Multi-orgasm, is experiencing of multiple orgasms one after another, without an intermediate refractory period.

Are males multi-orgasmic?

No. Usually after orgasmic experience, in a male, a refractory period ensues (during which sexual stimuli fail to arouse) following which arouse ability is regained. Therefore, for multi-orgasmic experience the male has to train himself.

Multi Orgasm in Females

Multi-orgasmic capacity is a natural physio-anatomical female asset for which no training is required. After experiencing orgasm, females maintain sexual arouse ability and therefore can experience multiple orgasms in succession. In short, for a female multi-orgasmic capacity is a natural potential and for a male it is an acquired art.

Though different people describe orgasm in different ways, and call it by different names, in essence they all agree that it is a state of supreme pleasurable satiety where there is a feeling of ‘enough and nothing more’.

Gujarati people call it ‘Sukh’ (happiness), Hindi speakers term it as ‘Santosh’ (satisfaction) Bohras name it as ‘Paramsukh’ (eternal happiness), Maharashtrians call it ‘Samadhan’ (satisfaction), in Urdu it is called ‘Sukun’ (perfect satisfaction), Sindhis call it ‘Shanti’ (peace), in Tamil, it is termed as ‘Trupti’ (satisfaction) and as ‘Santrupti’ (perfect satisfaction) in Telugu, in Kashmir it is called as ‘Khushi’ (ecstasy) and slum dwellers call it ‘Nasha’ (intoxication), English speaking people call it ‘Climax’.

It is interesting to note that different people in the diversity of their ethnic, socio-cultural and linguistic background are united in the expression and description of their orgasmic experience, which they unanimously agree, is, in essence, a sense of supreme pleasurable satiety and ecstasy.

No. Local genital stimulation is not mandatory for reaching orgasm. The female anatomy provides for multiple erogenous zones any of which may be stimulated to reach orgasm. In fact, it has been observed that in the event of absence or trauma to the external genitalia, existing alternate erogenous zones become more sensitive and new ones develop. Some women can reach orgasm by nipple stimulation alone. I have come across women with absent vagina who are able to reach orgasm satisfactorily by alternate means.

In a study carried out on ritually circumcised South African women, Hanny Light foot Klein reports that these women had retained their orgasmic capacity in spite of the local genital mutilation.

When one reaches orgasm, one usually has gasping uncontrolled movements, or a sense of suspension which are nonverbal communications to the partner that one has had an orgasm. It is usually accompanied by vaginal contractions in female and the visible associate of ejaculation in males. Later, after completion of the sex act, one appears calm and physically satisfied. The signs of having had an orgasm are quite fleeting. The best way is to ask the partner.

Is it normal to reach orgasm by clitoral stimulation?

Absolutely. There are women who are unable to reach climax by vaginal intercourse alone. Climaxing by clitoral stimulation is in no way inferior.

Are different erogenous zones important?

Yes. One need not reach orgasm by genital stimulation alone. One may stimulate any erogenous zone to the point of orgasm.’What is important is the end and not the means to the end’.

When an individual has sexual desire he departs from the normal state and enters into the ‘sexual state’ and is deemed to have undergone ‘sexual grounding’. ‘Sexual grounding’ or the ‘Sexual state’ is a state in which the subject becomes receptive to the perception of stimuli inputs as sexual. Once this occurs, psycho-biological stimuli arouse the sex centre in the brain which starts sending out impulses, which are usually pleasurable. When such impulses reach the genitalia they lead to congestion of blood which is usually manifested as erection in the male and lubrication in the female. Further stimuli further arouse the individual and eventually lead to orgasm.

Here we classify orgasmic dysfunctions, on the basis of one single central parameter - the subjectively reported orgasmic experience, into four broad categories. They represent the discrepancy between one’s idealized expectation and one’s actual experience.

1. Early Orgasmic Response - (EOR): This category includes cases in which orgasm is experienced earlier than one’s idealized expectations, which are within rational limits.
2. Delayed Orgasmic Response - (DOR): This category includes cases in which orgasm does ultimately occur, but is delayed beyond one’s idealized expectations, which are within rational limits.
3. Impaired Orgasmic Response - (IOR): This category includes cases in which there is a reduction in the intensity of orgasmic pleasure.
4. Absent Orgasmic Response - (AOR): This category includes cases in which there is a complete failure to experience orgasmic pleasure.

This classification, based on one central subjective parameter provides conceptual clarity, specific terminologies for different disorders, uniformly encompasses all known male and female disorders, gives information whether a disorder is primary or secondary to some other pathology, and has the scope to include other associated parameters, if and when they are disturbed, along with the main diagnosis.

Orgasm represents the zenith of human pleasurable experiences. ‘Orgasm’ is derived from the Greek word ‘orgaos’ which means ‘to swell, with lust. This literal translation very appropriately encompasses the true essence of orgasm.

Orgasm is defined as, ‘an explosive cerebrally encoded neuromuscular response, at the peak of ‘sexual arousal by psycho biological stimuli, the pleasurable sensations of which are experienced in association with dispensable pelvic physiological concomitants’.

Sex is not merely the means to an end (procreation). It is both, the means to an end, as well as an end in itself (pleasure). Nature, with its natural masterstroke, of providing an inherently sensual pleasure oriented side to our personality, has ingeniously accomplished this dual objective (pleasure + procreation). An attempt to rationalize the philosophy of sex undisputedly establishes the fact that humans indulge in sex to gratify their inherent pleasure instinct. One indulges in sexual activity for what one ‘gets’ out of it, and not for what one ‘may beget’ out of it. One indulges, not to ‘lose’ fluids but to ‘gain’ an orgasm.

The pleasure principle has, is and always will be ‘principal’.

What are the common sexual misconceptions prevalent among the middle aged men and women?

Men harbour the misconception that increasing age and excessive use may lead to weakening of the genitals and end in ‘seminal bankruptcy’. Because of this misguided belief, they observe sexual abstinence. One should remember that it is disuse which leads to atrophy and not the use. As a man grows older, he walks slow, he talks slow but he expects that his erection should not be slow! One needs to remember that this is a normal phenomenon.

