Spontaneoustermination is called miscarriage. Induced termination is the one that is abortion. It is the outcome of unintended and unwanted pregnancy. And the abortion can be medical by medical professionals under the law or unsafe by untrained non medical people which may be against the law.About 20 – 22 million such unsafe abortions annually around the world are responsible for medical emergencies and deaths.

Types of abortion

Spontaneous Abortion or Miscarriage

An unintentional expulsion of embryo or fetus before 24^th week of pregnancy is called miscarriage or spontaneous abortion. After that time it is pre mature birth in case of alive birth and stillbirth in case of dead delivery. Less than 50% pregnancy goes beyond first trimester.

Causes of miscarriage:

• Chromosomal defect
• Diabetes
• Hormonal disorders
• Infection
• Abnormalities of uterus
• Vascular diseases
• Trauma
• High age of mother
• Previous history of abortion

Induced Abortion

Induced abortion can be:

• Legal or illegal
• By trained and authorized medical professional or untrained person
• Therapeutic (on health ground of mother or child) or elective (personal choice)

Choice of procedure depends on

• Months of pregnancy (gestational age)
• Legal acceptance of procedure
• Availability of procedure
• Choice of doctor
• Choice of person

Types of induced abortion

Medical

These are done by certain pharmaceutical products like mifepristone, prostaglandin analog, methotrexate etc. This is preferred choice in early weeks of pregnancy.

Surgical

• Vacuum suction aspiration, manual or electric
• Dilatation and Curettage (D&C)
• Dilatation and Evacuation (D&E)
• Intact Dilatation and Extraction(IDX)
• Hysterotomy abortion

First three are for first trimester and can be done under local anesthesia whereas later two are for second trimester done under general anesthesia.

Other methods

Some traditional but unreliable methods like herbs or causing trauma by force or non surgical instruments. They have side effects and can even cause death.

How safe are abortions?

Abortions are very safe if :

• done at appropriate time
• done in appropriate conditions
• done by appropriate procedure
• done under supervision or by appropriate people (medically trained)

Complications of abortion:

Though rare but if precautions are not taken, following complications can occur:

• Pain
• Infection
• Uterine perforation
• Complications due to retained products

Why unsafe abortion?

It is estimated that about 20 million unsafe abortions are done annually.

It causes:

• medical complications
• injury
• secondary infertility
• possible death

Why do women opt for unsafe abortions?  Some common reasons are:

• Non availability of legal abortion
• Need to hide identity
• Choice of ‘easier method’
• Lack of availability of effective contraception

Abortion debate:

Induced abortion raises debate on spiritual, religious, political, ethical, moral, legal, medical, biological, philosophic, value system, human rights and responsibilities issues.

Those against abortion see abortion as murder and talk about Right of fetus to live as human being. Those in favor talk about Right of woman to decide about own life, own body and reproduction. Some neutral factors like risk to mother’s life also play a role. Most countries now legally favors abortion as woman’s right.

Gender based abortion:

This refers to abortion determined by gender of fetus. Termination of female fetus is more common due to desire of son as symbol of power, protection, future care and successor. It is facilitated by sonography (ultrasound) and amniocentesis.  The bad impact of this is deterioration of sex ratio between male and female in society. Most countries have agreed to eliminate discrimination against girl child and have enacted laws to prevent and ban such abortions.

Termination of pregnancy by removal or expulsion of embryo or fetus is called abortion.

Spontaneoustermination is called miscarriage. Induced termination is the one that is abortion. It is the outcome of unintended and unwanted pregnancy. And the abortion can be medical by medical professionals under the law or unsafe by untrained non medical people which may be against the law.About 20 – 22 million such unsafe abortions annually around the world are responsible for medical emergencies and deaths.

Types of abortion

Spontaneous Abortion or Miscarriage

An unintentional expulsion of embryo or fetus before 24^th week of pregnancy is called miscarriage or spontaneous abortion. After that time it is pre mature birth in case of alive birth and stillbirth in case of dead delivery. Less than 50% pregnancy goes beyond first trimester.

Causes of miscarriage:

• Chromosomal defect
• Diabetes
• Hormonal disorders
• Infection
• Abnormalities of uterus
• Vascular diseases
• Trauma
• High age of mother
• Previous history of abortion

Induced Abortion

Induced abortion can be:

• Legal or illegal
• By trained and authorized medical professional or untrained person
• Therapeutic (on health ground of mother or child) or elective (personal choice)

Choice of procedure depends on

• Months of pregnancy (gestational age)
• Legal acceptance of procedure
• Availability of procedure
• Choice of doctor
• Choice of person

Types of induced abortion

Medical

These are done by certain pharmaceutical products like mifepristone, prostaglandin analog, methotrexate etc. This is preferred choice in early weeks of pregnancy.

Surgical

• Vacuum suction aspiration, manual or electric
• Dilatation and Curettage (D&C)
• Dilatation and Evacuation (D&E)
• Intact Dilatation and Extraction(IDX)
• Hysterotomy abortion

First three are for first trimester and can be done under local anesthesia whereas later two are for second trimester done under general anesthesia.

Other methods

Some traditional but unreliable methods like herbs or causing trauma by force or non surgical instruments. They have side effects and can even cause death.

How safe are abortions?

Abortions are very safe if :

• done at appropriate time
• done in appropriate conditions
• done by appropriate procedure
• done under supervision or by appropriate people (medically trained)

Complications of abortion:

Though rare but if precautions are not taken, following complications can occur:

• Pain
• Infection
• Uterine perforation
• Complications due to retained products

Why unsafe abortion?

It is estimated that about 20 million unsafe abortions are done annually.

It causes:

• medical complications
• injury
• secondary infertility
• possible death

Why do women opt for unsafe abortions?  Some common reasons are:

• Non availability of legal abortion
• Need to hide identity
• Choice of ‘easier method’
• Lack of availability of effective contraception

Abortion debate:

Induced abortion raises debate on spiritual, religious, political, ethical, moral, legal, medical, biological, philosophic, value system, human rights and responsibilities issues.

Those against abortion see abortion as murder and talk about Right of fetus to live as human being. Those in favor talk about Right of woman to decide about own life, own body and reproduction. Some neutral factors like risk to mother’s life also play a role. Most countries now legally favors abortion as woman’s right.

Gender based abortion:

This refers to abortion determined by gender of fetus. Termination of female fetus is more common due to desire of son as symbol of power, protection, future care and successor. It is facilitated by sonography (ultrasound) and amniocentesis.  The bad impact of this is deterioration of sex ratio between male and female in society. Most countries have agreed to eliminate discrimination against girl child and have enacted laws to prevent and ban such abortions.

Early adolescence (ages 12- 15) is a precarious period in youths’ sexual development because of the inter-relationship between sexual development, cognitive development, and emotional development. Youth at this age lack the cognitive and emotional maturity that is necessary to make wise and healthy decisions regarding their sexuality and are ill-prepared to cope with consequences of sexual activity. This is particularly unfortunate as today’s adolescents are becoming sexually active sooner than previous generations.

During early adolescence boys will experience frequent erections since this is the normal response of the male body to sexual excitement. Erections can also occur spontaneously for no apparent reason at all as boys’ bodies adjust to the extreme chemical and hormonal changes initiated during puberty. Similarly, girls may find they produce vaginal secretions for no apparent reason, even when they’re not menstruating. Sometimes, these secretions are caused by sexual arousal, but increased vaginal secretions can also be caused by normal hormonal fluctuations during their monthly cycle.

By ages 13-14 years, guys will have a more obvious interest in sex than girls do. Because sexual pleasure is a new experience, boys may want to masturbate quite frequently. Girls may not masturbate as frequently because they may be less aware of their sexual arousal. The sexual fantasies of boys are much more specific. They are mainly interested in the sexual activity itself. For most of them, sexual desire and satisfaction are immediate physical experiences quite unrelated to any particular social setting.

