Sex Education and Sexual Health

Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs) spread through the exchange of bodily fluids, generally during sexual activity like vaginal sex, anal sex or oral sex. Occasionally, they can be transmitted non-sexually, for example from mother to child during pregnancy or by sharing needles.

STIs can be caused by bacteria, viruses and parasites. STDs include Herpes, Human Immunodeficiency Virus (HIV), gonorrhoea, chlamydia, syphilis, human papillomavirus (HPV) and more. Some common symptoms are painful urination, painful sex, discharge from the penis, abnormal vaginal discharge, vaginal burning, unusual vaginal bleeding and sores or bumps on the genitals or around the mouth.

The most effective way to prevent STDs and STIs is to not have sex. But since there are many health benefits of sex, forgoing it altogether may not be the best way thing for your overall health. Here are some other options: 

• Have safe sex: Use a new condom for each and every sexual activity. Do not reuse condoms and do not use two at the same time. For oral sex performed on a woman, a dental dam may be used.
• Don’t share needles.
• Be in a healthy monogamous relationship.
• Get tested regularly and get vaccinated.

Being in a monogamous relationship with someone who does not have an STD considerably lowers your chances of contracting one. Vaccinations are available for HPV and Hepatitis B.

STDs don’t always have obvious symptoms. The only way to know that you’re free of any STDs or STIs is to get tested for all of them.

Now, should everyone get tested? And how often should you get tested?

Well, if you’re sexually active, you should get tested at the following times:

• Before entering a sexual relationship with a new partner.
• If you have had unprotected sex.
• If you have sex with multiple partners.
• If you feel like you might have been exposed to an STD.
• If you notice any symptoms that could indicate an STD or STI, you should consult your doctor who may prescribe tests such as the chlamydia test or the VDRL test for syphilis, based on your symptoms and the physical examination.

When it comes to contraception, only condoms (male or female) can protect you from the transfer of fluids during sexual intercourse. Latex condoms are the most effective, they are 98% effective in preventing unwanted pregnancies and almost 100% in preventing HIV if used correctly.

If you’re trying to avoid getting pregnant, there are many birth control methods available for use. Male and female condoms keep you safe from STDs but if you’re in a monogamous relationship in which that isn’t a concern, or if you require the use of an added contraception method, you can choose from birth control or contraceptive pills, contraceptive injections, patches, intrauterine devices or IUDs, diaphragms, etc.

Talk to your doctor about your options.

The vulva is part of the external sex organs. It consists of many parts like the labia, clitoris, vaginal opening, urethral opening (from where you urinate), etc. The labia are the folds of skin you can see outside and they protect your vaginal opening from being exposed at all times. Your vaginal opening is the gateway to the internal sex organs - the vagina and then the cervix, which connects your uterus to the vagina. Back to the outside, the clitoris is located at the top of your vulva and contains a very large number of nerve endings. Most women orgasm due to clitoral stimulation. There are many more sex organs like the fallopian tubes, ovaries, etc that help your body function the way it does. An awareness of these organs, their functions and their well being is essential in maintaining your sexual health.

Sexual health for women comes with an added concern - pregnancy. There are all kinds of aspects to the subjects, though, depending on what phase of life a woman feels she is in. If you want to get pregnant, there are ways to plan it carefully with a lot of consideration. There are also tips on how to get pregnant. While for many women these tips are enough, some couples might face trouble conceiving, in which case there are other options like fertility treatments you can discuss with a specialist.

If you are pregnant and find yourself wanting to, for whatever reason, terminate the pregnancy, you can reach out to your doctor and ask for a referral to a facility that provides the required medical procedure, called an abortion.

Sexual dysfunction is extremely common and not something to be ashamed of. Some female sexual problems can keep you from having a healthy sex life. These can include low libido or sex drive, anorgasmia (inability to have an orgasm), persistent genital arousal syndrome, vaginismus (involuntary spasming of vaginal muscles) and dyspareunia (pain during sex). There are therapies and treatments you can try for all of these. It is important to recognise the symptoms and address the issue instead of letting it fester and living with the problem.

 The male sexual organs also consist of external as well as internal organs. Externally, we have the penis, scrotum and testicles. The penis is the one that is involved in sexual intercourse - increased blood flow during arousal makes it erect, making penetration possible. The testicles are responsible for producing testosterone (hormone) and sperm. The scrotum is the sac-like covering of skin around the testicles. The internal sex organs include the vas deferens, prostate gland, urethra, etc. Together, all these organs make it possible for men to feel aroused, be sexually active and, if needed, procreate.

Sexual dysfunction in the male body refers to any men’s sexual problems that might keep one from deriving pleasure or satisfaction from sexual activity. For men, these could include low (or loss of) sexual drive, erectile dysfunction (impotence or the inability to reach/maintain an erection) and ejaculation disorders (premature, delayed or retrograde). There are medications and therapies available for these problems, depending on the cause, and can be discussed with a medical professional after a diagnosis has been reached.

Consent is the most important concept to understand when it comes to sex education. In sexual situations, it refers to the permission one gives or receives before commencing sexual activity. It must be freely given and not coerced or assumed. It is also extremely important to understand that consent can be retracted as soon as you start feeling uncomfortable, yes, even in the middle of sex. On the other hand, if your partner seems uncomfortable or reluctant in any way, you should take a break. Talk about the situation, get your partner to open up to you, reassess where you stand and then take a call on whether to proceed or stop completely.

Yes, sex is one of the most natural things in our lives. But that doesn’t mean that it doesn’t take work.

To have a smooth experience, you can prep for it as you would for an exam - do all your research so you know what to expect and have all your tools ready beforehand, including spares in case of an accident.

Your tools, when it comes to having sex, will include condoms (many of them, this isn’t a time to be stingy) and lubricants (a variety of them, in case one doesn’t seem to suit you or your partner). In case of an accident, like a condom getting torn during sex, you should again know that you have the option of a morning-after pill as well as STD testing.

Not everyone actively looks out for their partner’s interests in a sexual relationship. You must be careful when entering a relationship with such people and remember not to get so involved that you forget to take care of your own self. In case you feel like you’re in an abusive or toxic relationship or even if you feel like things might be taking a turn towards that, seek help and end the relationship. Your health takes priority and you need to make decisions that reflect that. 

Different people have different likes and dislikes. It’s the same when it comes to sex - different people have different preferences. Unfortunately, some of these preferences might put you at a higher risk of becoming pregnant or contracting STDs or STIs. Some such behaviours are:

• Having unprotected sex (vaginal, anal or oral).
• Having multiple sexual partners.
• Using drugs or excessive alcohol. 
• Having anal sex.
• Having a high-risk partner. 
• Paying for sex.
• Being a sex worker.