Hymen and Virginity- Rakhesh (Ed.)
A girl who has never had sexual intercourse (a virgin) is supposed to have her hymen intact. In many societies, a girl’s virginity until marriage is considered a great virtue. For a girl who possesses such chastity, getting married becomes easy.
The hymen is a fleshy, thin membrane, which partially closes the mouth (entrance) of the vagina. It has a central opening, which may be rounded or elongated. Usually a finger can be introduced through the opening without breaking the hymen. This opening is necessary in order to let out the menstrual flow from uterus.
Sexual problems, irrespective of the causative factors, frequently cause serious psychological problems such as hostility between the marital partners and even complete breakdown of the marriage itself.
When the girl has sexual intercourse, the hymen is stretched and ruptured by the erect penis. This may be accompanied by some discomfort and bleeding. Apart from sexual intercourse the following also can cause rupture to the hymen:
  1. An accident or injury, such as falling astride on a projecting substance, trying to climb over a fence and tripping
  2. Sports activities like horse riding, bicycling, playing seesaw, high jump, and hurdles and activities like dancing
  3. Masturbation, especially when indulged with a large foreign body like candlestick or vibrator
  4. Introduction of instruments by doctors during examination or surgical operation
  5. Faulty technique while douching (cleaning) the vagina. The rubber or plastic tube introduced into the vagina to let in the douching solution can lead to hymen rupture.
It now becomes clear to us that a girl with the ruptured hymen is not necessarily unchaste. Contraception and Family Planning
Contraception means preventing the conception of a child or preventing a woman from getting pregnant. Birth control methods must be used not only to avoid unwanted pregnancies, but also to plan the number of children a couple actually wants and to space them, so that the best possible care and protection can be given to the new born and the mother.
The main methods of birth control now in use are:
  1. The pill
  2. The Intra Uterine Devices (IUD) or loop.
  3. The cap
  4. The condom
  5. Spermicides
  6. Withdrawal methods (Coitus interruptus)
  7. The rhythm method
  8. Emergency contraception
  9. Sterilisation
  10. Abortion or medical termination of pregnancy.
Of these, the pill, the IUD, cap and spermicides are to be used exclusively by women.
The condom and coitus interruptus are the male methods. Both females and males can be sterilised through surgical operation. Abortion has to be performed only as a last resort, when a woman gets pregnant. Whatever may be the method used, the basic principle of birth control is to prevent the sperm uniting with the egg (ovum). Thus fertilisation of the egg is prevented. Without fertilisation there can be no embryo, or child.
1. The Pill: It acts by preventing the ovulation. It contains synthetic versions of the natural female hormones – oestrogen and progesterone. These hormones are involved in the normal monthly cycle of ovulation and menstruation. By altering the natural hormone balance of a woman's body, oral contraceptives interfere with the cycle and prevent the egg from being released from ovary and there by fertilisation is avoided. If used properly, this is a highly effective method. Whenever a woman wants to have a child, all that she has to do is stop taking the pills.
2. The IUD: IUD is known as the Intra Uterine Device or the loop. It is a small, flexible device made of plastic or metal, which has to be placed inside the uterus. The introduction has to be done by a doctor. It comes in various sizes and shapes. The exact mode of its action is not clearly known. It is believed that the presence of IUD in uterus prevents the fertilised egg to rest (sink) on the endometrium. An IUD has to be changed once in 2 to 3 years. The IUD prevents conception about 90% of the time.
3. The Cap: The cap is also known as the diaphragm. It has to be placed inside the vagina between the cervix (mouth of the womb) and the vagina. Once placed, the cap acts as a barrier to sperms. It physically blocks the passage of the sperms into the uterus. The cap is usually made of rubber and metal rim. This has to be worn by the women before sexual intercourse and has to be removed six hours after the intercourse.
Initially the cap has to be fitted by a doctor. Later on, a woman can get herself adequately trained to place it properly. Used alone, the protection given by the cap is not adequate. But when used along with spermicides the effectiveness of the cap is greatly increased.
4. The Condom: It is also known as the sheath, rubber or French leather. It is made of a thin rubber sheath. There is a small chamber at the closed end in which the semen is collected after ejaculation. Thus sperms are prevented from reaching the uterus.
Condom is the only contraceptive that gives some protection against some venereal diseases. It is of utmost importance to check the condoms for any holes before using it. If there are any gaps or holes then semen will leak out and pregnancy can occur. The condom gives about 90% protection against pregnancy.
Using a Condom
The condom has to be used in a proper manner, otherwise there is a likelihood of the condom getting torn and the semen seeping into the vagina and thereby an accidental pregnancy might occur. The diagram below explains the proper method of using a condom.
  • Carefully remove the rolled condom from its foil packet.
  • Unroll about an inch of the condom and squeeze the tip between the thumb and the forefinger to leave an empty space beyond the penis to catch the sperm and prevent the condom bursting.
  • Unroll the condom onto the erect penis. (Either partner can do this and the action can be incorporated into lovemaking) Be careful not to damage the condom with your fingernails. Do not use Vaseline or other grease as a lubricant.
  • After orgasm and before the erection subsides, withdraw the penis from your partner's vagina, taking care to hold the rim of the condom close to the penis.

Open the package carefully so that the condom does not tear.

Pinch the condom's tip between forefinger and thumb.

Continue squeezing the condom tip and unroll the condomto cover erect penis.