Common risky adolescent behaviors

• Unprotected Sex
• Substance abuse
• Violence

Children should be told frankly and sensibly about the upcoming changes in their body. Information about sex should be provided in a way that is easily understood and that leaves no questions unanswered. This information is best supplied by a parent or someone with whom the child has an emotionally stable relationship. In many schools, programs are available tat highlight the dangers of casual sex, smoking, and alcohol and drug addiction.

It is determined by factors such as anatomy, physiology, intellect, emotions, socioeconomic, value system, religious, spiritual, familial, sexual learning and personal choice. At larger level it can be determined by cultural, political, legal and philosophical aspects of life.

Individual unique sexuality gives a basic orientation to every human being. It can be:

• Heterosexuality – to opposite sex
• Homosexuality – to same sex
• Bisexuality – to both sex
• Asexuality – to none

Why do human beings get interested in sex?

It can be due to:

• Genetic influence
• Hormonal factors
• Learning by exposure
• Pleasure principal
• Social learning
• Driven by needs
• For reproduction

Types of sexual activity:

1. Based on activity

• Conventional like vaginal sex
• Non conventional like anal sex
• Perversion like fetish
• Criminal like rape

2. Based on number of participants

• One person activity like masturbation with or without sex products
• Two person activity like vaginal sex, anal sex, oral sex, mutual masturbation etc.
• More than one person activity like group sex

Types of sexual relationships:

• Marriage
• Love based commitment
• Short term relationship
• Casual relationship
• Single act relationship like one night stand
• Sex for mutual interest or favors
• Paid sex

Evolution of sexuality

Traditionally the sexual activity was driven by purpose like reproduction, attraction or pleasure. With the rise of socialization, it has served a purpose for bonding, emotional connect, remove insecurity, be part of a group, acceptance by others, to gain sense of achievement, as a skill development, business development, aesthetic and artistic growth  and even spiritual growth.

A typical sexual activity

It has

• Arousal – developing the desire and physiological changes
• Fore play – pleasure acts before main act
• Main act – like intercourse
• After play – pleasure acts after main act
• Resolution – calming down of desire and physiological changes

Frequency of sexual activity

• Abstinence – zero activity
• Low frequency – less than once in fifteen days
• Average frequency – 1 to 3 times a week
• High frequency – once or more than once a day

The frequency declines with age, appearance, hygiene, emotional state, health status, after menopause in females, with quality of relationship and with priorities of life.

It is always a good idea to know a little about the machine that you wish to use. There are two main components of sexual system. One is the brain and second is the external and internal genitalia.

Brain

Brain is the central processing unit. It receives signal from vision, hearing, touch etc and also internal signals from stored memory of past. It perceives pleasure and coordinated sexual hormones, nerves, muscles and blood circulation to create sexual response. The sexual thoughts, desires and fantasies are coming from cerebral cortex, the outer layer of brain. The sexual emotions and feelings come from limbic system of the brain. Pituitary gland in brain under the control of hypothalamus releases sexual hormones which are oxytocin, prolactin, follicle stimulating hormone FSH and luteinizing hormone LH. Of these FSH is said to be responsible for relationship bonding. It is released during sexual intercourse at the time of orgasm there called ‘Hormone of Love’. These hormones are also responsible for pregnancy and lactation.

Female anatomy of sex

External anatomy

The soft area over pubic bone located between umbilicus and vagina is monsveneris also called mount of venus. It is sensitive as it has many nerve endings. The entrance starts with labia majora, the outer lips followed by labia minora the inner lips. Labia majora are elongated folds of skin covered with hair. Labia minora meet and form clitoral hood which has clitoris with very high number of nerve endings, it is the seat of pleasure and orgasm. Labia minora contains rich supply of blood vessels and nerves. It covers the vaginal and urethral opening. Lower portion of labia minora contains bartholin’s gland which secrete alkaline fluid. This is essential as sperms can not survive acidic environment.

The vaginal opening is surrounded by bulbocavernosus muscle and vestibular bulb. These help vaginal grip on penis during intercourse. It is flexible to accommodate penis of all size. Inside vaginal opening there is hymen, a thin membrane that partially covers the vaginal opening. It is seen as a sign of virginity although in addition to intercourse it can get broken by other reasons like physical activity.

Breasts are also considered as part of external sexual organs. They contain mammary glands and fatty tissue. Their basic purpose is to prepare and provide milk to infant. Nipples are pink to brown colored and are very sensitive. Breasts too play a role in sexual stimulation.

Internal anatomy

The female internal organs are vagina, uterus, fallopian tubes and ovaries. The vagina is canal like structure from vulva outside to cervix inside. During intercourse penis ejaculates sperm in vagina. The vagina has capacity to expand as it does during intercourse and also during childbirth. Front wall of vagina contains a spot called G Spot which is said to be sensitive and take part in sexual stimulation.

Between vagina and lower end of uterus is the cervix. Uterus is a muscular organ where fetus grows. Uterus occupies the pelvic cavity below abdomen. The fertilized egg is implanted on inner layer of uterus called endometrium which comes out as menstrual cycle every month when there is no fertilization. Fallopian tubes starts from side upper end of uterus both sides and extend sideways towards ovaries. Fallopian tubes pick eggs from ovaries. In these the eggs travel and get fertilized. Ovaries are female gonads and produce egg and female hormones estrogen and progesterone. In ovaries eggs grow inside a capsule called follicle. Every month one or more eggs get mature and egg is released. A female releases about 400 eggs during lifetime.

Male anatomy of sex

External anatomy

The external genitalia contain penis, scrotum and testes. Penis is cylindrical organs and helps in sexual intercourse and also as passage of sperms and urine. In non erect state it is about 3 to 3.75 inch in length and 1 to 1.2 inch in diameter. In erect state it is 4 to 6 inch in length and about 1.5 inch in diameter. The top portion of penis is glans which is covered by foreskin. In some cultures, this foreskin is removed in a process called circumcision. The main body of penis is shaft which has three cylinder shaped bodies of spongy tissue with many tiny blood vessels. These bodies get filled with blood to create erection in penis. Urethra, a tube like structure runs through penis to open outside at meatus as outlet of urine and sperms. The lower end of penis is root that gets attached to pubic bones. Underneath the penis there is a sac like structure called scrotum. It holds testes.

Internal anatomy

It contains testes, prostate gland, cowper’s gland and the duct system.

Testes are male gonads responsible for production of sperm cells and sex hormones, androgens like testosterone. Everyday millions of sperm cells are produced. These are carried in duct system. The duct system from testes to penis consists of epididymis near testes leading to vas deferens which extends into ejaculatory duct passing through prostate gland. Semen is produced in prostate. The ejaculatory duct finally merges into urethra towards penis.

Having sex is fun. But what might be less obvious is that it’s also good for you mentally and physically. It has many benefits. Some of them are discussed below:

Sex increases immunity – Having sex at least once or twice a week can boost immunity. Those who had sex once or twice a week had higher levels of IgA, an antibody that could help you avoid a cold or other infection.

Sex reduces pain – it can reduce pain and PMS symptoms.

Stronger pelvic floor muscles – Regular sex also strengthens pelvic floor muscles

Sex can help you sleep better – The oxytocin released during orgasm also promotes sleep

Sex gets you and keeps you closer to your beloved – Having sex and orgasms boosts levels of the hormone oxytocin, the so-called love hormone, which helps people bond and build trust.

Sex reduces stress – Having sex could lower your stress. People who had had intercourse responded better to stress than those who engaged in other sexual behaviors or abstained.

Sex boost self-esteem – when people raise the potential of sexual expression, it boosts their self-esteem and gives them a sense of being attractive, desirable, proficient, and confident

Sex increase blood flow – It goes without saying that when we get aroused our blood starts to pump at a quicker rate and, thus, blood flow to our brain increases.

Sex relieves headaches – A lovemaking session can release the tension that restricts blood vessels in the brain.

Sex is good for your heart – the average peak heart rate at orgasm is the same as during light exercise, such as walking upstairs. That’s not enough to keep most people fit and healthy.

Sex is good for glowing skin – An orgasm triggers a rush of endorphins and growth hormones, like DHEA, that help heal damage caused by the sun, smoking, and cortisol buildup, which is associated with the thinning of the skin.

