Dating and Sex
As you journey into young adulthood, you will have many new life experiences and opportunities. Some may involve relationships and falling in love. As a person with a bleeding disorder, you will have to approach these life experiences in an informed, responsible manner so you can make the best decisions for yourself and those you love.
This section of Step Up will cover:
Relationships Beyond the Casual Date
By now you’re taking care of yourself. You may be going onto or finishing your education after high school or you may even be living on your own and have a job. You might be thinking about the future and who you would like to share it with. Maybe you’re dating someone special now or maybe you’re still looking for the right one.
The decisions you make about relationship partners do not only affect you but also your partner, your partner’s family, and your own family. Taking a well-thought-out approach and being sensitive to other’s feelings and reactions to your bleeding disorder can make a big difference in how everyone views your bleeding disorder in the future.
This section of Step Up focuses on issues involved in choosing the right partner for you. It covers:
- Choosing a Partner: Things to Consider
- Talking With Your Parents About a Serious Personal Relationship
- Talking With Your Partner’s Family
Perhaps you’ve been dating someone for a while and are seriously considering if this person is the right one for you in the long term. While there are many reasons to pursue a relationship that is deeper than previous ones, adding a bleeding disorder to the mix brings special considerations.
Here are some questions to help give you a better idea about whether or not this one is a keeper:
- Does your partner take an active interest in your bleeding disorder? Does he or she want to learn more about and understand the daily care that’s involved in having a bleeding disorder?
- Does your partner take an interest in you as a person and not just your bleeding disorder?
- Does your partner want to learn about your bleeding disorder or does he or she consider it to be your problem?
- Does your partner have interests outside of your life together and does he or she support your interests?
- Do you feel you can count on your partner's help for support in a crisis or do you think your partner will become an additional burden for you?
- Do you feel you can express your thoughts, be open and honest about your feelings, and trust that your partner will be supportive?
Finding a partner isn’t easy. A solid relationship can only be built on trust, how enjoyable you find his or her company, and whether or not you feel comfortable sharing your innermost feelings.
Once you feel you have found this special person, convincing your parents that this person is the right one for you can be a hurdle sometimes. It’s not easy for parents to view their son or daughter as an adult, especially when their child has a chronic condition, such as a bleeding disorder.
Imagine what your parents may be feeling right now. They have supported and cared for you since the day you were born. Now you’re asking them to give up that role to someone they hardly know. Give them time to get to know your potential partner. Help them see what you see in this person.
Here are a few suggestions on when and how to introduce that special person to your family:
- Be Patient. There’s no need to rush into a relationship. Take the time to get to know the person you’re interested in before bringing him or her home for a family dinner. Decide first for yourself if this is the person you want to get serious with before you introduce him or her to your family.
- Understand Your Parents’ Perspective. Give your parents time to adjust to their new, less hands on caregiver role. Try to remember how difficult it was at times for your parents to adjust to your increasing independence when you were growing up. Bringing another person into the family who also cares about you may bring up those same feelings. Take the time to understand your parents’ feelings and talk with them about the ways they can still support you.
- Reassure Your Parents. Explain to them that you and your partner have talked about the implications of living with someone who has a bleeding disorder.
You have lived your whole life with a bleeding disorder. You may think of it as no big deal; it’s something you have incorporated successfully into your daily life. But, to those on the outside, especially the parents of someone whose son or daughter is developing a strong relationship with you, your bleeding disorder may be frightening. They may have concerns you have not considered, including fears about your health and the health of their son or daughter. They may not understand your bleeding disorder and how it does or does not affect you, your daily life, and your ability to attend college, get a job, acquire health insurance, and have children. In addition, just like your parents are protective of you, your partner’s parents may be protective of their son or daughter, as well. Taking the time to educate them, help reduce their fears, and reassure them will benefit you, your partner, and your relationship with his or her parents.
Here are some questions and concerns your partner’s family may have:
- Your health
- What is a bleeding disorder?