Impression that “one failure in making it means an end to sex life”. As a result, many men move from effective sexual functioning to various degrees of impotence. I always emphasize that occasional failures are common and failure does not mean an end. Women harbour the misconception that menopause marks the end of sex life. Menopause merely marks the end of a woman’s reproductive career and not the conjugal career which can continue upto the end of one’s biological life. In fact, the maturity of the partner’s end the relationship, alongwith guaranteed natural contraception may enhance the sex life. The misconception that “sex after 60 is not possible” needs to be changed. Men and women can continue to remain sexually active till the last day of their lives provided they are in sound physical and mental health.

What physical changes occur when a person grows older?

As a man grows older, erection takes a longer time to occur. Similarly, in women, lubrication takes a longer time to occur. A man may often require direct physical stimulation to achieve erection and the same is also true of a woman’s lubrication. The colour of the semen changes from white to light yellow, the consistency gets thinner and the quantity decreases. When, people are not informed about these facts, anxiety can be generated, as there is a vast discrepancy between the unrealistic expectations and the real experience. This paralyses the sexual response leading to avoidance of sexual overtures. Older persons tend to become obese because of sedentary lives, lack of exercise and changes in hormonal levels. Exercises for toning up the muscles and good functioning of the body, are essential. All these help in improving the self-image and making a better sex life.

How do Contraceptive (Spermicidal) Suppositories work?

They work by immobilizing the sperm by chemical actions and need to be inserted at least 5 minutes prior to intercourse. The effect lasts for an hour and usually gives protection for a single coitus. If she desires to indulge in intercourse again, she will need another suppository. Some of them are biodegradable and need not be removed after use. Instructions regarding use should be very clear and lucid. There are instances of women who have used spermicidal suppositories orally and some who have inserted them in the anus! It is best to use them under the guidance of a gynecologist.

What is an IntraUterine Contraceptive Device (IUCD)?

It is a contraceptive device which has to be inserted into the uterus.

There are medicated and non-medicated varieties available. The advantages include: the one time motivation, no systemic metabolic side effects, no interference with local sensitivity, high success rate and long duration of action. The disadvantages include increased incidence of pelvic inflammatory disease, increased bleeding, dysmenorrhoea and increased risk of ectopic pregnancy.

What are the contraindications for using an IntraUterine Contraceptive Device (IUCD)?

IUCD should not be used if a woman has menorrhagia (excessive bleeding), an abnormal uterine cavity; undiagnosed bleeding from the uterus or the vagina; pelvic infection; history of ectopic pregnancy or tubal surgery. IUCD is generally not advised for women who have not yet borne a child.

Why is family planning necessary today?

Population control assumes importance if one considers the fact that forty years ago the population of our country was a mere three hundred and forty million which, in 1981 had swelled to six hundred and seventy million, in 1991, increased to eight hundred and forty four million and, by the turn of the Country, may well escalate to the one billion mark! I his galloping increase have to be tackled on a war looting. The socio-economic benefits of family planning to the individual, society and nation cannot ho overemphasized. One needs to remember that Family Planning’ is ‘Family Welfare’.

Is vaginal douche after intercourse a safe method of contraception?

No. It is practiced as a method of local hygiene and not as a method of contraception.

Is Coitus interrupts a safe method of contraception?

No. Coitus interrupts involves withdrawal just prior to ejaculation so that ejaculation occurs extra vaginally. It requires repeated motivation ind a tremendous amount of will-power, during each act of coitus, to be effective. Hence, the failure rate is very high. Moreover, some men may not be able to predict the moment of inevitability every time. It also affects the response and performance as the individual is constantly under tension to withdraw at the moment of inevitability and is unable to enjoy the intimacy. This gives a tinge of mechanical sex and often leaves the partner unsatisfied.

What is Post Coital Contraception?

Post-coital contraception is the employment of a contraceptive measure after intercourse, within 48 to 72 hours of an unprotected intercourse. It is more effective when used within 24 hours.

1 Hormonal - This involves taking high doses of an estrogen (Diethyl stilboesterol — 25-50 mg/day for live days or ethinyl estradiol 0.5-5mg/day for five days) and is associated with high incidence of nausea and vomiting.

Alternatively two tablets of a combination pill (Ethinyl Ostradiol 100 micro gm and 0.5 mg levonorgestrel taken initially, followed by two more tablets after precisely twelve hours, can be given. If this type of contraceptive fails there is risk of foetal malformation. 2, IUCD — A simpler method is to introduce an IUCD, ii acceptable, especially a copper containing device.

What are the common misconceptions about ‘The Pill’?

There are women who are under the mistaken, impression that the effect of the pill lingers for many months after they have discontinued it and may lead to sterility. Some again mistakenly believe that for effective contraception a pill should be taken after each coitus while others discontinue taking the pill just because of vague symptoms of mimicking pregnancy.

Are Oral Contraceptive Pills Effective from the first cycle?

Oral contraceptive pills act by interrupting the ovulation (release of the egg), thus creating an anovulatory cycle. It takes at least one ‘pill cycle’ for anovulation to get established. Hence, during the first cycle, one must use an alternative method of contraception.

What should a woman do if she forgets to take a pill?

If the woman forgets to take the pill at the usual time and remembers the lapse on the same day, she should take the scheduled pill on the same day, as soon as she remembers it. If the woman forgets to take ‘the pill’ for one day and remembers so only on the next day, she should take two pills on that day i.e. the ‘forgotten pill’ of the previous day, in addition to the scheduled pill for the day.

If, however there is a lapse in taking pills for two consecutive days then the woman must consider herself ‘unprotected’ and adopt another method of contraception for the rest of the cycle.

What is an Oral Contraceptive Pill Contraindicated?

If the woman has a history of liver disease, abnormal liver function tests, steroid dependent cancer e.g. breast cancer, abnormal uterine/vaginal bleeding or evidence of circulatory disease including hypertension, migraine; oral contraceptive pills are contraindicated. Other contraindications include, diabetes, the first six months in the case of nursing mothers and epilepsy. However, a gynaecologist’s opinion should be sought prior to use.

Detailed information on video from youtube of functions of the female reproductive sex organs and the life-long consequences of hysterectomy, including shortened vagina, loss of physical sexual sensation, personality change, loss of creativity and vitality, bone joint and muscle pain, profound loss of energy and stamina, loss of short-term memory, blunting of emotions, reclusiveness, irritability, heart disease, and osteoporosis.

What are the different contraceptive methods available today?