Methods

• Barrier methods
• Hormonal methods
• Intrauterine devices
• Surgical methods
• Natural methods

How to choose

• Personal choice
• Age
• Health status
• Presence or risk of disease
• Individual suitability
• Duration for which contraception is required

Barrier Methods

Condoms

Available for both men and women. They are made of thin sheath and work as barrier for sperm to enter female genital tract. They also help in protection against sexually transmitted diseases. Males wear condoms on penis before intercourse by simply rolling it over when in erect state. Precaution is that it should not be torn or slips after ejaculation when penis becomes relaxed. It should not be put in toilet but should be carefully thrown in bin. Female condom is worn inside vagina before intercourse. Condoms are about 98% reliable.

Hormonal methods

Pills

These are hormone based pills used by females. These can be single or combined hormone estrogen and progesterone. Taken daily for 21 days and then a break of 7 days.They stop the ovulation that is release of female egg. These are about 99% effective. These are not recommended if there is heart disease risk.

Injection

These are hormone based injections. Also prevent sperm reaching the egg. They work similar to pills but required less frequently. About 99% effective. Some side effects are mood swings, increase in weight, headache and thinning of bones.

Contraceptive patch

A patch which releases hormone is put on arm. One patch for a week, three such and then break of one week. Work like pills. Effectiveness is about 99%.

Contraceptive Implant

A tiny instrument put under skin of arm by medical professional. It releases hormones like patch. It protects for three years but is irreversible. About 99% effective.

Diaphragms and caps

Reusable, made of rubber or silicon these are inserted into vagina. They contain spermicide, an agent to kill sperm. They work as both barrier and by killing sperm cells. About 96% effective.

Emergency contraception

In case where other method has gone wrong like torn condom or after unprotected sex, one can use emergency contraception. There are two kinds. Pills to be used within 48 hours and Intra Uterine Device within five days of exposure.About 95 to 99 % effective.

Intrauterine Devices and system

Intra Uterine Devices IUDare tiny devices made of copper and plastic that is placed inside female genital tract. They work for years. They prevent sperm from travelling to cervix and also prevent implantation. About 99% effective.Can be removed when not required. When such devices are used with hormones they are called Intra Uterine System IUS. They prevent ovulation in addition to IUD action. They too are 99% effective.

Surgical method

This is the surgical method of contraception in which the pathway is obstructed through a simple surgery. It is vasectomy in males or tubal ligation in females. Although permanent but a reversal can be tried in cases. These are free from side effects and offer almost 100% protection.

Natural methods

These methods work on the understanding of menstrual cycle.

Calendar based abstinence – Regulating the timing of intercourse to prevent conception. Time when egg is present for fertilization is prevented. Abstinence can be long term method if that is ok for both to remain without sex.

Lactation – First six months after delivery if the mother is breast feeding the child, the conception does not occur.

Withdrawal – Also called coitus interruptus. During intercourse penis is withdrawn just before ejaculation. This is highly risky due to failure of withdrawal in time.

Body based method – In this symptoms of body like body temperature are used to determine most fertile period and that is avoided.

Dual protection

Combining two birth control methods is helpful in increasing effectiveness of methods. Adding barrier method can help in preventing sexually transmitted diseases. Sometimes they compliment each other like combination of natural and barrier method.

Real facts to dispel misconceptions

There are many misconcepts but must be removed. Here are the real facts:

• Douching or washing of female genital tract after intercourse does not protect.
• No menstruation like in young girls before her first period is no guarantee against conception.
• Sex during less fertile phase can still cause pregnancy.
• Conception can not be increased or decreased by altering sex positions.

Specific behaviours during early childhood sexual development include sexual play, masturbation, swearing, sex jokes and dressing up as the other sex. Many parents are surprised, even shocked, when they discover their children engaging in some form of sex play or exploration.

Common behaviours of childhood sexuality

• Curiosity-based sex plays with same and opposite sex friends.
• Occasional masturbation. For some children masturbation may begin to take on a pleasure oriented rather than relaxation focus.
• Kissing, flirting, innocent seduction behavior
• Occasional interest in the private body parts of others
• Use of slang words to describe body parts and sexuality.

Parental intervention in their child’s sexuality

Children learn certain values related to sexuality that lay a foundation for later sexual development. The healthy development of our children is something we all desire. Learning to distinguish between normal and alarming childhood sexual behavior is key to ensuring healthy sexual development. Here are some points for the parents to remember when addressing their child’s sexuality:

• Parents and caretakers need to develop an open and trusting relationship so that the children in their care feel comfortable talking with them about anything.
• Become familiar with the developmental tasks and needs of children that pertain to their sexuality.
• Expect your child to be exposed to sexual matters. Don’t assume that because you don’t “show it or say it” at home your child won’t know something about it.
• Educate yourself about sex and sexuality and practice talking about it so you become more comfortable.