- What are your treatment options?
- What is the severity of your disease: mild, moderate, or severe?
- Your future
- What educational opportunities will you have?
- What are your career prospects?
- Will you be able to financially support a family?
- Having a family
- Can someone with a bleeding disorder have children?
- What is the likelihood of your children having a bleeding disorder as well?
- Will you and your family have access to health insurance?
- Impact on their child
- Will my child become more of a caretaker than partner to you?
- Will my child have time for his or her own interests?
Here are some suggestions to help your partner’s parents understand your bleeding disorder:
- Educate. Refer your partner’s parents to Web sites you trust. They can start right here at Steps for Living! Give them written materials to read over at their own pace. Set up a time for them to ask you questions about your bleeding disorder. You can also ask them if they would like to meet with your physician or Hemophilia Treatment Center (HTC) team to ask questions and get more information. Your HTC team may be able to introduce them to other people with bleeding disorders who are married with families and have careers to help them see that these possibilities are easily attainable for you and your partner.
- Reassure. Share with them the steps you take to prevent injuries and bleeds and promote your overall well-being. By reassuring them that maintaining good health has always been a top priority for you, you’ll help them to see a future for you and their son or daughter.
- Discuss. Talk to your partner and his or her parents about the genetics of your bleeding disorder. Explain what it means to have a bleeding disorder that is passed on though DNA. Talk honestly about the possibility of having children with a bleeding disorder.
- Go Slow. You’re in this relationship for the long haul. You have plenty of time to move your relationship to the various next levels. Taking your time will help your partner’s parents learn who you are.
- Don’t Be Judgmental. You don’t want to be judged for having a bleeding disorder, so you shouldn’t judge your partner’s parents for not understanding your condition or for needing time to get to know you as a person and not just as a person with a bleeding disorder. Being patient and understanding will help you develop open and honest communication among you, your family, your partner, and his or her family.
Sex and Bleeding Disorders
Whether you are still looking for Mr. or Ms. Right or you’ve already found that special person, sex will likely be an issue you’ll want to discuss with your partner. Your partner may be wondering, as you may be, if sex is a safe activity for someone with a bleeding disorder.
This section of Step Up will focus on sex concerns for persons with bleeding disorders. It covers:
- Sex and Your Bleeding Disorder
- Safe Sex
- The Lesbian, Gay, Bisexual, and Transgender (LGBT) Community, Bleeding Disorders, and Safe Sex
If you have a bleeding disorder, you may have questions about sex that go beyond the basic birds and bees. Like most questions you have about your bleeding disorder, it’s best to ask the experts at your Hemophilia Treatment Center (HTC) specific questions you have about sexual activity and your bleeding disorder. Really, don’t be embarrassed to ask. They’ve heard just about everything.
Below we’ll address some of the most common questions individuals with bleeding disorders have about sexual activity:
- Is It Safe For Me to Have Sex?
- Will I Be Safe From Bleeds if I Avoid Having Penetrative Sex?
- What Signs of a Bleed Should I Watch Out For After I’ve Had Sex?
- Can I Have Sex During My Period?
- Am I More Likely to Contract a Sexually Transmitted Disease (STD) If I Have a Bleeding Disorder?
If and when you choose to have sex is a decision you should think through carefully. Sex is just one of many ways you can be intimate with your partner. However, it can have very serious consequences, such as an unplanned pregnancy or contracting a sexually transmitted disease (STD). You need to be responsible and take precautions to be safe.
Sexual acts can involve parts of the body that have a lot of blood vessels (e.g., mouth, genitals, anus), and you can get a bleed anywhere your blood flows. Sex is like most other strenuous physical activities for a person with a bleeding disorder, and it could potentially cause a bleed in any part of the body or in any joint. After sex some men experience lower back, abdominal, pelvic and/or upper thigh-groin pain, and tingling or numbness in the affected thigh if they bleed into their deep pelvic muscles. The deep pelvic muscles are large muscles, and as with any large muscle bleed, a lot of blood can be lost into the muscle, leading to low blood volume and potentially serious problems with circulation. Deep pelvic muscle bleeds can be limb and/or life threatening and should be considered a medical emergency. Call your Hemophilia Treatment Center (HTC) team or hematologist as soon as possible for help and treatment instructions. They have seen and heard it all before. There is nothing to be embarrassed about!