After sexual activity remove condom carefully without spilling.
Knot the open end of the condom
Wrap the condom in a paper and throw it in a dustbin.

5. Spermicides: Spermicides are chemical products that either destroy the sperms or create a barrier of foam or fluid to sperms. They come in various forms like creams, jellies, aerosol foams and pessaries (tablets which can be introduced into the vagina). As mentioned earlier they have to be used along with the caps. By themselves, they are not a hundred percent effective.
6. Coitus Interruptus: It is also known as the withdrawal method. The male partner withdraws his penis from the woman's vagina just before orgasm and ejaculates outside. Thus, it is ensured that the semen does not enter the female genital tract. This is a highly unreliable method. The fluid, which oozes out of the penis during the foreplay, may contain sperms. And normally it is very difficult for the majority of people to withdraw the penis at the right moment.
7. Rhythm Method: It is also known as the safe period and natural birth control. It is based on an understanding of a woman's natural monthly cycle and involves having sexual intercourse only during the least fertile (safe) periods of the month. This means that the sexual intercourse must be avoided around the time of ovulation (when an egg is released from the ovary). Generally, ovulation occurs around the 14th day of the normal and regular menstrual cycle.
The greatest likelihood of pregnancy taking place is around this time. Since the exact date of ovulation cannot be judged accurately, some couples avoid sexual contact the week prior to the 14th day and the week after. The main problem in this method is to establish accurately the time and date of ovulation. Many women may not have a regular 28-day cycle. A lot of self-discipline is required to practice this method.
8. Emergency Contraception: When an unprotected sexual intercourse takes place due to unavoidable circumstances, emergency contraception can be resorted to. The woman may take high doses of synthetic oestrogen within 72 hours of intercourse. This synthetic hormonal pill is also known as “morning after pill”. This method is about 98% successful. Though the method of action is not clear, the pill acts probably by preventing the ovum from travelling through the fallopian tube or by preventing the fertilised ovum from settling down on the inner lining of uterus “endometrium”. This method of contraception has some side effects like nausea, vomiting, giddiness etc. If there is vomiting, the doses have to be repeated.
9. Sterilisation: It is an ideal method of contraception for couples that want no further children. It is highly effective and the best solution to the problem of birth control. Contrary to popular misconception, it does not decrease the sex drive. In fact, by removing the fear of pregnancy, sexual pleasure and drive are increased.
Female sterilisation or tubectomy is a surgical procedure in which the fallopian tubes, which carry the eggs from the ovaries to the uterus, are cut and ligated (tied). Thereby the eggs are prevented from reaching the uterus and getting fertilised. In earlier days, this operation has to be done through the abdominal route and required five to six days' stay in the hospital. Today, a more simplified method, which does not require hospitalisation, has been developed. In this method, a laparoscope is introduced through a tiny opening in the abdomen and the fallopian tubes are blocked by cauterisation (electrical destruction of the tissue). Male sterilisation or vasectomy is a minor surgical operation in which the tubes that carry sperms from the testes to the penis (vas deference) are cut and tied. The man continues to ejaculate as before but the semen no longer contains sperms, which are re-absorbed by the body. Vasectomy, the safest surgical method for birth control is performed in the out-patient clinic and takes only a few minutes. Most men can return to work the same day. The choice of the contraceptive procedure to be followed rests with the couple. But it is advisable that the couple chooses the proper method after consulting the family physician.
10. Abortion (Medical Termination of Pregnancy): Abortion means the deliberate termination of a pregnancy by medical or surgical means. This method actually does not prevent pregnancy. Instead, it prevents childbirth by terminating the pregnancy.
The usual methods employed for this purpose are:
  • Dilation and Evacuation or Menstrual Regulation: In this method, under anaesthesia, the cervix (the entrance to womb) is gently dilated with the help of an instrument and the contents of the uterus are evacuated either with the help of a suction apparatus or through instruments.
  • Dilation and Curettage: In this method the cervix is dilated and the contents of the uterus are scraped out with a metallic instrument known as “Curette”. It is advisable to undertake abortion within the first three months of pregnancy, whichever be the method resorted to.
Puberty: Onset of Sexual Awareness
Puberty is, technically, the time when secondary sexual characteristics appear. On an average, a child enters a period of accelerated growth just prior to pubescence. With puberty begins adolescence, the transitional phase between childhood and adulthood.
Physical Changes
In Girls:
Spurt in height occurs around 11½ years. First menstrual period occurs between 11 and 14 years. The body fills out, breasts enlarge and hair grows under the armpits and on the pubis. A girl is now physiologically capable of conceiving a child.
In Boys:
Change of voice, increase in size of genitalia and growth of hair in the groin occur. These changes will be completed by 15 years for boys on an average. Physiologically, a boy is now capable of sexual intercourse and impregnating a girl.
In both sexes, the process of puberty begins when the hypothalamus, a part of the lower brain, stimulates the nearby pituitary gland by a chemical factor. The pituitary then starts producing two hormones involved in the sexual development of both males and females. These hormones, known as Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH) act on the male and female sex organs. The male sex organs produce testoterone and the female sex organs produce oestrogen and progesterone enabling the development of the reproductive system.
Psychological Changes
Puberty is often considered to be a stormy period because the child suddenly develops a sex drive and its horizons broaden. This generates anxiety and may provoke defensive behaviour, which may, in extreme cases, lead to delinquency. The more common reaction is conflict or defiance towards adult authority as with parents and teachers.
Day dreaming, as a means through which gratification of frustrated needs is achieved, increases during this period of life. It may be difficult to accept, but this is normal behaviour. It is imperative that there is some understanding on both sides. Teenagers must try to appreciate the difficulty which adults experience in understanding adolescents.
Because of the rapid changes inside the body and consequent emotional reaction, the adolescent has a natural inclination to withdraw from all problems and therefore, from others. This is the time when one's innate urge to seek human company can help greatly. The adolescent should make every effort to take part in the social activities of school or college, such as dramatics, sports, debates, social service, scouts etc.
During this period, there is a strong natural desire to read love stories and books that narrate sexual acts explicitly. Though there is no harm in reading such literature, to do so exclusively tends to make escapism attractive. It reduces the determination to face the daily problems and limits the mental horizons. What happens during sexual intercourse
Sexual intercourse is a biological reproductive device. Sensual pleasure motivates humans to have sex. Certain changes occur in both genders before, during and after sexual intercourse. These include changes in the genital organs and other parts of the body.
