Sex isn’t the easiest thing to talk about. (Remember that cringey 8th grade sex ed class that didn’t exactly include everything you needed to know to be informed and safe?) Well, we’re going to go there anyway, because sexual health shouldn’t be taboo, and it can be an important part of your weight care journey.

After all, sex isn’t only about the physical part—it includes the emotional and mental parts as well. So let’s put those 8th grade memories behind us and really talk about sexual health. 

First, it should go without saying that sex should always be consensual, healthy, and positive. Full stop. The Centers for Disease Control and Prevention defines sexual health as “a state of well-being in relation to sexuality across the life span that involves physical, emotional, mental, social, and spiritual dimensions.

Sexual health is an intrinsic element of human health and is based on a positive, equitable, and respectful approach to sexuality, relationships, and reproduction, that is free of coercion, fear, discrimination, stigma, shame, and violence.” And if you have excess weight, there are some factors that can impact your sexual health.

Often, physical health can limit the amount of sex you have. It may be tough to get in certain positions when you have excess weight. And both men and women with higher BMIs could experience medical issues. Men who have overweight or obesity, for example, are more likely to suffer from erectile dysfunction (ED).

In one recent study, researchers at the University of California, Los Angeles reviewed 47 studies on sexual health among 31,742 men and concluded that obesity was consistently linked to lower sexual function and was a precursor for ED. And in the largest study performed to date among men and women who were getting bariatric surgery, researchers discovered that obesity was also associated with ED, and that physical health limited sexual activity in 38% of women and 44% of men. You deserve to have a great sex life, so if you feel like you’re having issues, talk to your doctor. 

Emergency contraceptives like Plan-B and Ella decrease in efficacy depending on weight for those who are able to get pregnant.

Planned Parenthood advises that, “If you take an emergency contraception pill with levonorgestrel (like Plan B One Step, Take Action, My Way, and others) and you weigh 155 pounds or more, it may not work.” And they say that if you weigh more than 195 pounds, it might not work at all.

The good news is other methods, like IUDs, can be used within five days of unprotected sex as a back-up—but it’s important to consult your doctor right away if you think you’re at risk. In 2011, researchers sent surveys out to Craigslist ads for “Men Seeking Men” across multiple countries. Of the 576 people who responded, the study found that having a higher BMI was linked to a lower likelihood of rejecting sex partners and less consistent condom use. Having excess weight, being a gender minority, and practicing unsafe sex can lead to Sexually Transmitted Infections (STIs) and HIV risk.

There’s also evidence that women with obesity are more likely to have more unprotected sex and unplanned prengnacies than those with lower BMIs. For both women and men, condoms are a great way to prevent STIs and an unplanned pregnancy when getting frisky.