Today, wide range of contraceptive methods are available and the current approach is to provide a ‘cafeteria choice’ i.e. to offer all the different methods to an individual, from which, any method may be adopted depending on individual suitability and preference.

How should a Condom be used?

Though seemingly simple, a certain protocol needs to be followed when using a condom for contraception

1. A new condom should be used for every act of coitus.
2. Condoms are available in pre-tested, pre-sterilized packs and need not be tested prior to use.
3. It is to be rolled onto the erect penis just prior to insertion. Practice of delaying and putting it on just before ejaculation should be avoided.
4. It should be removed immediately after ejaculation otherwise the penis becomes flaccid and the semen is likely to spill into the vagina.
5. For removal, it is to be held on to the base of the penis, and should be withdrawn along with the penis.
6. It may be used with some spermicidal jelly to maximize its contraceptive effect.

What is Vasectomy?

Vasectomy is a permanent method of contraception by male sterilization. It is performed under local anaesthesia. Two small one cm incisions are made on either side of the scrotum. This gives access to the spermatic cord in which the vas is lound. A small segment (one cm) of the vas is cut ind the snipped ends are tied (closed) off, so that the sperm will be unable to pass through. The incisions are then closed with an absorbable suture. This operation is simpler than the sterilization of a female. Hospitalisation is not necessary and the patient can walk back home. The procedure only affects the fertility and the virility is left intact.

In which conditions, vasectomy should not be encouraged?

Vasectomy should be postponed in cases where

1. A man is equating his masculinity with fathering of the child,
2. There are unresolved doubts and conflicts about the procedure and its outcome,
3. Local conditions where surgery becomes difficult (infection, varicocele, large hydrocele, inguinal hernia, filariasis or scar tissue from surgery).

Vasectomy should be deferred until a specialist is consulted.

Can Vasectomy help Sexual Functioning?

By removing the fear of possible pregnancy and eliminating the need for artificial aids which often impair local sensitivity, vasectomy may lead to an improvement in the sexual performance in some individuals.

How soon after Vasectomy can one resume Sexual Activity without Contraception?

Don’t count days, count the number of ejaculations. At least 10 ejaculations after vasectomy and/or two consecutive semen analysis reports need to be sperm negative. Till then, effective contraceptive methods should be used.

Is Vasectomy reversible?

Yes, but the success of the reversal operation depends upon the skill of the surgeon, the technique used at the time of sterilization, duration after which reanastomosis is performed and the technique used for reanastomosis. However even after a successful reversal operation by the best of micro-surgical techniques, a man’s chances of impregnating the female are fifty-fifty.

How can Vasectomy be made more acceptable?

Ideally, the man and his wife both should be counselled together about the surgical procedure, the operative risk and the outcome. It needs to be emphasized to the couple that the procedure is merely contraceptive and will have no effect on the man’s virility. Ligating the vas will not have any effect on sexual desire, response and performance. The orgasmic capacity, ejaculation and quantity of ejaculate all remain the same. This will remove any misconceptions that the couple may harbour about the procedure. Its advantages over other methods of contraception, such as its permanency, high success rate, only one time motivation required, absence of systemic side effects, non-impairment of local sensitivity, potential reversibility and its relative ease and safety over tubectomy should also be stressed additionally. Thus, vasectomy can be made more acceptable by education.

What is Tubectomy?

Tubectomy is a permanent method of contenception by female sterilization, involving the excision of the tubes to interrupt the passage of ova. Its contraceptive measure does not leave any residual effect on the female’s sexuality.

Is Tubectomy reversible?

Yes, Tubectomy is reversible by microsurgicat techniques, but, this is more difficult than reversal of vasectomy. The success rate depends upon the method of tubectomy and the skill of operating surgeon.

Does Tubectomy affect Estrogen Levels?

No. Ligation of the tubes merely interrupts the passage of the ova thus preventing conception. It leaves the hormonal levels unchanged and has no effect on the female sexual desire.

Is there any change in sexual enjoyment after Tubectomy?

In fact, it may enhance one’s sexuality as it offers contraception without decreasing local sensitivity, it unlike barrier contraceptives.

Does the Female Superior Position prevent pregnancy?

Alas! No!

Are there any complications after Vasectomy?

Yes, occasionally. They may be surgical, immunological or psychological. Surgical complications are the least serious. They consist of bleeding (scrotal haematoma) or infection. This usually occurs a week later.

Immunological complications are extremely rare and no cause and effect relationship is known. Psychological complications occur chiefly because of inadequate counselling prior to the operation.

What preparations should one take after Vasectomy to prevent Surgical Complications?

An athletic supporter or a tight fitting jockey type underwear should be worn for a week t help relieve swelling and to support the scrotum to relieve the discomfort. The small gauze bandages protecting the incisions should be changed every two days.

What happens to the residual sperms?

The residual spermatozoa are phagocytosed (swallowed and destroyed) by the lymphatics of the testicle and epididymis and are rapidly disposed off.

Does the male hormone (Testosterone) level go down after Vasectomy?

No. Vasectomy has no effect on testosterone levels. A study was carried out by my colleagues and myself at the Institute of Research in Reproduction (ICMR), Bombay, on 45 vasectomised males with sexual dysfunctions. The duration of vasectomy was from fourteen days to fourteen years and revealed no significant change in the testosterone levels.

Is sexual desire and potency affected by Vasectomy?

No. The testes have two varieties of cells. One variety secretes testosterone that goes directly into the blood stream and is responsible for sexual desire and potency. The sperms are produced by the other variety of cells and they pass through a tube known as the vas. Thus, tying or ligation of the vas will have no effect on desire or potency. Sex life will remain unchanged. Erections, ejaculations and pleasure at orgasm will be as before.

Do hair on the breast suggest any pathology?

It is not uncommon for a woman to have a few hairs around the areola of the breast that does not need any treatment. However, they may be removed by electrolysis by a qualified person, if one so desires.

Which positions do women prefer?

The best position would depend on the individual’s preference and the woman’s anatomy. However, in personal interrogation with more than 3,000 women, if given a choice as to which position they would prefer, 75% of them preferred the female superior position. This is perhaps because the clitoris is stimulated well and it also adds a feature of novelty.

Is it necessary to stimulate the clitoris during sexual intercourse?