In both males and females the sexual response cycle is divided into four phases:
  1. Excitement phase
  2. Plateau phase
  3. Orgasmic phase and
  4. Resolution phase
The main purpose of these phases of the sexual response cycle is to ensure effective intercourse leading to the fertilisation of the egg (ovum).
1. Excitement Phase
In Males:
When aroused, blood is pumped into three cylinder-shaped bundles of spongy tissues in the penis. This makes the penis stiff and rigid, thereby helping it to standout of the body. The scrotal sac is raised slightly due to its muscular contraction, thereby drawing the testes upwards.
In Females:
The walls of the vagina start secreting lubricating vaginal fluid. The walls also turn purple. The inner two-thirds of the vagina lengthens. The uterus (womb) rises in the pelvis. The labia majora (outer vaginal lips) open. The labia minora (inner vaginal lips) thicken. The clitoris lengthens and swells.
2. Plateau Phase:
In Males:
The penis grows slightly larger. The head of the penis (glans penis) develops a reddish purple colour and becomes shiny. A few drops of sticky watery fluid (mucus) appear from the opening at the tip (meatus). The testes are drawn still higher.
In Females:
The outer one-third of vagina swells as more blood flows into it. The swollen outer vagina and labia minora (inner lips) form a long elevation known as orgasmic platform. The clitoris hides behind its hood.
3. Orgasmic Phase
In Males:
A series of involuntary rhythmic contractions in the testes and the penis force out semen from the penis. It is these muscular contractions that give the sexual pleasure. This process of expulsion of semen from the penis is known as ejaculation. These forceful ejaculations can squirt semen up to a distance of two feet.
In Females:
The orgasmic platform contracts rhythmically 3-15 times at 0.8-second intervals. These rhythmic contractions of the orgasmic platform along with structures in the pelvis give sexual pleasure.
4. Resolution Phase
In Males:
This phase is divided into two stages. In the first stage, the penis quickly shrinks to half its fully erect size. In the second stage, the penis returns to its normal flaccid size from the semi-erect or rigid stage. The second stage takes a little longer than the first stage. As the penis shrinks, the scrotum becomes loose and the testes come downward.
In Females:
Ten seconds after the vaginal contractions, the clitoris returns to its normal position. The entire vagina returns to its normal colour, size and position in about 15 minutes. Uterus regains its normal position in about 20 minutes. The inner and outer lips of the vagina revert to their original colour and size.
Duration of the Phases
The excitement phase may last minutes or hours depending on the techniques used and the lack of distraction. The plateau phase is brief and intense. orgasmic phase is the shortest of all, which lasts for merely a few seconds. Many of the changes in the resolution phase are over in ten minutes. Renewed stimulation will arouse most women just after intercourse, but most men have a refractory period immediately after sexual intercourse when re-stimulation and achieving an erection is impossible.
Changes in Other Parts of the Body
In both genders, apart from the changes in genitals, certain significant changes in other parts of the body occur. In about 75% of women and about 25% of men, reddish spots known as sex flush appear on the abdomen, throat and breasts. They disappear five minutes after the orgasm. Muscle tension occurs, causing nipple erection, tense thighs, arched back, flared nostrils etc. This tension fades within five minutes of the orgasm.
A thin film of perspiration may cover the entire body after orgasm. Heart rate, breathing rate and blood pressure go up in both genders during excitement, plateau and orgasmic phases. They return to normal soon after orgasm. Childhood and Sexual Evolution
Till recently it was believed that children had no sexual feelings until puberty. This mistaken notion had led people to assume that children were non-sexual entities and prevented the parents and elders from educating children properly in matters of sex. In fact, the foundations of adult sexuality are largely built during early childhood. Children become interested in the intimacy they observe between their parents. They want to know what happens in the parents’ bedroom. However, direct observation of parental sex upsets children. They are unable to understand what they see and often conclude that sex is a form of a violent struggle.
Children’s attitudes to sex are influenced by the environment at home. Parental disapproval is absorbed into the child’s personality and becomes an internal watchdog, a type of conscience.
Stages of Childhood Sexual Development
According to Freud, childhood sexuality develops in the following stages:
Oral Stage: Persists through the first year of life. Pleasure from sucking and eating is centred on the mouth. Hence the name oral stage.
Anal Stage:: Begins around two years of age. Toilet training becomes an important challenge for the child. The child derives pleasure from retaining the expelling faeces. Here, the pleasure is located near the anus. Hence the name anal stage.
Phallic Stage: Begins around the start of the third year. Interest centres on the penis. Boys fear castration (cutting off of the penis) as a sexual punishment. Girls envy penises and worry that they are castrated males.
Oedipal Stage: Develops when the attachment to the parent of the opposite sex becomes deeply possessive and passionate. The child even fantasises about killing the other parent. In the girls, it is referred to as electra complex.
Latent Stage: Usually sets in after the age of five, when sexual interest becomes repressed until puberty. In this stage, boys and girls form their own (gender) groups and do not mix with the opposite sex.
Genital Stage: Mature adult sexuality. Its healthy aim is intercourse with a life partner.
General Roles
General role behaviour is to a great extent established during childhood. Boys and girls tend to follow the behaviour patterns demonstrated by their parents. They learn from them such things as how to relate to members of the opposite sex and what types of work and emotions are appropriate to members of each sex. In conservative Asian societies, the roles for each sex are clearly determined. Men are the main income earners and decision-makers. So, boys are encouraged to be outgoing, self-reliant and dominating. Women are expected to keep house, care for children and be submissive. Even when women in many strata of society have become wage earners, girls are given a sheltered childhood, and expected to learn domestic chores and be submissive. Sex and the Adolescent
The term adolescence comes from the Latin word adolescere, which means, to grow up. The adolescent years are the link between childhood and maturity, and are often marked by turmoil, confusion and stress. It has been observed that this is the phase when there is a search for a sense of personal identity, the time when the adolescent is expected to develop and accept emotional independence and autonomy from parents.
Adolescence has many facets to its stormy nature, one of which is the little understood, widely controversial, adolescent sexuality. While talking about adolescent sexuality and its associated concerns, we have to distinguish between those arising out of innate biological drives and those that arise out of a conflict between the demands of these drives and their surrounding psychosocial forces.
Biological Changes
  1. Variations in attaining pubertal land marks. These include menstruation and breast development in girls, facial hair, muscle development and deepening of the voice in boys and development of pubic hair in both. (Refer Puberty)
  2. Nocturnal emissions
  3. Tendency to masturbate
  4. Acne. Adolescents feel the urge to be attractive to the opposite sex. Acne threatens the prospect. Hence the fear and resultant anxiety about it.