• Abortion – The termination of a pregnancy before it has reached viability.
• Adolescence -The period of life between childhood and adulthood, usually age 11–16.
• Anorgasmia -The inability to have an orgasm.
• Auto Immune Deficiency Syndrome or AIDS – A deadly sexually transmitted disease, no cure yet but there are good medicines to control.
• Basal body temperature method of family planning -Natural method of birth control that uses the woman’s daily body temperature to determine when a woman is ovulating.
• Bi-curious -State of sexual interest in both sexes in order to determine one’s sexual orientation.
• Bisexuality -Sexually attracted to members of both sexes.
• Calendar method or rhythm method -Natural method of birth control that in which abstinenceis observed during the time of month when the woman is likely to become pregnant.
• Candidiasis or yeast infection -Fungal infection that is sometimes affects genitals through sexual contact.
• Cervical cap -Barrier method of birth control in which a small cap is used to fit over the cervix and block sperm.
• Cervical mucus method – Natural method of birth control that checks the consistency of the woman’s cervical mucus to see when a woman is ovulating and is more likely to conceive.
• Cervix -The entrance to the uterus in a female’s anatomy.
• Chlamydia -A common sexually transmitted disease.
• Circumcision -The surgical removal of the penis foreskin.
• Climacteric –Phase of menopause with characteristic changes.
• Clitoris –The sensitive part of the female genitalia found within the vulva. It is said to be the organ of pleasure in women.
• Condom – Barrier method of birth control worn by men over the penis. Also a good method of protection against sexually transmitted diseases.
• Contraception -The intent, efforts and methods to avoid unintended pregnancy.
• Cunnilingus –Oral sex done on vagina.
• Depo-Provera:Hormonal method of birth control.
• Detumescence–Fading arousal after ejaculation in males, penis returns to flaccid state.
• Diaphragm -Barrier method of birth control in which a domeshaped cup blocks the rear part of the vaginafrom sperm.
• Dildo -A penisshaped object that is inserted into vagina to simulate the sexual feeling.
• Ejaculation –Emission of sperm from penis as a result of orgasm.
• Erectile dysfunction or ED –A condition when a man is unable to have an erection.
• Erection -A penis that is stiff and hard in a state of arousal.
• Estrogen -A female hormone.
• Fellatio –Oral sex done on penis.
• Female superior position – Sexual position with woman on top.
• Foreskin -A sheath of skin that surrounds the glans and opens at the top. This is surgically removed in the process called circumcision.
• Frottage -The homosexual activity of two men rubbing their bodies against each other until they reach climax.
• Genital warts by human papillomavirus HPV – A typeof sexually transmitted disease.
• Glans -The head of penis.
• Gonorrhea –A type of sexually transmitted disease.
• Group masturbation also called circle jerk -Mutual masturbation in a group.
• Hepatitis B – A type of sexually transmitted disease.
• Herpes – A type of sexually transmitted disease.
• Heterosexuality –Sexual attraction only to members of opposite sex.
• Homosexuality -Sexual attraction only to members of same sex as own.Men and women are respectively gay and lesbian.
• Hormone replacement therapy- Medical treatment by hormones for menopause and post it.
• Human immunodeficiency virus HIV – Sexually transmitted virus that causesautoimmune deficiency syndrome AIDS.
• Hysterectomy – The surgical removal of the uterus.
• Impotency –Inability in man to get an erection when wanted.
• Intrauterine deviceIUD:Method of birth control in which a small device is implanted into the uterus with use of hormones or copper to prevent pregnancy.
• Laparoscopic sterilization –Type of female sterilization in which a small instrument inserted through a small incision.
• Libido -The desire to have sex.
• Masturbation -Sexually pleasuring oneself usually ending in orgasm.
• Meatus – Theexternal opening of the glans.
• Menarche -First menstrual period.
• Menopause -The end of menstruation with resultant changes.
• Menstruation or menstrual cycle -The monthly process of releasing eggs and bleeding in case of non conception.
• Missionary position – Male on top position of sex.
• Molluscum contagiosum – A type ofsexually transmitted disease
• Mons pubis andMons Veneris -A portion above the female’s pubic bone and is said to be sensitive to sexual stimulus.
• Mutual masturbation –Pleasuring each other by masturbating the partner.
• Natural family planning method –Using natural method like abstinence to prevent pregnancy.
• Nocturnal penile tumescence -Erection during sleep.
• Orgasm –The climax of sexual excitement experienced as intense pleasure and with ejaculation in males and similar feeling in females.
• Ovulation -Process in which ovaries release egg.
• Pedophile -A person who wants to have sex with children.
• Pelvic inflammatory diseasePID:An infection that has spread into the deeper organs of reproductive system.
• Perineum -The area between the genital organ and the anus.
• Peyronie’s disease -Condition in which the erect penis curves to one side to the extent that sex becomes impossible.
• Premonitory sensation -The feeling or point of no return before ejaculation in men.
• Priapism –Long lasting painful erection.
• Progesterone -A female hormone essential for pregnancy.
• Prostate gland – The prostate gland is located at the lower end of man’s bladder and it produces fluids that makepart of semen.
• Psychogenic erection -An erection caused by non specific stimulus that triggers the brain to release hormones resulting in erection.
• Pubococcygeus muscles – Muscles in the genital area in both male and female that causes the most contractions during orgasm.
• Retarded ejaculation –Condition in which ejaculation is delayed or difficult.
• Retrograde ejaculation -Condition in which during ejaculation the semen flows backwards into the bladder.
• Scrotum -The sac at the base of the penis that holds the testis.
• Sexual orientation -The state that tells what gender a person is attracted to. Like homosexuals are attracted to same gender as own.
• Sexually transmitted diseaseSTD -A disease or infection that is transmitted by sexual intercourse.
• Smegma –A substance that forms under the foreskin from excretions and dead skin cells.
• Spermicide -Chemical used as contraceptive to kill sperm.
• Sterilization -Permanent birth control method by surgery, in males it is vasectomy and tubal sterilization in females.
• Syphilis -A type of STD that gives chancres and if untreated leads to serious complications.
• Testicles or testes -Part of the male genitals present in scrotal sacs.
• Tribadism -Two women rubbing their genitals together while one is lying on top of the other.
• Trichomoniasis –A type of sexually transmitted disease.
• Tubectomy or tubal ligation – Permanent method of birth control in female by surgery.
• Uterus – Female organ where a fertilized egg implants and develops into fetus.
• Vagina – Part of the female genitals, sort of muscular tube that extends from the external opening vulva to the cervix.
• Vaginismus -A condition in which a woman’s vaginal muscles involuntarily contracts tight that makes penetration by the man’s penis is painful or even impossible.
• Vaginitis – Infection of vagina.
• Vasectomy- Permanent method of birth control in male by surgery.
• Vibrator –Sex toy or device that gives intercourse like clitoral stimulation for a woman.
• Vulva – The visible part of the female genitals.

Scientists show that sex is extremely beneficial for our health but it can also be harmful in many ways. Some of the harmful effects if sex is not disciplined are discussed below:

The Harmful Effects of Sex Addiction

• It can cause a person to exhibit uncharacteristic behavior and make poor decisions.
• It increases a person’s risk for contracting a sexually-transmitted disease.
• A person’s self-esteem may be eroded by his or her addiction to sex.
• It can lead to various acts including pornography addiction, chronic masturbation, phone sex, extramarital affairs for married individuals, voyeurism, and sexual intercourse with anonymous person.

The Harmful Effects of over Masturbation

• Though not harmful as such but excess can cause harm.
• People feel shame and guilt because of their masturbation habits
• Chronic masturbation can cause fatigue and weakness.
• It can affect sexual performance.
• It can negatively affect your work, relationships, self-esteem, finances, social support, and have legal problems if you’re not able to find a balance between being responsible in life and satisfying your pleasures and desires.

The Harmful Effects of sex during Menstruation

• Having intercourse during your period can increase the chances of irritation to the swelled up walls.
• The cervix is slightly opened during menstruation to let out blood. This heightens the risk of infection, not being limited only to the vagina, but additionally to the uterus.

The homosexual orientation defines how a person is likely to find the satisfying and fulfilling relationships. In addition to sexual behavior between partners, this includes nonsexual physical affection, shared goals, shared values, mutual support, and commitment.

Coming out

Coming out of closet is a phrase that refers to one’s disclosure of sexual orientation. First phase of this is self realization, second phase is telling others and third phase is living openly. This can be stressful and can face hurdles due to attitude of close ones. The term outing is used to publicly reveal a person’s sexual orientation by others.

Once a person realize own orientation, he or she can go through many emotions. There can be

• Denial
• Guilt
• Shame and embarrassment
• Anger
• Isolation
• Depression

Due to more social acceptance and awareness, more people now accept own orientation without huge emotional turmoil. But they can still face challenges when it comes to living a normal life:

• Opposition in family and by friends
• Discrimination at work place
• Ridicule in society
• Difficulty in finding right partner
• Challenges of a safe future

The good thing is that society is more open. Laws are in favor. And people’s attitude is more positive and respectful

Research and studies

Research has now proved it as normal. In first Diagnostic and Statistical Manual of Mental Disorders published by American Psychiatric Association in 1952, homosexuality was included as disorder. Later in 1973 it was removed.  Similarly WHO listed homosexuality as illness in ICD 9 but removed in ICD 10.

Cause

Research favors genetic and early embryonic environmental factors.

According to American Psychological Association and American Psychiatric Association

Currently, there is no scientific consensus about the specific factors that cause an individual to become heterosexual, homosexual, or bisexual—including possible biological, psychological, or social effects of the parents’ sexual orientation. However, the available evidence indicates that the vast majority of lesbian and gay adults were raised by heterosexual parents and the vast majority of children raised by lesbian and gay parents eventually grow up to be heterosexual.

According to Royal College of Psychiatrists

Despite almost a century of psychoanalytic and psychological speculation, there is no substantive evidence to support the suggestion that the nature of parenting or early childhood experiences play any role in the formation of a person’s fundamental heterosexual or homosexual orientation. It would appear that sexual orientation is biological in nature, determined by a complex interplay of genetic factors and the early uterine environment. Sexual orientation is therefore not a choice.

According to American Academy of Pediatrics

Sexual orientation probably is not determined by any one factor but by a combination of genetic, hormonal, and environmental influences. In recent decades, biologically based theories have been favored by experts. Although there continues to be controversy and uncertainty as to the genesis of the variety of human sexual orientations, there is no scientific evidence that abnormal parenting, sexual abuse, or other adverse life events influence sexual orientation. Current knowledge suggests that sexual orientation is usually established during early childhood.

Kinsey Scale

The Kinsey scale which is also called the Heterosexual Homosexual Rating Scale, describes a person’s sexual history or episodes of sexual activity at a given time. The scale is from 0 meaning exclusively heterosexual to 6 meaning exclusively homosexual. Report also use X for asexuality.

Family and parenting

Homosexuals are as fit as heterosexuals in making a family and as parents. Their children can be either homosexual or heterosexual like any other child.

Health

There are no major or different health problems than those seen in heterosexuals. The psychological issues like denial, guilt or depression are mostly due to society attitude.