Some women report that they get enough clitoral stimulation during normal sexual intercourse. Some prefer a little pressure on the clitoris with the pelvic bone. Some prefer gentle stimulation along with a little pressure. For some women intercourse is enough to reach climax, while for others additional clitoral stimulation is essential.

Do clitoral adhesions lead to inhibited sexual response?

I have yet to come across a case where clitoral adhesions have inhibited sexual response. Besides they are extremely rare.

What conditions can make women frigid?

Distraction, disturbed interpersonal relationship, anti-hypertensive drugs, tranquilisers sedatives, hypnotics and sometimes oral contraceptives can all lead to decline in sexual desire. Any pain at the time of coitus, whether it is vaginitis, pelvic infection or different uterine position, may lead to frigidity of sudden onset.

What is female circumcision?

It is a barbaric custom of female genital mutilation that varies in the extent of mutilation perpetrated. Its most disfiguring form — the Pharonic circumcision practiced in Sudan and Kenya; involves cutting off of the clitoris, labia majora and labia minora followed by close apposition of the tissue that remains leaving only a tiny hole at the bottom for the passage of urine. This severe local mutilation makes sex, a painful encounter. In its mildest form, it involves excision of the clitoris or the clitoral hood alone. It is performed due to the misconception that unless it is performed a woman will become overtly promiscuous.

Do women ejaculate?

Few women do report squirting of fluid at the time of orgasm, but this is rare. Female ejaculation is an entity that remains to be proven.

After pregnancy, many times couples report that they don’t experience the pleasure that they used to. Can this be helped?

After normal delivery often-vaginal walls become lax and the penovaginal contact reduces. Thus some people do report less pleasure. This can be helped. While doing the episiotomy, the gynecologist should take one more stitch known as husband’s stitch to ensure adequate apposition that helps in increasing the peno-vaginal contact, thus giving more pleasure.

What are the most common causes of lax vagina? How can it be prevented?

This may occur following childbirth. Proper management of labor with perineal support and an adequate and timely episiotomy can best prevent it.

What is the treatment for a lax vagina?

Kegel’s exercises for contracting the perineal muscles by holding the urine and releasing it, 20 such contractions and relaxations three times a day, may help increase the muscle tone. If this does not work, one may go in for vaginal reconstructive surgery.

What are women’s misunderstandings about men’s sexuality that many lead to sexual dysfunctions?

Often when a man is a premature ejaculator, many women may consider him a poor lover or the woman may make an attempt to reach orgasm early also. At times, this leads to a shortening of periods of intimacy. In cases of retarded ejaculation, where there is a delay in reaching orgasm, the woman starts getting a feeling that her partner does not love her or she is not attractive to him any more which may disturb the intimate relationship. Also most women consider it improper to actively participate in intercourse and prefer to remain completely passive or only minimally responsive leaving the onus on the male who is now under pressure to perform. This may create a situational anxiety that may impair his response and performance. Even if the male is able to perform properly in these circumstances, the minimal or deliberately subdued response of his partner due to traditional misconceptions will leave him with the feeling that the encounter has not been mutually satisfying. If this occurs repeatedly, it instills a sense of inadequacy and frustration in him that may affect his performance and his sex drive may decline.

How should a physician deal with a sexual problem?

Alter an adequate history taking the physician should try to determine exactly where the problem lies misconceptions, unrealistic expectations, disturbed interpersonal relationships, hostility towards a partner. The physician should counsel the couple as a unit, clarify and explain the situation to them, and clear misconceptions. He may offer specific therapy if and when the situation demands.

Are alcohol and smoking safe during pregnancy?

No, both alcohol and smoking are unsafe during pregnancy as they lead to intrauterine growth retardation.

Can stretch marks on the breasts and abdomen following pregnancy be removed by any medicines?

No. Once stretch marks have occurred, they may somewhat decrease in size on their own but cannot be removed by any medicines or creams. They also occur during puberty, obesity, and Gushing’s syndrome besides pregnancy.

When can a women resume sexual intercourse after delivery?

One should not indulge in sexual intercourse:

• If the episiotomy scar (the cut made to ease the birth of the baby) has not healed properly.
• If there is bleeding per vaginum. Usually, after three weeks of delivery a woman can comfortably resume sexual activity.

Is episiotomy necessary during normal delivery?

Yes. It may be advised largely because it facilitates delivery of the fetal head, prevents vaginal and perineal tears, prevents excessive vaginal laxity, and prolapse of the uterus, bladder and rectum.

Can a virgin become pregnant?

Yes. If the sperms are deposited near the vulva, they may pass through the small hole of an intact hymen and may travel up through the full length of the vagina and uterus and meet the ovum resulting in a pregnancy.

Is sex safe during pregnancy?

Usually, a healthy woman can safely indulge in sexual activity during pregnancy. However, coitus should be avoided if there is pain and/or bleeding at any stage. If the woman has aborted in the first three months in the past, coitus during the first trimester should be avoided. In the second trimester coitus is contraindicated if the woman has a history of ‘habitual abortion’ because the cervical Os or the mouth of the uterus is ‘incompetent’ to hold the foetus. In the last trimester i.e. from the seventh month to labour, one may safely indulge in sexual activity till the day of delivery by altering the position so as to ensure that the direct weight does not fall on the foetus.

It must be understood that whenever, because of any reason, intercourse is forbidden during pregnancy, the woman must avoid reaching orgasm by any other means including masturbation. The contractions of the uterus following masturbation are far more intense as compared to normal sexual intercourse.

An obstetrician may be consulted regarding the indulgence in sexual activity during pregnancy, as each case needs to be evaluated individually about any possible contraindication or modification to be made.

What is the G-Spot and how can one stimulate it?

The G-spot or the Grafenberg spot is an area of increased sensitivity with maximum potential for arousal. It is located on the anterior vaginal wall about two inches from the introitus. After sliding the fingers in that position and with forward, backward or side-to-side movement, the female will be able to pin point the spot where she appreciates increased sensitivity. With increased stimulation, the G-spot swells like a nodule, and becomes firm. Simultaneously clitoral stimulation can enhance sexual pleasure.

What is the most common female sexual problem?

As per my observation, painful sexual intercourse leading to vaginismus is the most common sexual problem.

What could be the cause of excessive vaginal lubrication during sexual intercourse?