Peer Group Culture
It is during puberty that boys and girls feel the onset of adulthood. They question the sources of authority such as parents and teachers. They feel closer to people of their own age and interests, in other words, their peers. In school or college, in their teens, adolescents learn many things apart from what is taught in classrooms. Out of this emerges the peer group culture - where the likes, dislikes and values adopted by the most adventurous, the most dynamic and the most admired tend to be the accepted norm. Very often, in their anxiety to conform to this norm, an adolescent’s individuality and the sense of self-worth is curbed. The strong need to belong to the peer group leads most youngsters to experiment with cigarettes, alcohol and drugs. The urge for freedom from adult authority and the need to establish some kind of an image or identity, further pushes the adolescent in these directions.
Cult figures and personalities with sex appeal projected by the media make a strong impression on adolescents. A beefy masculine figure, smoking a cigarette, or a debonair socialite, drinking whisky, gains an iconic status. In teenagers whose personality development is marred by insecurity, distrust, fear and anger a blind following of roles may lead to addiction.
Sexual Drive
While one’s sexual drive is the strongest between the mid-teens and the early twenties, the sexual expression is not governed by one’s biological make up. Rather, it is largely influenced by such factors as parental authority, schools or colleges, peer group, religion, books and movies.
In their early teens, boys and girls tend to develop strong emotional attachments towards members of the same sex. For example, a shy introverted girl may be attracted to an aggressive extroverted girl. This homosexual phase (to be distinguished from homosexuality as a form of adult sexual behaviour) is soon followed by the heterosexual phase (between age 15-18). During this phase, there is an attraction towards members of the opposite sex resulting in strong infatuations or deep passionate feelings. Romantic entanglements, eloping and suicide pacts are more common during this stage than any other. During this period, boys develop an interest in nude figures, pornography etc. to satisfy their erotic impulses. Girls, on the other hand, develop a thirst for passionate love stories, romantic movies etc.
Fantasising plays an important role in sexual development. Male fantasies usually revolve around physical urges, whereas female fantasies are largely romantic and emotional in nature. There is often a tendency to assume that the member of the opposite sex thinks and feels the same as oneself. This assumption, which is far removed from reality, results in a lot of confusion, misunderstanding and tension. especially during the process of dating.
Preoccupation with Body Image
During adolescence, the body growth is rapid when compared to the emotional development. Often, the suddenness of these changes undermines the adolescents’ self-confidence. Not having sufficient skills to adjust to changes, they often become pre-occupied with themselves, their looks, clothes etc. This may lead them to spend hours admiring themselves in the mirror or worrying about their pimples, height, figure, hairstyles etc. Day-dreaming becomes excessive and they often turn self-centred, much to the annoyance of elders.
The strong emotions of early puberty continue into the later stages. However, the focus switches from self to interpersonal relationships. In the initial stages, the emotional excitement lies in thinking about the other - the yearning for a special person in one’s life (we mainly have novels and movies to thank for this). Though dating is not very common in India, the more adventurous youngsters venture to date each other, sometimes with much initial self-consciousness.
Casual relationships wear off, but serious ones persist. At this time, the couple’s decision whether to meet openly or resort to clandestine meetings is dependent on the social context. The boy may be anxious to be seen in public as a boost to his image, whereas the girl worries about her reputation. Thus, there is a struggle between the desire for sexual expression and the socio-ethical code.
Premarital Sex
Despite the taboo on it, premarital sex is not unheard of in India.
Greater mobility, greater anonymity, influence of the movies, peer group culture, and decline in parental authority are factors that have led to a reduction in inhibitions and thereby a greater incidence of premarital sex. It would be erroneous to assume that boys and girls indulge in sex for physical pleasure alone.
Social psychologist, Dr. R. C. Sorenson, states that youngsters indulge in sexual activities for variety of reasons such as:
  1. Physical pleasure
  2. A means of communication
  3. A search for a new experience
  4. An index of personal maturity
  5. A need to conform to peers
  6. A challenge parents or society
  7. Reward or punishment
  8. An escape from loneliness
  9. An escape from other pressures
An unfortunate outcome of premarital sex is the poor show of responsibility thereafter, by the youngsters in question. Boys are often unconcerned about the consequences to the girls and some girls are not fully aware of the problems they may have to encounter. The orthodoxy of the Indian society prevents them from seeking adequate protection. This emphasises the strong need for proper sex education.
Teenage Pregnancies
Premarital sex often leads to teenage pregnancies. This poses a serious health hazard, both physical and emotional. The teenage mother is not emotionally ready for the responsibilities of parenthood. Further, she has the social stigma to contend with. The traumatic experience may also hamper sexual adjustment, in the event of marriage, later in life.
Delayed Marriages
Today’s formal education extends well into the early twenties. The struggle for employment necessitates a further delay in marriage. Moreover, today’s economic and social standards require that both husband and wife be employed. The sex urge, a natural consequence of sexual maturation, is at its peak during these unsettled years. It is the pull of divergent forces - the biological and emotional on one side and the social and economic requirements on the other, which gives rise to many problems that surround adolescent sexuality.