Get it right. Yes, sex can be and should be learned. True that it is natural activity but one can master it and can take it to the level of art. To experience it best, it is necessary to be skillful. Even the most sexually active people do not have correct information or skill. This leads to frustration, sexual disorder and deviant sexual behavior which is enough to ruin life.

• Remove ignorance, wrong facts and myths
• Remove poor technique
• Be fully informed and aware
• Learn better skills and techniques
• Learn to avoid sexual disorders
• Learn to manage sexual disorders
• Learn the art of intimacy and relationship
• Understand the difference between healthy and unhealthy sex
• Learn the difference between mental and physical sexual appetite

People have many questions about sex and how they can become better in this. Unfortunately this crucial aspect of life has no teachers. Everyone get to know from others in group, books or pornography. Most of the knowledge is far from truth. No doubt frustration and dissatisfaction is the result. Unhappiness thus created can affect the entire life. Society must give importance to this and help young ones to learn about skills of healthy sex. Following must be made available to every boy and girl as they grow and learn.

• Sex Education in school
• Counseling in school and college
• Informative books and websites on sex and sexuality

Society should no longer feel embarrassed in talking about sex and better sex skills. Let people learn it and create happiness in life.

Psychological explanation

Sigmund Freud is famous for defining libido as life force or energy which is the instinctive unconscious part of the psyche. This comes as impulse but is often in conflict with norms of society. A person uses defense mechanism to avoid conflict with society. But excess suppression leads to neurosis. Carl Jung described libido as “It is the energy that manifests itself in the life process and is perceived subjectively as striving and desire.”

Factors that can reduce libido

Psychological factors

• Lack of intimacy
• Stress or fatigue
• Emotional turmoil
• Stress from bad environment
• Poor self image
• Attractiveness of partner
• Sexual anxiety
• History of abuse or traum

Physical factors

• Lack or deficiency of sex hormone, testosterone
• Other hormonal disorders
• Poor fitness level
• Poor nutrition
• Lack of energy
• Anemia
• Smoking, alcohol and drug abuse

Medications

• Anti depressants
• Antipsychotics
• SSRI
• Beta blockers
• Hormones like contraceptives

Endogenous substances affecting libido

• 5-HT1A agonist
• Acetylcholine
• Cortisol
• Dopamine
• Estrogens
• Oxytocin
• Progesterone
• Serotonin
• Sex hormone binding globulin
• Testosterone

Libido and menstrual cycle

Since libido is linked to body hormones, women may experience a high libido before ovulation. This is said to be linked to gradual rise of testosterone level in every cycle which is at peak around 13^th day. Changes in hormones may cause high or low libido around menopause.

Aphrodisiac

Some products that are said to enhance libido or sex desire. There effects, benefits and side effects are a matter of debate and study.

• Alkyl nitrites or poppers
• Ambergris
• Bremelanotide
• Crocin
• Dopamine agonist
• Ginko biloba
• Ginseng
• Melanotan
• Musk
• Phenylethylamine
• Spanish fly
• Testosterone
• Water melon
• Yohimbine

How to increase libido naturally

• Reduce obesity, alcohol, smoking
• Reduce stress, organize life
• Overcome sexual myths
• Keep fit exercise regularly, do yoga, strength training
• Eat right food, nutritious and not causing lethargy
• Try safer aphrodiasics like yohimbine, ginko biloba, ginseng
• Attend sex therapy
• Activate sexual mindset, think sex
• Feel sexy Look sexy Be sexy
• Try outfits which helps including the type and color
• Use pleasant odors
• Create atmosphere to tease libido
• Learn sexual skills to feel sexually confident
• Smooth skin is aphrodisiac
• Try sexual touch
• Sexual fantasy

Male masturbation

The most common male masturbation technique is simply to hold the penis with a loose fist and then to move the hand up and down the shaft. This type of stimulation is typically all that is required to achieve orgasm and ejaculation. There are many other variations on male masturbation techniques. Men may also rub or massage the glans, the rim of the glans, and the frenular delta. Some men place both hands directly on their penis during masturbation, while others may use their free hand to fondle their testicles, nipples, or other parts of their body. Men may also use sex toys like vibrators and may use lubricant or lotions to increase pleasure and protect against irritation.

Female masturbation

Female masturbation techniques include a woman stroking or rubbing her vulva, especially her clitoris, with her index and/or middle fingers. Women can sexually stimulate themselves by crossing their legs tightly and clenching the muscles in their legs, creating pressure on the genitals. Another way is your bathtub! Position yourself under the tap so that your genitals are directly under the running water. Let the water continuously hit your clitoris. Some women swear by it! Almost all female masturbation techniques will focus on stimulating the clitoris in a variety of ways until orgasm is reached.

Child masturbation

Masturbation is self-stimulation of the genitals for pleasure and self-comfort. Children may rub themselves with a hand or other object. Masturbation is more than the normal inspection of the genitals commonly observed in 2-year-olds during baths. During masturbation, a child usually appears dazed, flushed, and preoccupied. A child may masturbate as often as several times each day or just once a week. Masturbation occurs more commonly when a child is sleepy, bored, watching television, or under stress. By age 5 or 6, most children can learn some discretion and will masturbate only in private. It is not abnormal or excessive unless it is deliberately done in public places after age 5 or 6. It does not mean your child will be oversexed, promiscuous, or sexually deviant.

Sex is a normal part of healthy adult life, but it is seldom discussed openly.Wrong beliefs are the common cause of many broken hearts and relationships. Here, is a list of some common sexual myths and facts for your benefit:

• Myth: Men need or want sex more often than women.

Fact: Not true. Sexual drive varies from person to person in both men and women.

• Myth: Losing one drop of semen is equal to losing about 40 drops of blood.

Fact: Semen is not made of blood. Losing semen is in no way related to losing blood.

• Myth: Too much masturbation makes the penis shrink in size.

Fact: Not true. No amount of masturbation will make the penis shrink. An adult male’s penis will remain the same size throughout his life.

• Myth: Menopause is the end of a woman’s sex life.

Fact: Women cannot conceive after menopause but can continue to have a normal sex life.

• Myth: You can’t get pregnant the first time you have sex.

Fact: One sexual encounter is enough for pregnancy to occur. If you do not wish to conceive, it is extremely important that you use a contraceptive, even for your first intercourse.

• Myth: Simultaneous orgasms are a must for a good sex life.

Fact: Most couples do not achieve simultaneous orgasm. If you are otherwise happy with your sex life there is no cause for concern.

• Myth: Females also ejaculate when they have an orgasm.

Fact: Not true. Female orgasm does not lead to ejaculation.

• Myth: Oral sex can get you pregnant

Fact: Most women carry fears of unwanted pregnancy. Oral sex alone cannot result in pregnancy.

• Myth: Atleast 8 inch penis should be there to have good sex

Fact: Wrong. Sexual satisfaction is not based on penis size. It is the overall relationship and the sexual skill that makes a good sex. Secondly vagina is flexible and grips penis so no penis is big or small for vagina.

• Myth: Masturbation is harmful

Fact:Wrong. Masturbation is safe natural activity and do not cause any harm to sexual, to any physical or mental function of body.

• Myth: Pregnancy will not occur if man do not ejaculate inside

Fact: False. Pregnancy can occur due to pre ejaculation fluid.

• Myth: Woman must have orgasm for good sex

Fact: Not necessary. Unlike man, woman can enjoy good sex even without orgasm although if both male and female learn good skills then orgasm is more likely to occur.

• Myth: Use of lubricants is weird and done by sex addicts

Fact: False. Dryness makes sex very difficult. Using lubricants make it easy and enjoyable.

• Myth: Oral sex is absolutely safe, can’t cause any STIs

Fact: The fact is that body fluids get exchanged during oral sex, so chances of transmitting infections are high.