Sexual activities other than penetrative sex may be less likely to cause bleeding. However, any activity that brings blood to the surface of the skin, such as getting a hickie, could be a problem for persons with bleeding disorders.
Sexual activity may cause bleeding anywhere in the body, including your joints and muscles. However, some parts of the body are particularly vulnerable to bleeds during and after sex, and the signs and symptoms may not be visible immediately.
Men should look out for any injury to the penis, which may be marked by external bleeding, swelling, pain, and discoloration of the urine. If you have any of these signs and symptoms, call your Hemophilia Treatment Center (HTC) as soon as possible. Sex may increase the risk of internal bleeding in the deep pelvic muscles in men, which may be extremely hard to recognize. After sex some men experience lower back, abdominal, pelvic, groin and/or upper thigh pain, or numbness and tingling in the affected thigh if they bleed into their deep pelvic muscles. (These bleeds are commonly called psoas muscle bleeds; but they really involve more than just that muscle).
With bleeds into your deep pelvic muscle there is a risk of artery, vein, and/or nerve damage due to compression of these structures by the swollen muscle. The nerve damage could become permanent if not treated promptly. Your deep pelvic muscles are large muscles, and as with any large muscle bleed a lot of blood can be lost into the muscle, leading to low blood volume and potentially serious problems with circulation. Deep pelvic muscle bleeds can be limb and/or life threatening and should be considered a medical emergency. Call your Hemophilia Treatment Center (HTC) team or hematologist as soon as possible for help and treatment instructions. They have seen and heard it all before. There is nothing to be embarrassed about!
There’s no reason why sexual intercourse can’t occur during menstruation. What’s most important is that you and your partner are both comfortable with the idea, and that you’re prepared for a bit of a mess. Remember that it’s still possible to become pregnant while you are menstruating, and the spread of sexually transmitted diseases is always a risk. Make sure to use a condom.
No, your risk of contracting an STD is not higher because you have a bleeding disorder. However, regardless of your bleeding disorder, if you don’t practice safe sex, you’re more likely to contract an STD, compared to a couple who practice safe sex.
When you discuss your bleeding disorder with your partner, it may also be a good time to talk about practicing safe sex and using condoms. While a bleeding disorder is not contagious, sexually transmitted diseases (STDs) are. If you are HIV positive, or have hepatitis B or C, herpes, or any other contagious condition, let your partner know ahead of time. Not only might it be illegal to willfully expose another person to these diseases through unprotected sex, but your partner will thank you for your concern and appreciate your honesty!
For a person with a bleeding disorder, having safe sex also means looking out for any signs of injury or bleeding during and after sexual activity. People with bleeding disorders may experience bruising or bleeding on any part of the body for a prolonged time. Men with bleeding disorders may experience more bleeding around the deep pelvic muscles, across the lower back, thighs, and on the genitals.
Certain body positions during sex may be less strenuous on your joints and muscles and may help you avoid bleeds. The safest positions may vary from person to person. So, talk with your partner; you may have to try a few different positions before you figure out the right one for you. If you tend to get more bleeds in the muscles on the front of your body, ask your partner to support more of his or her own body weight during intercourse. Sometimes a pillow or other support may help you have sex safely and comfortably. Get to know your body so that you will be able to quickly detect an injury if one occurs.
Sex can be safe for people with bleeding disorders, regardless of sexual orientation. While exercise or any strenuous behavior may increase the risk of a bleed, sex will be safer if you use condoms. Be aware of your body, and be mindful of your vulnerable areas.