Sexually Transmitted diseases (STD)
Unsafe sexual practices carry a high risk of contracting sexually transmitted diseases. Some of these STDs can irreversibly damage the reproductive organs and debilitate them for life.
Disinterest in Studies
It is paradoxical that an acute problem of adolescent sexuality is non-sexual in nature - a flagging interest in academic work. However, sexual development does play its role in the manifestation of this problem. This is more evident between the ages of 14-18. That more boys than girls are affected, fits in with the fact that the latter have by this age, due to their earlier pubertal onset, come to terms with their body changes.
Though parental concern over this problem is justifiable (that is, their anxiety about their offspring scoring good marks and consequently getting admitted into colleges), their methods of dealing with the problem, appear by and large irrational. Parental outbursts, angry criticism, and constant nagging only serve to alienate and perhaps provoke the impulsive and immature adolescent to give up studies. Some may run away from home. The most depressed of the lot may even contemplate suicide.
The adolescent has drawn very little attention in India till recently and the sexuality of the adolescent, even less. Except for a small number of social workers, teachers, psychologists, counsellors and doctors, by and large the policy makers, the educationists and unfortunately most parents have turned a blind eye to the problems faced by the average adolescent, during the adolescent’s most turbulent period of development and transition.
A significant elder, be it a parent, teacher or a counsellor, who is not only equipped with the knowledge, but is also comfortable in dealing with matters of sexuality, can guide an adolescent to face the future with confidence. Sex and the Adult
By the late teens, physical maturity will be attained. But adult psychosexual maturity may not follow automatically. Young women may be scared of penetration, fearing pain or a sense of humiliation. Men are afraid of their inexperience and the possibility of a bad performance. These fears may result in sexual problems like impotence, or premature ejaculation in men, vaginismus and lack of orgasm in women.
The first sexual experience can greatly help or hinder confidence. Many a time a person’s sexual problem may stem from failure in the first sexual encounter, which, in turn, stems from the above mentioned fears. Sexual maturity does not begin and end with the ability to have sexual intercourse. In the first years of marriage, sexual activity and frequency is often high and the pleasure intense. But as the years pass by, the frequency and intensity will gradually decrease and stabilise at a particular level.
One major fear is that sex in marriage life will become routine and boring to both partners. This is a myth. Intelligent and adventurous couples will learn to keep sex alive at all times, in their marriage through various methods.
Although one’s sex drive declines with age, the rate and the extent of this decline are often exaggerated. In fact, desire and capacity for intercourse are often retained into old age. Usually, fears of social disapproval, worries about not being attractive as before, or doubts about sexual performance may lead a couple to give up sexual activity prematurely
Stages in Adult Sexuality
There are four stages to adult sexuality. · Young Adult
    • Interest in the opposite sex becomes intense.
    • Attempts at making friends with members of the opposite sex increase.
    • Embarrassment about sexual activity disappears.
    • Pressure from family and friends to marry begins.
· Early Years of Marriage
    • Sexual activity is legitimized by marriage.
    • The levels of sexual activity are high.
    • Birth of children is followed usually by a decline in frequency and intensity of sexual activity.
· Middle Years of Marriage
    • Marital intercourse rates may fall.
    • Dissatisfaction may lead to extramarital affairs.
    • Work pressures may cause marital problems.
    • Non-sexual aspects of marriage become increasingly important to marital stability and continuity.
· Later Years of Marriage
    • Sexual activity declines further as physical energy and attractiveness decrease.
    • Children leave home.
    • Other non-sexual commitments take up most of one’s married life.
Masturbation generally means the stimulation of the sex organs to obtain pleasure. Boys as well as girls indulge in it. The term masturbation is derived from the Latin word masturbari, which means, “to populate oneself”
Perhaps no other act of sex has been associated with as many myths and misconceptions as masturbation. The act of masturbation creates an inferiority complex, a feeling of guilt and sin. Masturbation does not cause any damage to the nervous system.
Masturbation is a perfectly normal act. Even small babies handle their own genitals. This is simply a part of the normal process by which they explore and learn about their own bodies. Although the sensation is pleasurable, it cannot be called sexual at this stage.
Masturbation may be regarded as a sort of imitation of real intercourse. The big and real difference is that it is entirely self-centred, while real love-making is very much a shared experience, a means of expressing mutual love and a giving as well as taking of pleasure and emotional satisfaction.
Some Myths about Masturbation.
The following are some wrong opinions people have about masturbation:
  • Only the young, the immature and the unmarried practice masturbation
  • Only men practice it.
  • It leads to weakness, insanity, impotence, homosexuality and dark circles around the eyes.
  • People who masturbate are not sexually normal.
  • Frequent masturbation can lead to sexual inadequacy.
  • Regular masturbation will lead to shrinkage of the penis.
Sexual Myths
The concepts of sex being ‘a necessary evil’ and ‘the less said about it the better’ have led to many misconceptions about sex. Most common sexual myths arise out of ignorance. Given below are a few of them.

