal variation, and give yourself permission to get checked when something feels off.
Disclosure
This article is for general educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Sexual health needs and risks can vary based on your body, medications, medical history, and sexual practices. If you have symptoms that are severe, persistent, worsening, or concerning to you, or if you think you may have been exposed to a sexually transmitted infection, contact a qualified health care professional. If you have severe symptoms such as sudden, intense testicular pain, heavy bleeding with dizziness or fainting, or fever with severe pelvic or abdominal pain, seek urgent medical care.