Physiologically, lubrication occurs in the vaginal walls during sexual arousal. This could increase in certain conditions of heightened sexual excitement and vaginal infection/allergy. The best thing is to find the cause and treat it. At times, a small dose of an anti-histaminic may prove useful.

Do women like breast stimulation?

Most women enjoy stimulation of the breasts as they form an important erogenous zone of the female anatomy. But, enjoyment depends upon the way in which they are stimulated. Also there are times when the breasts are tender and an attempt to stimulate them causes pain. This usually occurs premenstrual and during pregnancy and in women using oral contraceptive pills, when the breasts are engorged due, to hormonal influence. Hence, it is best to ask the partner about whether "to do, or not to do".

Is the breast size important?

No. Large breasts are not more sensitive to stimulation than smaller one's.

Are there any medicines or creams to enlarge the breasts?

No.

Can the breast size be increased?

Certain exercises can help develop the Pectoralis Major muscles that would add a little bulk to the chest (but not the breasts themselves) and this may help to apparently increase the breast size. Plastic surgery may also prove beneficial.

Are there any exercises for sagging breasts?

There are no exercises that can help sagging breasts because there are no muscles in the breasts except the smooth muscles in the nipple. Wearing of a proper brassiere can help minimize sagging.

Does disparity in breast size require treatment?

Disparity in the size of the breasts may be due to various reasons - physiological and pathological. Disparity due to any pathological cause must be thoroughly investigated and treated. For physiological disparity, no treatment other than counseling and reassurance is required. For cosmetic reasons, if the difference is minor, padding the brassiere cup of the smaller breast would suffice. If the difference in size or contour is large then an enhancement! Enlargement mammoplasty of the smaller breast or a reduction mammoplasty of the larger one may be carried out after evaluating each case on individual merit.

What is virginity?

The word ‘virgin’ means one who has not had sexual intercourse, which may be verified by an intact hymen. However, a girl whose hymen is intact may have had intercourse; whereas a girl who has never had intercourse may not have an intact hymen. The idea of chastity and virginity needs to be clarified. There are virgin individuals who are not chaste and chaste individuals who are not physiologically virgin.

Is it a fact that girls who menstruate early also tend to begin intercourse early?

No. The timing of coitus depends upon individual sex drive, situational factors and sociocultural background.

Does pre-menstrual tension affect sexuality?

Yes, it does. Women tend to become irritable with associated symptoms such as nausea, backache and breast tenderness. There is a feeling of discomfort in the pelvic region and, at times, there may be emotional disturbances and varying degrees of depression. In some, however, it is found that the sex drive is enhanced, perhaps resulting from increased pelvic congestion, insufficient to cause discomfort but sufficient to cause intense pelvic ‘awareness’.

Do oral contraceptive pills prevent pre-menstrual tension?

Yes, oral contraceptive pills do prevent premenstrual tension in about 50% and painful periods in over 90% of the women.

What s the difference between a transvestive and a transsexual?

A transvestite is an individual who becomes sexually aroused by donning the apparel of the opposite sex, and a transsexual is one who strongly fools that he or she belongs to the opposite sex.

How can one diagnose transsexualism?

Transsexualism is an overriding feeling of discomfort with one’s anatomic sex and a constant desire to be rid of one’s genitals to become a member of the opposite sex. In other words, a male mind in a female’s body and vice versa. The diagnosis is made only if the disturbance has been continuous for at least two years; if there is no evidence of psychological disorder like schizophrenia; and is not associated with physical intersex or genetic abnormality. The differential diagnosis must be made among true transsexuaiism, transvestism and homosexuality. Physician should be aware that Gender transposition might occur in cases of severe personality disorganization associated with psychosis. A behavioral sex change may emerge even later in life in certain rare cases of temporal lobe epilepsy or as a consequence of senile dementia.

Are eunuchs transsexuals?

No. Eunuchs are not necessarily transsexuals. They are castrated males, who have had their testicles removed prior to puberty so that the secondary sexual characters do not develop. As against this, transsexuals are individuals who have an overwhelming desire to be the opposite sex.

What is paraphilia?

“Para” means ‘beyond’, and “philia” means love. This includes Fetishism, Transvestism, Zoophilia, Podophilia, Exhibitionism, Voyeurism, Sexual Masochism, Sexual Sadism, and others. They are more common in males than among females.

Fetishism: the condition in which a person is dependent on a talisman or fetish object, substance, or part of the body in order to obtain erotic arousal and facilitate or achieve orgasm.

Transvestism: behaviorally, the act of dressing in the clothes of the opposite sex; psychically, the condition of feeling compelled to cross-dress, often in relation to sexual arousal and attainment of orgasm.

Zoophilia: the condition of being responsive to, or depending on, sexual activity with an animal in order to obtain erotic arousal and facilitate orgasm; also known as bestiality. Sexual contact (oral or genital) with an animal may occur sporadically in the course of human development without leading to long-term zoophilia.

Pedophilia: the condition in which an adult is responsive or dependent on the imagery or actuality of erotic/sexual activity with a pre-pubertal or early pubertal boy or girl, in order to obtain erotic arousal and facilitate or achieve orgasm. A pedophiliac may be a male or a female. Pedophilic activity may be replayed in fantasy during masturbation or copulation with an older partner.

Exhibitionism: the condition of being responsive to or dependent on the surprise, debasement, shock, or outcry of stranger (usually female) unexpectedly exposed to the sight of the genitals, in order to obtain one’s erotic arousal and facilitate or achieve orgasm. The actual event may be replayed in a masturbation or coital fantasy.

Voyeurism: It is also called as scoptophilia. The desire to observe the genital of others or to watch sexual intercourse becomes the condition of erotic excitement and gratification. A voyeur is also known as a “peeping Tom.” The actual event may be replayed in masturbation or a coital fantasy.

Masochism: the condition of being responsive to or being dependent on receiving punishment and humiliation in order to obtain erotic arousal and facilitate or achieve orgasm. As the partner of a sadist, a person may impersonate a masochist for commercial gain, within the limits set by the pain threshold.

Sadism: the condition of being responsive to or dependent on punishing or humiliating one’s partner in order to obtain erotic arousal and facilitates orgasm. A person, especially a woman, may impersonate a sadist to oblige masochistic partners for commercial gain.

Frottage: rubbing or pressing against some object, usually the buttocks of a fully clothed woman, in public places, becomes the condition for sexual excitement.