Women also ejaculate during sexual intercourse.

Women do not ejaculate during sexual intercourse.


Simultaneous orgasms are a must for sexual satisfaction.

Simultaneous orgasms are not necessary.


Only men have wet dreams.

Women also experience nocturnal orgasms.


Wet dreams are sexual disorders.

Nocturnal emissions (wet dreams) are not a sign of sexual disorder. They are a part of normal sexual process.


One drop of semen is equivalent to 40 drops of blood.

Completely unfounded. Semen is produced by testes, seminal vesicles and prostate gland and not directly by blood.


Men have fixed quota of semen. If they masturbate, this quantity is quickly disposed of.

There is no fixed quota of semen. From puberty to death, semen will be produced, provided the testicles are healthy.


Venereal disease occurs when god of love visits a man.

Venereal disease is produced by infective organisms. God has nothing to do with it. Unless one of the partners is harbouring the disease producing germs, the other cannot contract it.


Venereal disease is cured if the man has sex with a virgin

Not true. On the contrary the Venereal disease sufferer will transmit the disease to the virgin.


Frequent masturbation makes the penis shrink.

Even when a person indulges in masturbation frequently, the penis never shrinks and becomes small. Once any part or organ of the human body has attained its maximum size, it will never become small unless it is partially cut off accidentally or surgically.


Special food and exercise will make the penis grow big.

Not true. Whatever that is good for other body parts is also good for sex organs.


Masturbation leads to nervous breakdown.

Not true. Masturbation is a normal physiological activity. Only, physiologically or emotionally sub-normal people do not masturbate.


Vasectomy makes a man impotent.

Sterilisation (vasectomy in male and tubectomy in female) does not reduce desire and performance. In fact, by removing the fear of pregnancy, sexual desire and the performance are increased.


Men have stronger sexual urges than women.

Not true. Sexual urge is equal in both the sexes.


Anal sex is only practised by homosexuals.

Anal sex may be practised by heterosexuals also.


Oral sex is a perverted act.

Oral sex is a normal act and may be practised when both partners are interested and free from infections.


A normal man should be able to get an erection whenever he wants it.

A man have an erection of the penis just by desiring it. The entire physiological sexual response should be gone through before an erection occurs.


A man is not a male if he cannot get a penile erection.

The masculinity of a person is not judged by the ability to get an erection. There are other criteria. (refer Gender Identity)


A woman is not considered to be a female if she cannot conceive a child.

The femininity of a person is not judged by the ability to conceive a child. There are other criteria. (refer Gender Identity)


Menopause puts an end to a woman’s sex life.

Menopause is not the end of a woman’s sex life. It is the end of her reproductive life only.


Imparting sex education to youngsters will lead them to promiscuity.

Talking to youngsters on sex or imparting sex education will not lead to promiscuity. Even without sex education, people indulge in promiscuity. In fact, more married people have promiscuous relations than youngsters. Educating the young on sex and sexual behaviour helps them to develop a healthy and positive attitude towards sexuality. More importantly, better interpersonal relationship will develop leading to a harmonious family and marital life.