What happens inside us during sex? The research has clearly established the changes right from arousal to orgasm and after. According to Masters and Johnson, the human sexual response cycle consists of four phases:

1.      Phase of excitement – Motivation and urge for sex

2.      Phase of plateau – Changes and preparation for orgasm

3.      Phase of orgasm – the climax

4.      Phase of resolution – resolution of excitement and return to unaroused state

The sexual response cycle in males

1.      Phase of excitement – The sight or thought of sex leads to beginning. Two centers in spine causes erection. The heart rate rises, in penis there is vasoconstriction and start to be filled by blood, scrotum thickens, there is shortening of spermatic cord and testes gets engorged with blood.

2.      Phase of plateau – Penis increase in size, the testes gets more engorged and there is secretion of preseminal fluid from Cowper’s gland.

3.      Phase of orgasm – There is rhythmic contraction in every 0.8 seconds. In first part there is contraction of vas deferens and in second there is ejaculation.

4.      Phase of resolution –There is resolution of excitement and return to unaroused state. There is a refractory phase or rest period before which next cycle can start. This vary person to person and increase with age.

The sexual response cycle in females

1.      Phase of excitement – It start with increase in heart rate, respiratory rate and blood pressure. Vasocongestion can result in flushing of skin, increase in breast size and erection of nipples. There is swelling of clitoris, labia and vagina. Uterus elevates, vaginal opening becomes tighter and releases lubricating fluid.

2.      Phase of plateau – There is intensification of first phase changes.

3.      Phase of orgasm – The physiological changes reach their peak, pelvic muscles, uterus and anal sphincter contracts. There is high level pleasure resulting in orgasm with rhythmic contraction of muscles.

4.      Phase of resolution  -There is resolution of excitement and return to unaroused state.

• Conception between female egg and male sperm – This can be natural by sexual intercourse or through assisted reproductive technology.
• Implantation and development of fetus in uterus – It is usually divided into three trimesters or three phases.
• Delivery of fetus – This can be natural, induced or surgical.

Conception

Female releases eggs by the process called ovulation. Pituitary gland in brain secretes Follicle Stimulation Hormone FSH and Luteinizing Hormone LH which controls this release and prepares female genitalia for fertilization and implantation. Once follicle rupture in ovary and egg is released, it is picked up by fallopian tube and start to travel towards uterus. It is here the egg gets fertilized by sperm. If the egg is not fertilized, menstrual cycle occurs. The release time of eggs is about midway between two normal menstrual cycles.

Be it natural as in sexual intercourse or assisted as in artificial insemination or in vitro fertilization, the first thing to occur is the fertilization of female egg or gametes or oocyte merge with male spermatozoa. This merger also leads to merger of genes of male and female side. This fused product is called zygote or fertilized egg. This merger commonly occurs in fallopian tube.

Implantation and Development

The zygote continues to move towards uterus, reach there and gets attached to uterine wall, a process called implantation. The cell mass is now called embryo. It begins to develop different types of cells to form future structures. Supporting structures like placenta and umbilical cord which help in sustaining and growth of embryo also develops.

Start date

There are three starting dates based on events:

1. From first day of woman’s last menstrual period
2. From date of conception that is about two weeks before next expected menstrual period
3. From the date of implantation

Duration

Normal pregnancy is estimated to be about 280 days or 40 weeks of gestational age. It is 280 days of gestational age that is from first day of last menstrual period. A difference of 8 – 10 days is commonly seen.

Term

Full term – 40 weeks

Term – 37 to 42 weeks

Preterm or premature – Before 37 weeks

Post term post mature–After 42 weeks

Both preterm and post term babies can have complications.

Delivery

Delivery or childbirth is the process in which infant is born. It begins with labor when woman begins to experience regular uterine contraction. This is followed by effacement and dilatation of cervix. Most deliveries occur naturally but in some cases induced or surgical assistance is required. This can be due to malposition of baby, problems with placenta or umbilical cord or health risk to baby or mother. During after delivery or post natal period, the mothers body return to non pregnant state.

Diagnosis and symptoms of pregnancy

• Missed menstrual period
• Nausea, vomiting, tiredness, frequent urination
• Urine and blood test for presence of HCG – 12 to 15 days after implantation
• Increased basal body temperature
• Darkening of cervix, vagina, vulva – Chadwick’s sign
• Softening of vaginal portion of cervix – Goodell’s sign
• Appearance of lineanigra, darkening of skin in midline of abdomen
• Tenderness of breast
• Increase in abdomen girth
• Baby movements inside abdomen

Investigations

• Blood and urine test for detection of HCG. Commonly called as pregnancy test. Can be positive as early as 12 days of implantation. Home kits are available.
• Ultrasonography to detect pregnancy, age and how baby is doing.
• Blood and urine test to detect hormonal status and health status of mother and child
• Amniocentesis to detect chromosomal disorders

Precautions during pregnancy

• Better the health of mother better is pregnancy. Same is true for mother’s happiness
• Alcohol and smoking puts baby at risk and can cause birth defects
• Drugs like marijuana can have devastating effect
• Toxins like lead and mercury present can cause serious defects in baby
• Air and water pollution pose health risk to mother and child
• Caution must be taken to prevent injury
• Sex is safe during pregnancy but one should be cautious and discuss with the doctor
• Mild gentle exercises supports pregnancy

Complications in pregnancy

• Anemia
• Back pain
• Nausea and vomiting
• Increased urinary frequency
• Pregnancy induced hypertension
• Pregnancy induced diabetes
• Edema and swelling
• Heartburn and GERD
• Hemorrhoids
• Post delivery depression or psychosis
• Urinary tract infection UTI
• Varicose veins
• Ectopic pregnancy
• Thyroid problems

All these conditions can be prevented and well managed under medical supervision.

Can we have sex during pregnancy? This topic is crucial for every couple due to reasons of both kinds.

If we avoid:

• Removes the happiness of sex from life
• Causes stress and strain relationship

If we do not avoid:

• It causes pain
• It feels awkward
• It can harm pregnancy and child

Experts say that there is no harm in having sex during pregnancy and can even provide psychoemotional support to woman. It is mutual choice.

Will it harm baby?

It will not in case of gentle sex. Nature has given enough protection to baby. But caution is required in case of possible infection, bleeding, low placenta and previous spontaneous miscarriage.

Does she have sexual desire?

Sexual desire may vary. It depends on how she feels about having sex during pregnancy. Some women experience very high libido during pregnancy and enjoy sex. Condition like nausea of pregnancy, weakness etc can affect libido.

Which position is good?

If ‘man on top’ position is uncomfortable there are many other positions:

• Lying on side
• Lying on the edge of the bed
• Sitting
• Woman on top
• Oral sex is also safe

And post delivery?

Again mutual choice but four weeks is good time to wait. A lot depends on woman’s health, emotional status and baby care.

Middle-aged women are more satisfied with their sex lives as they get older – even though they have less sex and say their partners have performance issues in the bedroom. Men, on the other hand, say they are less satisfied as time goes on. A loss of sex drive and the need for physical intimacy might be acceptable to some folks as they mature, but there are millions of men in their 40′s, 50′s, 60′s, and older, that perish the thought of dwindling sexual relations at or after middle age.

Midlife sex takes extra effort. The challenges associated with reaching middle age like stress, overwhelming responsibilities, aging kids and parents, exhaustion and body changes, leave anything that takes extra effort low on the priority list.

Both male and female libidos tend to decline with increasing age and males tend to lose their libido faster than women. However, this is not to say the desire for sex is lost completely or even that it decreases for everyone. The female menopause has been linked to a loss of interest in sex and to a desensitisation of the genital area. In some cases sexual intercourse can even become painful for older women

Sex between elderly people is often treated as a taboo by society. Whilst sex itself is a sensitive topic due to its private nature, sex between seniors is often treated with extra care. STD’s are also prevalent in later life despite common misconceptions that STD’s only affect younger people groups. Many men in older age do not believe they need to use protection such as condoms as they age and their partners often feel likewise, so it can be difficult to stress the importance of continued use of protection for elderly couples.

Sex is a way to express love and it also provides the feeling of security and reconfirms the feelings shared between people, regardless of age. It has a symbolic value which is independent of age.