Gorontophilia: the condition in which one prefers to obtain sexual gratification from an elderly person.

Necrophilia: in this condition, gratification is obtained by indulging in sexual activity with a corpse.

Is homosexuality common in India?

Surprisingly, homosexuality in India is far more common than thought of. Male homosexuality, female homosexuality and bisexuality are on the increase in India today.

What is lesbianism?

Mutual sexual attraction, and/or indulgence in sexual activity between two women is termed as lesbianism. It is a specific term for female homosexuality

What is bisexuality?

Attraction towards, and/or indulgence in sexual activity with partners of both biological sexes is termed as bisexuality.

What health hazards does bisexuality pose?

Bisexuals are usually more promiscuous and are prone to health hazards due to multiple sexual partners such as STD’s, AIDS, rectal prolapsed with sphincter incontinence. They are also more prone to paraphilias.

What precautions can one take to avoid AIDS through sexual contact?

As mentioned earlier with a potentially infected partners “prevention is the only cure”. However, precautions that one may take to reduce the risk of transmission are:

1. Avoid sex with individuals who are in a ‘high risk’ group such as - male and female prostitutes, homosexuals, bisexuals, people with multiple partners, individuals who have had sexual contact with an AIDS patient, hemophiliacs, patients on renal dialysis, intravenous drug abusers etc.
2. Avoid sex with multiple partners especially with unknown/casual partners.
3. Avoid sexual activities that lead to exchange of body fluids as, this is risky (the virus has been isolated from the saliva, blood, semen, tears and urine of infected individuals). Therefore avoid oral sex, peno-vaginal sex and peno-rectal sex.
4. Use condoms during sex as they reduce the risk of transmission of the virus.

What are safe sexual practices for uninfected individuals?

Uninfected individuals should avoid all sexual practices that involve exchange of body fluids, when indulging in sexual activity with potentially infected partners. They may safely indulge in non- oral and non-coital sexual practices such as fondling, stimulation of erogenous zones, sensate focus exercises, mutual or self-masturbation, penetration alternatives such as intercourse between the thighs, inter mammary intercourse etc. An orgasm is an orgasm, and is equally satisfying by whatever means it is achieved.

What is an alternative orientation?

Any sexual orientation apart from the popular heterosexual (Attraction towards, and/or indulgence in sexual activity with, partners of only the biologically opposite sex.) orientation may be termed as an alternative orientation. It is not necessarily an aberrant or deviant expression of one’s sexuality. No one knows definitely why some people develop such alternate preferences.

What is homosexuality?

Sexual attraction towards, and/or indulgence in sexual activity with partners of the same biological sex as oneself are called as homosexuality.

Do casual homosexual encounters in early years make an individual a life-long homosexual?

No, they do not. In fact, in a study carried out by Alfred Kinsey, 28 per cent of the females and 50 per cent of the males have had homosexual experiences one time or another in their lives.

What is the ideal thing to prevent AIDS (through sexual transmission)?

In a like India, it would be ideal to use barrier contraceptive devices like the condom, which may offer protection against infection as well as conception.

How can parents help their children in avoid AIDS?

Parents should educate their children about AIDS so that when they become sexually active they know exactly what risks they are taking. Just moralizing does not help to persuade people in changing their behavior. It must be emphasized that there is no cure for AIDS; at the same time one should also emphasize that it is not transmitted via casual contacts, like serving meals, giving hair cuts, shaking hands, using public toilets or swimming pools. Early and accurate information is absolutely essential in the prevention of AIDS, as well as, unnecessary panic and anxiety.

Why is anal sex more risky than vaginal sex?

The rectal mucosa is more prone to abrasions and tears as compared to the vaginal mucosa. Thus, a discontinuity of the lining mucosa creates a direct portal of entry into the blood stream. Thus, AIDS virus from an infected partner will be transmitted more easily during anal sex.

What precautions should a homosexual take?

If possible, avoid. If not, then while indulging in oral sex, avoid taking the partner’s semen in your mouth. While having anal sex insist on the partner wearing a condom.

Can one tell by inspecting a potential partner if he/she is infected?

No. One cannot definitely say whether an individual harbors the virus by mere inspection, as the vast majority of individuals who have been infected are Symptom less carriers’ and show no evidence whatsoever, of the infection. They may themselves be unaware that they are infected. The best method of finding out whether an individual is infected is to undergo a blood test.

Does concentration of semen lead to longevity and ethetic excellence?

If this had been based on physiological facts, then all bachelors would have become athletes and lived longer!

Does reduced consistency of semen indicate sexual inadequacy?

No. Consistency of semen may vary as it depends upon several factors like period of abstinence, intensity of stimulation etc. However, as a man grows older, consistency does thin out, but it has nothing to do with the individual’s sexuality.

Do reduced quantity and change in color of semen indicate a waning virility?

No. As mentioned earlier, the quantity of semen often depends upon the intensity of stimulation, period of abstinence and age. As a man grows older, the color of the semen changes from white to light yellow and the quantity may decrease, but the color and quantity have nothing to do with the sexuality of an individual. Neither does it have any relation to partner satisfaction.

What is AIDS?

It is an Acquired Immune Deficiency Syndrome, a viral disease in which the immune system becomes so weak that the individual becomes susceptible to any infection or disease that an otherwise healthy person would be able to resist easily. AIDS victims can be devastated by the common cold or by a simple attack of diarrhea.

Do you need to worry about AIDS?

Yes. AIDS can spread easily through any infected secretion of an AIDS patient. So far no cure has been discovered for this eventually fatal disease that cripples the immune system making the body increasingly prone to infections. Once contracted the prognosis is usually poor, and the motto one must follow is “Prevention is the only Cure.”

Is AIDS contagious?

Yes. The AIDS virus has been transmitted between male homosexuals, heterosexuals, intravenous drug users sharing contaminated needles, from blood transfusions, contaminated blood products, contaminated secretions like saliva, semen, tears, urine of an infected person, as well as vertical transmission from mother to infant. Tattooing, shaving, dental work, acupuncture, electrolysis needle, can also infect one; surgical procedures etc. if sterile aseptic probations are not used.

How should parents react to their child’s masturbation ?