Sexually Transmitted Diseases (STD)
These are diseases, which are transmitted from one person to another mostly through sexual contact. Till recently, these diseases were collectively called Venereal Diseases (VD) after 'Venus”- the Roman goddess of love.
The major sexually transmitted diseases are:
  • Syphilis
  • Gonorrhoea
  • Chancroid
  • Lympho Granuloma
  • Granuloma Inguinale
The minor diseases are:
  • Non-specific Urethritis
  • Genital Warts
  • Molluscum Contagiosum
  • Genital Herpes
  • Trichomonasis

Major Diseases
  • Syphilis: This is the gravest and most feared venereal disease. Initial symptoms are light and may pass unnoticed. Untreated syphilis may irreversibly damage vital organs causing blindness, insanity, paralysis and death. A spiral shaped bacterium called “Treponema palladium” causes syphilis.
Course of the Disease: The primary sore most often occurs on a man's glans penis (head of penis) or foreskin or on a woman's vulva (external genital) lips or clitoris. It starts as a small red spot that grows moist and eroded, with a hard base that feels like a button. First Stage Syphilis: Usually 10 to 40 days after the infection, a painless sore appears on the area that had directly been infected. Besides the genital area the sore can appear at the anus, on the lips or on the nipple. The glands nearby may be swollen. The chancre (sore) clears up on its own within 4 to 10 weeks. At this first stage, a complete cure is possible. Second Stage: Between six weeks and three months after the infection, a skin rash appears and patches of hair drop out. There may be headache, sore throat, a slight fever and swollen glands. Sufferers are very infectious and can transmit the disease even by kissing if the skin of the mouth is broken. All signs of the disease vanish within a year. Third or Latter Stage: After a lull of up to 30 years, the disease may attack any part of the body like heart, blood vessels, brain or spinal cord. Other effects include mouth ulcers and erosions of the skin, bones and ligaments. Major effects can be blindness, paralysis, insanity and death. Damage, by this time, is irreversible. Congenital Syphilis: Mothers with syphilis may pass it to their unborn babies via the placenta. One-third of the babies produced by these mothers, are born with syphilis. Treatment of the mother, early in pregnancy, protects the baby.
  • 2. Gonorrhoea: Gonorrhoea is a disease, which is produced by a bean-shaped bacterium called “Neisseria gonorrhoea”. It is mainly spread by sexual intercourse. Rarely, kissing or the use of soiled towels can also be the route of spread. Only about 20% of the infected women show symptoms of the disease. In both genders long standing infection can invade the blood stream and affect skin, joints and even the brain.
Gonorrhoea in Men: Genital infection produces a watery greenish-yellow discharge from the penis. There is a frequent urge to urinate. Passing urine is very painful, with a burning sensation. Testes may swell and become painful. Anal infection in homosexuals can produce ulcers and sore throat. Long-term infection can produce painful joints (arthritis), skin rashes, brain fever and heart damage. Gonorrhoea in Women: Genital infection produces a red, raw vulva, with greenish-yellow discharge. There is a frequent urge to urinate. Urination is painful, with a burning sensation. Lower abdominal pain and menstrual irregularity may occur. Symptoms of anal and mouth infection are the same as in men Complications of Gonorrhoea: In Men:
    • Urethra (urinary tract in penis) can be blocked and thereby the kidney may be damaged.
    • Testes may get damaged and the man may lose the ability to produce sperm and thereby can become infertile.
In Women:
    • Fallopian tubes can be damaged and blocked.
    • Ovaries can be damaged and the follicles and eggs will be killed.
Both or any of the above can result in sterility (inability to bear or beget a child). In Newborns:
    • At birth babies can get infected in the eyes during their passage through the vagina. It may result in blindness.
  • Chancroid: This is produced by a bacterium called “Haemophilus ducrei”. Nearly three to seven days after the infection, several soft, painful ulcers appear on male or female genitals. Later a painful one-sided swelling develops in the groin.
  • Lympho Granuloma Vernerum: This is produced by “Chlamydia bacterium”. Around 5-21 days after the infection, a small painless ulcer may appear on the penis or vulva. Weeks later, painful swellings and abscesses appear on the groin. There may be fever, headache, pain in the joints and genital swellings.
  • Granuloma Inguinale: This is produced by “Donovan bacilli”. About two months after the infection, a red painless swelling appears on the genitals. It slowly spreads forming bright red ulcers, which heal very slowly. The scars often break down and tissue and even the penis may be destroyed.
Minor diseases 1. Genital Warts: These appear on the genitals or around the anus. Cluster groups give the appearance of a cauliflower. These are due to a virus. They appear one to six months after sexual contact. 2. Molluscum Contagiosum: This is a harmless viral infection, which can be caught in swimming pools but is usually due to sexual contact. The virus produces small, painless, pink spots on the genitals. They appear months after contact and will be firm and smooth. 3. Genital Herpes: This condition is produced by a virus. The same virus produces cold sores around the mouth also. About four to five days after sexual contact, itchy blisters appear on the genitals which burst and raw, shallow, painful ulcers are produced. 4. Trichomonasis: This condition is produced by a parasite by name “Trichomonias vaginalis”. It produces a foul-smelling greenish vaginal discharge. There is pain and itchiness in the vulva and vagina. Intercourse is painful. Most infected men suffer from no symptoms and act as carriers. Some General Symptoms of Sexually Transmitted Diseases The following are only a few important signs indicating sexually transmitted diseases. The list is by no means exhaustive. When in doubt, please consult your family physician. Indications in the genital area:
    • A sore, ulcer or rash on the penis, vagina or vulval lips
    • A sore, ulcer or rash on or near anus
    • Swollen glands in the groin
    • A burning sensation or pain on urination
    • An itchy or sore vagina or an itchy penis tip
    • Pain on intercourse
    • Unusual discharge from the penis or vagina
    • A frequent urge to urinate