Changes in the male

• Low sex hormones
• Low libido
• Lesser erection
• Less bodily agility and flexibility

Changes in the female

• Low sex hormones
• Low libido
• Less bodily agility and flexibility
• Dryness of vagina

Keep it going

Some ways to spice up sex life, age no bar:

• Keep fit – Maintain fitness and good lifestyle to enjoy sex longer.
• Take it easy – Don’t rush into sex. Let it build up at its own pace.
• Do not compare – Do not compare with your younger age. This is new and different.
• Be playful – It is not display of strength. Be playful with small things like touch, kisses etc.
• Foreplay – Foreplay in itself can be complete fun. Do not make intercourse necessary. Manual stimulation can be good fun.
• Lubrication – If dryness is problem, use lubrication.
• Medication and therapy – Conventional or herbal medication or therapies like acupuncture can be tried to boost up sex life.

What can sex do for you:

• Keep relationship spark shining
• Refresh memories
• Relieves stress
• Good for health

Sexual desire and functioning is a combination of psychology, nervous system, hormonal system, cardiovascular system and sensory system. Illness can affect these negatively. Treatment of illness can too interfere in these. Psychotropic, anti hypertension and anti diabetes drugs are well known for their effect on sexual functioning.

How illness can affect sex life?

Though effects on every individual vary, there are some common problems:

• Emotional disturbance – Long term suffering from chronic illness can affect emotional status and lead to sadness and anxiety. These can affect sex life.
• Energy lack – There can be a loss of energy. The natural zest can be lacking. This is dampener for good sex.
• Loss of libido – Chronic illness can reduce libido. There can not be good sex with low libido.
• Medicine side effects – There are side effects of medicines which can affect libido and sexual functioning.
• Pain – Pain alone is sufficient to hurt sexual desire and functioning.
• Complaints of disease – Many symptoms of disease like limitation of mobility, nausea, and cough can easily spoil sex life.
• Surgery – Surgery can limit sex life due to feeling of limitation or disfigurement.

How to continue with good sex life

• Communication – Discuss with your partner about your feelings, needs, what is painful and what feels good.
• Foreplay – Focus on fun. Foreplay itself can make a complete satisfaction.
• Treatment – Getting correct treatment and easing pain can pave way to great sex life.
• Simple sex – If trying different sex positions is not happening due to complaints, try simple things like gentle massage, mutual masturbation etc for satisfaction.
• Best time for sex – Look for the time when the pain or suffering is less and make best use of this time to have good sex.
• Nutrition – Take care of nutrition as this can help in boosting up energy and reducing the complaints. Avoid sex immediately after meals as energy is diverted in digesting food.
• Habits – Cut down on alcohol and smoking as they will further affect health and drain energy.
• Seek help – Seek help of counselor and therapist to improve sex life.

Doctor’s role

Doctor’s role is crucial in:

• Assurance and removing anxiety
• Giving correct information
• Giving correct treatment
• Teaching specific lifestyle changes
• Discussing sexual concerns

Any physical challenge does not mean end of sex life. It can be as satisfying as ever.

Acceptance

Acceptance of fact that sex will be fun even after the physical challenge. No need to give up. Just like you have fought with physical challenge and have successfully brought life back on track, same can be done to your sex life.

Adjustment

Some adjustments might be in place. It depends on the kind of physical challenge. Partner too needs to adjust. Some partners become too fearful to cause any trauma. It can be different but the fun is same.

Communication

Discuss with your partner. Talk about the possibilities. Do not hesitate in talking about sexual needs. Discuss how do you wish to have fun.

Seek help

Seek professional help in sexual rehabilitation. Counselors, psychotherapist, physical therapist and others can help in their own way to improve sex life.

Innovation

You can design your own ways of sexual fun which can be away from standard sexual practices. Use ideas and creativity to have good fun.

Effective sex education provides young people with an opportunity to explore the reasons why people have sex, and to think about how it involves emotions, respect for one self and other people and their feelings, decisions and bodies. Young people should have the chance to explore gender differences and how ethnicity and sexuality can influence people’s feelings and options. They should be able to decide for themselves what the positive qualities of relationships are. It is important that they understand how bullying, stereotyping, abuse and exploitation can negatively influence relationships.

Sex education aims to –

• Reduce the risks of potentially negative outcomes from sexual behaviour, such as unwanted or unplanned pregnancies
• Reduce infection with sexually transmitted diseases including HIV
• Contribute to young people’s positive experience of their sexuality by enhancing the quality of their relationships

Common avenues for sex education

Sex education can take place in a variety of settings, both in and out of school.

• Parents or caregivers
• Formal school programs
• Public health campaigns

It is important for sex education to begin at a young age. Giving young people basic information from an early age provides the foundation on which more complex knowledge is built up over time. For example, when they are very young, children can be informed about how people grow and change over time, and how babies become children and then adults, and this provides the basis on which they understand more detailed information about puberty provided in the pre-teenage years. They can also when they are young, be provided with information about viruses and germs that attack the body. This provides the basis for talking to them later about infections that can be caught through sexual contact.

Sex education can be an important and effective way of enhancing young people’s knowledge, attitudes and behavior.

Sex education can help in

• Gaining accurate and authentic information
• Forming attitude and beliefs about sex
• Know the significance of timing and discipline
• Creating healthy sexual identity
• Developing healthy relationships and intimacy
• Developing healthy sexual skills and sexual confidence
• Saving from sexual abuse and exploitation
• Safeguard against sexually transmitted diseases
• Avoiding unwanted pregnancy
• Managing sexual perversions and disorders
• Managing prejudice and peer pressure
• Manage sexual conflicts and sexual risk

Sex education should be positive and proactive

• It should promote better communication
• It should promote questioning and clarifying doubts
• It should promote sex discipline
• It should promote safe and healthy sex habits
• It should promote healthy attitude, beliefs and morals

Core of sex education

Following is the basic core:

• Sexual development and sexual identity
• Reproduction, contraception & birth control
• Sexual relationships

Starting sex education

No age is too early. All that is required is to create content of sex education in a way that suits the age and circumstances of those receiving. Girls should be told about menstruation at about 8 years of age.

How to start?

It can be proactive in which actively information is provided or it can be done by helping a child to ask questions. It should be part of self development, personality development, values and moral development and life skill training. Be specific and matter of fact according to age of child. Do not use alternate terms or vague stories. Do not make it funny. Do not laugh or ridicule. Do not make child feel embarrassed or ashamed. Let the child know that this is natural. Explain the need of modesty and privacy. Try not to make it a lecture but it is better to provide information on day to day moments.

Is sex education harmful or promote sex?

Research has proved that sex education does not promote sexual activity. On the contrary it prevents unhealthy or early sexual activity.

Sexual responsibilities

One crucial element to teach is how to become sexually responsible. Sex can be good fun but can do negative as well depending on how one assumes responsibility and discipline. Do not create fear of sex in child mind but provide information about how he or she can stay away from problems and create a happy sexual identity.

Who can provide sex education?

• Parents
• Caregivers
• Teachers
• Counselors
• Social workers
• Doctors and healthcare professionals
• Community based programs
• Specifically designed websites or audio video programs 

Challenge of sex education

Unfortunately even in today’s world sex education is a difficult topic. People do not realize that your kids are left to learn sex from unreliable and possibly wrong sources. All sorts of myths and false information creep in. The result is distorted personalities, disturbed relationships and erratic sexual behavior which can even go to the extent of disorder or crime. Why don’t world realize the importance of sex education. It will not harm or push kids towards sex but will only promote sexual discipline. It is high time that the world must accept its responsibility towards children and adolescents.