Parents are usually disturbed when they find out that their child indulges in masturbation. They should understand that this is a normal stage of psychosexual development and a normal expression of childhood sexuality for males and females. It is neither indicative of psychopathology nor of potentially preferential homosexuality in adulthood. They should be very careful not to arouse any fear in the child by scolding or punishing him or making a big issue out of it. In particular the child should not be told any anxiety provoking statements such as, masturbation will damage his sex life or make him insane or lead to genital dysfunction or deformity. Parents should realize that as the child develops it will continue to have strong sexual urges, he/she will be more expressive about his/her sexuality, and will need to find some manner of release. Parents should realize that any anxiety provoking statements at this crucial incipient developmental stage will be detrimental to the child’s psyche. They should provide their constructive support if and when the child solicits it, doing no more; otherwise antagonism and failure are likely. The wisdom of this should be apparent to anyone who reflects upon his personal childhood memories.

Does masturbation lead to curvature of the penis?

No. Just as intercourse does not lead to any curvature of the penis, so also masturbation does not lead to any curvature.

Is semen vital? Does dissipation of semen devitalize a man and promote aging?

Semen is being secreted day in and day out by the genital apparatus. Sperms constitute less than one. percent of seminal fluid, the rest of the fluid is the secretion of the accessory sexual glands, prostate & seminal vesicles. It is being formed for being excreted and cannot be stored even if one wants to do so. Barring conception, semen is not vital. That one drop of semen is equal to hundred drops of blood, which in turn requires a lot of nourishing food, is one of the most rampant sexual myths prevalent.

What s the normal length of the erect penis?

Concern about penile size is as old as the human race. The width, length and erection of the penis vary from male to male, as does the length of the nose, the depth and spacing of the eyes and the width of the forehead. The average sexual length of the vagina is about 15 cm. and only the outer third (5 cm.) has the maximum nerve endings. The inner two-thirds (10 cm.) being virtually insensitive.

If one wants to arouse his partner, he should concentrate on the area where there are maximum nerve endings i.e. the outer lips (Labia Majora) and the outer third i.e. outer 5 cm. of the vagina. Therefore, for female sexual gratification, the size of the erect penis could be anything from 5 cm. plus. However, the size of the penis may be an important factor for women who harbor the myth “a man with a large penis can satisfy his partner better than one with a smaller one”. Penile size is unimportant for partner satisfaction. “An archer is known by his aim and not by his arrows”.

Is he length of the penis in the flaccid state important?

The length in the flaccid state is immaterial, as it is used for urination only. It is the erect penis that is used for performing the sex act and not the flaccid one.

Is the width of the penis important?

No. The vagina is highly elastic. It can expand from the size of the little finger to that of the baby’s head. The vagina distends according to the width and size of the inserted penis.

Can a small penis lead to conceptive inadequacy?

No.

Why do men fee weak after sleep emissions?

Post-emission weakness is totally psychological. Right from childhood the idea has been drilled into our minds that the genitals are special and anything coming out of it is equally special. This misconception about the value of semen generates tremendous anxiety in an individual leading to neurasthenic symptoms. In fact, the calories lost during sleep emission are equivalent to those contained in a glass of lime juice!

What is celibacy?

Celibacy is a state of sexual abstinence.

Is sexual abstinence disadvantageous?

Prolonged sexual abstinence may be detrimental to mental and physical health. There are people who are under the impression that sexual abstinence is conducive to human health and happiness. Because of this misguided belief, they make an attempt to conserve the so-called ‘energy’ by sexual abstinence. The moment they are unable to do this, they get a feeling of guilt and anxiety that they have done something detrimental to their health. When this is repeated several times, the roots of the problem get deeper and deeper. Consistent suppression of the sex drive leads to emotional instability and evokes an abundance of sexual imagery. This usually leads to inability to concentrate, insomnia, irritability and extreme nervousness. The extent of disturbance depends upon the individual’s own mental state and the environment. At times, the consistent suppression and continued inactivity of the sex organs lead to diminished ability to function. Besides, it would be a serious mistake to harbor any misconceptions about celibacy as, ‘celibacy is not hereditary’.

Is there any relation between the sizes of the body end the size of the sex organs?

No.

Is masturbation harmful ?

Is coitus harmful ? Then how can masturbation be harmful, because essentially masturbation mimics coitus. What the penis does in the vagina during intercourse is the same as what the penis in the hand or the finger does in the vagina during masturbation. It is a myth that masturbation causes acne, insanity, impotence, dark circles around the eyes etc. In fact, it trains the individual’s neurological system to respond. It also provides a pleasurable safety valve or outlet for the release of sexual tension, thus reducing the incidence of sexual crimes, unwanted pregnancies and sexually transmitted diseases including AIDS.

Is excessive masturbation harmful ?

Firstly, there is no such thing as excessive masturbation. Besides, just as excess of coitus cannot lead to weakness so also an excess of masturbation cannot lead to weakness. The individual mechanics of masturbation and coitus are the same. In masturbation they occur singly and in coitus they occur conjugally. Further, physiologically, it is disuse which is abuse as it is dis-use and not use which leads to atrophy. Does the tongue become weak in a talkative person and strong if one observes silence ?

I have come across a person who used to masturbate three times a day, regularly for 12 years. When he was examined later, his general condition was good, his blood examination (metabolic profile), and hormonal assays did not reveal any abnormality. His semen analysis was normal, there were no signs suggestive of any disturbance in the genital function and his performance was good.

Is there any treatment for masturbation ?

Masturbation per se is not an illness and hence does not require any treatment whatsoever. It requires treatment, if and only if, it becomes obsessive or compulsive and the individual perceives it to be a problem, and not otherwise. In this case the basic problem is psychological and it is the underlying disorder which merits therapy and not masturbation.

Is it a fact that women must bleed at the first attempt at sexual intercourse?

No. This usually occurs due to the rupture of the hymen in virgins. However, the hymen may be absent from birth or might rupture while playing games, doing exercises or using tampons. Hence, a woman need not necessarily bleed at the first attempt at sexual intercourse to prove her virginity. I have seen plenty of marriages going on the rocks because of this misconception.

Do man have a greater sex drive or women?

Sexual urge depends on the individual’s sexuality and a greater sex drive is not the prerogative of either sex!

For conception and ideal sexual, is simultaneous climax necessary?