Indications in the other parts of body:
    • Patchy hair loss
    • Eye infection
    • A sore ulcer or rash in the mouth
    • A sore throat
    • Body rash
    • A rash, sore or ulcer on finger or hand
Related Conditions from Internal Spread of Diseases:
    • Abdominal pain
    • Low backache
    • Excessively painful periods
    • Nausea
    • Low grade fever
Advice to Infected Persons:
    • If you suspect that you have a sexually transmitted disease, have a medical examination done as soon as possible.
    • Consult a qualified doctor. Call on your family physician.
    • Follow the prescribed treatment fully.
    • Never go to quacks, who may appear in newspapers or billboard advertisements. Due to their ignorance the disease will progress to a stage where the damage will be irreversible.
    • Confide in someone you trust.
    • Warn your sex partners to seek medical aid.
    • Avoid sexual contact.
    • Avoid re-infection. Avoid promiscuous sexual activity.
Some Tips on How to Avoid Getting Infected The following procedures will help to reduce the risk of infection. It can in no way guarantee prevention of STD
    • Wash genitals daily.
    • Change underwear daily. Use only cotton underwear.
    • Avoid contact with chemicals that irritate the genitals.
    • Wipe the bottom (anus) from front to back (especially women)
    • Keep sexual contact to one partner, who is free from infections
    • Look for discharge or sores on a new partner's genitals.
    • Use a condom during intercourse.
    • Wash genitals before and after intercourse.
    • Urinate immediately after intercourse.
Sexual Deviations
Sexual activities that are not practised by the majority of the population have been categorised as ‘deviant’ or “variant” behaviour. Small groups of people feel that since these do not fall under the expected social norms they should be termed as “perversions”. Whatever we call it, it is important for us to realise that no individual has chosen to be born to behave in a particular manner. We do know why these people behave and act differently. There are various theories but none of them has been proven beyond doubt.
In real life, most of us may indulge in some sexual activity, which is not considered “normal”, for thrill or novelty. But this will be only a passing phase and not a permanent trait. When people rely only on deviant type of sexual stimulation (to the exclusion of all other types) for sexual gratification then it will become problematic.
A few of these “unconventional” sexual behaviours are described below:
Transvestism: In this form of behaviour the individual derives sexual pleasure by dressing in the clothes of the opposite sex. This is more common among males than females. Transvestites are normally heterosexuals. They usually wear women’s undergarments and will often masturbate while so dressed.
Exhibitionism: This is an exclusive male form of behaviour in which the individual exposes his genitals, usually an erect penis, in the presence of a young woman in public. He achieves sexual excitement and self-assurance from the shocked reaction of the victim. Exposure is usually followed by masturbation. Exhibitionists are usually insecure and lonely individuals. They simply try to draw the attention of women and thereby reassure themselves of their masculinity.
Fetishism: Fetishism is a condition in which a person gets aroused usually by an inanimate object. A person who indulges in this type of behaviour is known as a fetishist. The fetishist, usually a male, becomes erotically obsessed with an object (a fetish) which is not sexual in the usual sense (such as gloves, shoes, furniture, or a car). He may symbolically fall in love with it and perform ritual acts in its presence. Fetishism is potentially within every one of us and a person, who, for any reason cannot achieve satisfactory sexual relations with a member of the opposite sex, may well seek gratification by turning to some other object with which success is more easily assured.
Voyeurism: This is a condition in which a person derives unusual sexual pleasure and gratification through the surreptitious observation of naked persons or sexual acts. Almost every one derives pleasure in looking at someone undressing or somebody engaged in sexual acts. Because of this voyeuristic tendency some of us are interested in using pornographic material. But compulsive voyeurs take great pains and risks in order to observe others, without the victims’ knowledge. Their sexual arousal is caused only by observing others in the act and not by the “normal” stimulation. These persons are timid individuals and are more of a nuisance than of any danger to others.
Sadism: Sadism is a condition in which a person derives sexual pleasure and gratification by humiliating or inflicting pain on a partner. Many couples, during their lovemaking, may inflict mild pain in the form of bites or scratches. These will be limited to a short duration and may not cause major injury. But in sadism, the intensity of the sadistic acts will be severe and physical injuries will be grave. Acts may include beating the partner with hands or with various instruments, punching, biting till bleeding occurs or even burning (either with cigarette butts or with other electrical implements). A sadist may tie up, gag or blindfold his victim. Pain or humiliation may also be inflicted verbally.
Masochism: Masochism is a condition wherein a person derives sexual gratification by being hurt or humiliated. This type of sexual activity is exactly opposite to sadism. To outsiders, this type of behaviour may appear to be cruel, but a masochist (the person who indulges in this type of activity) enjoys the pain and welcomes it. He may even go to the extent of hiring commercial sex workers to inflict pain on him.
Other Deviant Sexual Behaviour
There are many more types of behaviour, which may be categorised as deviant or variant behaviour. Only a few of them are listed below:
Frotteurism: A condition wherein a person rubs himself against strangers for sexual pleasures.
Kleptophilia: A condition wherein a person gets sexual feelings by stealing things.
Necrophilia: A condition wherein a person gets sexually aroused at the sight of a dead body and gets sexual pleasure by ‘having sex’ with the dead body.
Pedophilia: A condition wherein a person gets sexual pleasure only by having sex with children below the age of puberty.
Zoophilia: A condition wherein a person has sex with animals for fulfilling his sexual urges. This is also known as bestiality.