Some of the fields of study are:

• Biology
• Medicine
• Psychology
• Epidemiology
• Sociology
• Anthropology
• Criminology
• statistics

The beginning

• Greek philosophers Plato and Aristotle talked about homosexuality.
• Hippocrates discovered facts about human reproduction.
• Roman physician Soranus wrote on contraception
• Galen gave first sexual theory
• Leonardo da Vinci drew sketches of sexual process
• Fallopian and Bartholin gave anatomical description of sex organs

Later

• Clellan S. Ford and Frank A. Beach wrote book‘Patterns of Sexual Behavior’
• Ernst Grafenberg found G Spot
• Richard Freiherr von Krafft Ebing published Psychopathia Sexualis
• Havelock Ellis was first to describe homosexuality is not disease, immoral or crime
• Sigmund Freud developed theory of sexuality
• Magnus Hirschfeld founded Institute for Sexology
• Alfred Kinsey founded Institute for Sex Research known popularly as Kinsey Institute
• Kurt Freund developed Penile Plethysmograph to measure sexual arousal in males
• William Masters and Virginia Johnson released work Human Sexual Response and Human Sexual Inadequacy. They founded the famous Masters and Johnson Institute

And Now

• Technology like MRI and Neuroimaging has helped in clear understanding of sexual function specially the role of brain
• MRI could show the damage of sexual abuse on brain
• It is found that those watching porn or addicted to sex is not due to any changes in brain but due to high libido
• Steele, Staley, Fong and Prause used EEG to study effect of erotic material on brain
• New pills to improve sexual functioning and control pregnancy
• Surgery for sex conversion

Sexual behavior among the human beings, though biologically linked, is a social phenomenon. Several factors such as culture, religion and economy also influence a person’s sexual preferences and behaviour. It can be defined as a process which requires a number of sequential steps which ultimately lead to the expression of sexuality. The steps may include mate finding, attracting a partner, physical, emotional and sexual contact and finally sexual contact. Sexual activity also encompasses sexual intercourse, oral sex and masturbation. Most people engage themselves in the sexual activity just because they feel sexually attracted towards the partner and some indulge in sexual act just a matter of pity or sympathy.

Normal sexual behaviour generally has three purposes.

• For reproduction
• For pleasure
• To promote or strengthen interpersonal relationships

There are many different types of sexual behaviours.

• Abstinence – Sexual abstinence means refraining from any sexual stimulation.
• Masturbation – Masturbation refers to self-stimulation or manipulation of one’s own genitals for sexual pleasure.
• Coitus – vaginal intercourse is firmly established as the most desirable or usual sexual behaviour.
• Anal Intercourse – Anal intercourse is a common component of homosexual behaviour but is also a significant heterosexual behaviour.
• Orogenital Acts – Fellatio refers to mouth contact with the penis. Cunnilingus refers to mouth contact with the female genitalia.These practices may occur singly, alternately or concurrently either as a prelude to coitus or as a discrete act to lead to orgasm.
• Prostitution – A prostitute or sex worker provides a client with the use of his or her body in return for material gain

Sublimation is a process in which inner instincts are transformed into higher forms of thoughts, feelings and deeds. It can be spiritual, ideological, artistic, intellectual, scientific, social or even higher physical states like sports. The benefit of sublimations is:

• Better control on instincts and impulses
• Channelize energy into higher forms of life activities
• Higher achievements in life
• More social acceptance and appreciation
• More self worth and self esteem
• Better discipline in life
• Ideal for relationships and family life
• Stronger and more attractive body

Do I need to suppress or give up sex?

Not at all.Infact you will enjoy sex more. All you need to do is to create little sex discipline where in place of indiscreet sex, you willdevelop a higher sexuality in which your focus in on higher forms of activities. You will have high quality sex which is more satisfying and you will be able to use sexual energy to enhance your performance in activities like academics, scientific pursuits, art, music, sports, literature and others. You should not suppress sexual energy as that will strike back and lead to major disaster. Energy can not be killed, it can only be transformed.

Why should I sublime?

Because if you don’t, you are losing out on both – good sex and good life.Indeed it is your body, your life and you can have any amount of sex. But ask yourself:

• Will indiscreet sex make me a better or happier human being?
• Is this the only purpose of my life?
• Is this the only happiness that I can have?
• Is it actually giving me real happiness or it is momentarily pleasure?
• Has it become a kind of addiction in my life?
• If I can have great sex and develop higher skills like art or sports then why not have both?

Do I need to become spiritual? I do not like all that ‘purity’ stuff.

Get the facts right.

1. It is not necessary to follow any particular path of spirituality. Infact the word ‘Spirituality’ is misused in this world. Spirituality is not about being religious.
2. It is not necessary to be religious or perform religious acts, read holy books, chant mantras or meditate. If you wish to do that, it is your choice.
3. There is no question of pure or impure. Sex itself is pure.

How do I sublime sex?

• Hold yourself just a little back from your maximum sex desire and activity? It is like when you love to eat something, you have it but do not over eat. Over eating only kills the fun.
• Give priority to quality in sex than quantity.
• Give due place to activities like art, music, dance, literature, academics etc. This will give you achievements, enhance personality and enhance sexual pleasure as well.
• Organize wholesome life with good time management, regular exercise and healthy lifestyle.
• Create a mission in life. Something that gives you identity. A meaning to live. It could be your work, hobby or any other activity.

Pregnant teenagers require special understanding, medical care, and education–particularly about nutrition, infections, substance abuse, and complications of pregnancy. They also need to learn that using tobacco, alcohol, and other drugs, can damage the developing fetus. All pregnant teenagers should have medical care beginning early in their pregnancy.

Complications with Teenage Pregnancy

Young women generally experience more complications during pregnancy and childbirth than older women. Pregnant teens and their unborn babies have unique medical risks that are discussed below:

• Physical immaturity
• Lack of knowledge about healthcare
• Poor care during the pregnancy
• Poor diet, including not enough folate
• High levels of emotional distress
• Premature baby
• Low-birth-weight baby
• High blood pressure

How to lower the health risks of teen pregnancy

• Get early prenatal care
• Stay away from alcohol, drugs, and cigarettes
• Take a prenatal vitamin every day to help prevent birth defects
• Ask for emotional support
• Access pregnancy counseling

Preventive measures

There are many ways to promote and prevent unintended teen pregnancies. The educational aspect of introducing abstinence, condoms and contraceptives is essential but incorporating participate activities, evaluations, decision making skills and more will lead to success. Promoting condom use along with birth control methods, and most importantly abstinence, will all truly contribute to preventing unintended pregnancies and a decline in abortion rates from sexually active teenagers.

Preventing a serious issue like teen pregnancy must be done at all costs.  By informing teens early enough on condom use, contraceptive methods, and above all abstinence, we can aim for a possible extreme decline in teen birth rates. We must lead our teens to eliminate risks for their future and prevent the issue of teen pregnancy now.

Heterosexuality- It is the sexual attraction between members of the opposite sexes such as man attracts to woman and woman attracts to man sexually.

Homosexuality-It is the sexual attraction between members of the same sexes such as man to man and woman to woman sexually.There have always been people who have had homosexual sex, but prior to modern times they didn’t have a sense of themselves as homosexuals. It is a category of consciousness and a manifestation of consciousness aware of itself. Both practically and metaphorically homosexuality is self-reflexive. It is about the unity of the cosmos, rather than the duality. Males are referred to as gays and females lesbians.

Bisexuality– It is the sexual attraction to both the opposite and same sexes such as man to man and man to woman, woman to woman and woman to man.  Bisexuals may have a relationship with a man, and then after that relationship ends, may choose a female partner for a subsequent relationship, and many go back to a male partner next

Asexuality- It is also known as nonsexuality which is the lack of sexual attraction and sexual interest towards others. People who consider themselves asexual say their lack of interest in sex is a permanent part of their identity. But just because someone isn’t interested in sex doesn’t mean they’re not interested in love. While some are happiest alone, asexual people can feel romantic attraction and have intimate relationships. They may like to cuddle and be physically close to others. Some get married and even have children.

Pan sexuality – Pansexual people are people attracted to people regardless of their gender, identity or biological sex.. It is different from bisexuality. Bisexual people are attracted to both men and women, but pansexual people can be attracted to any people. This includes people who are neither male nor female. A pansexual could be open to someone who is male, female, transgender, intersex, or agendered/genderqueer.

Transvestism – Transvestism refers to the use of clothing of the opposite sex for sexual gratification. This behavior will often begin before puberty or in adolescence.

Transsexualism – Transsexualism is primarily a disorder of gender identity in which the individual wishes to be or feels that he/she is a member of the opposite sex.