No. Simultaneous climax in no way ensures conception. In fact the idea of conception often decreases the intensity of pleasure. As for pleasure, it is the pleasure itself that is important. Whether one got it before, with or after the partner is immaterial.

What is the most dangerous sexual myth?

“A sexologist is always a highly qualified professional”.

What are the most common sexual myth you come across?

Sexual myths and misconceptions leading to anxiety are the most common sexual problem. Commonest myths are those related to masturbation or dissipation of semen. Other prevalent myths are about celibacy, virginity, passing ‘dhat’ or ‘veerya’ in the urine, aphrodisiacs etc. These myths are being handed down from one generation to the next and, as a result, many people imagine more problems than they actually have.

What is masturbation?

Masturbation is a deliberate stimulation of the genitals for pleasure, which may or may not be pursued to the point of orgasm.

How do men masturbate?

For men, the commonest method is to fold the palm and fingers over the penis, so as to encircle it and produce friction by to and fro movements, often till orgasm and ejaculation are reached. Variations such as making coital movements against bed clothes, a pillow, pressing against some obje0cts etc. are also reported.

Do women masturbate? How?

Yes, women do indulge in masturbation. The usual method is by rubbing a finger on the clitoris. The female anatomy permits considerable variations such as thigh rubbing, rubbing clothing between the thighs and making vulval movements, instrumental masturbation by inserting an object into the vagina, striking the clitoris with a water jet etc.

Is it advantageous to use the vacuum apparatus or enlarging the penis?

No. The use of a vacuum apparatus may prove dangerous and may even lead to fibrous degeneration of the penis.

Is the penis usually inclined towards the left?

Yes, it is true for the majority of men. This is so perhaps because the left testis is lower than the right. Therefore, while wearing there under garments most men adjust their penis on the left side, as enough space exists on the left side as compared to the right.

Does a slight curvature of the penis lead to any difficulty in penetration?

No. A slight curvature of the penis either to the left or to the right, is common and does not affect penetration at all. It is a myth that an erect penis should always be at a right angle.

What is ‘Dhat Syndrome’?

Sometime one passes whitish fluid in the urine or while straining at stools. The belief that this fluid is semen is called as the ‘Dhat syndrome’. This is not a disease and it would not be inappropriate to say, “It exists only in the mind of the beholder.”

The physiological sphincter at the neck of the urinary bladder always remains closed and opens only when one is passing urine. Thus, it ensures that normally, urine and semen can never mix together i.e. normally; one cannot pass semen in urine. Sometimes, a physiological alteration in the urinary solutes may change the appearance of urine, making it whitish, which is mistaken to be semen by misinformed individuals.

In reality, it is a secretion of the prostate and the urethral glands. When a person squats in the toilet and exerts a little pressure, this pressure is relayed from the rectum to the prostate and the urethra, and a few drops of a sticky white secretion accumulate, coalesce and trickle down. The phenomenon is akin to there being 10 drops of perspiration on the forehead being joined by an eleventh and tricking down. In my opinion, this misconception is prevalent in our country because of squatting toilet habits, as people tend to look down and see the sticky substance, which they presume to be semen. In developed countries, most people use western style commodes, so they look straight ahead. Hence, ‘what the eye does not see, the mind does not know!’

Can Television or Media he helpful in promoting sex education?

Television can be a very effective medium for a multitude of reasons (As it is basically an audiovisual medium it can reach out to the illiterate as well as the literate masses). ‘Sex’ is considered a taboo in our orthodox society. If sex education were to be given via a public mass medium such as television, ii would reflect the government’s healthy attitude towards the issue and can decrease the social taboos significantly. Because of its tremendous reach, it will increase public awareness and pave the way towards ‘ii honest social environment and sexual literacy.

It is a medium through which education may be passively imparted to the masses, in the privacy of their homes. Thus, shy individuals who are unable to ask questions or seek help are also provided with the information they desire. Proper information about contraception and sexually transmitted diseases can help in spreading information about Family Planning and also decrease the incidence of STD’s. The potential for television, as an effective medium for sex education, is unlimited.

What should one tell children about sexual abuse?

One should approach the subject directly and objectively giving appropriate and honest information without communicating unnecessary anxiety. This will make the child aware of sexual abuse and enable him to recognize sexual abuse and potential sexual abusers, when he encounters them. School children may be warned not to accept favors from strangers.

In adolescent years, a more frank discussion can take place. A trusting parent-child relationship encourages children to report unusual incidents with other persons, to their parents. In fact, public recognition in the area of child molestation is absolutely essential. Specific incidents, which have already occurred, should be reported and discussed in newspapers and on television. This will help in proper handling of sexual molesters.

Can the incidence of sex crimes be reduced by sex education?

Yes. Occasionally when sexual desire becomes intense, and a partner is not available, the only release left is masturbation. Rampant myths about masturbation (that it leads to impotence, homosexuality, tuberculosis etc.) often discourage individuals from indulging in it. In such circumstances, the intensity of sexual desire outweighs moral bindings and one may resort to sexual activity by force i.e. rape. This leads to an increase in sexual crimes. Rapes are also committed due to a common prevalent myth; that a man would be cured of venereal diseases if he has sexual intercourse with a virgin. Sex education, by eradicating these misconceptions, can orient an individual to direct his sexual impulses in a socially acceptable manner.

Is it harmful if the parent’s answers are a little more than what a child can understand?

Parents worry a great deal as to whether this knowledge will harm the child. Though we live in a conservative society, scientific knowledge appropriate to the age of the child will not harm the child while ignorance may.

It is better to give the child the basic information asked for in a simple, factual and loving manner. Even if the parent occasionally replies a little more than what the child can understand, there is no harm because this will help in leaving the door open for further questions.

Does giving sex education stimulate urges and sexual desires leading to increase in unwanted pregnancies and venereal diseases?

No. Sex education does not stimulate urges and sexual desire. In fact it satisfies one’s curiosity with appropriate and correct information enabling one to recognize one’s sexuality and sexual orientation. As mentioned by Milton I. Levine at Cornell University Medical College in New York “There is no evidence whatsoever that sex education is harmful, that it excites curiosity or stimulates sex urges and desires. On the contrary, there is ample evidence that it does help in gaining a wholesome attitude towards sex and understanding of the normal sex attitudes, roles and relationships”. He further states that “ it may aid our boys and girls to learn to direct their sex impulses with more knowledge and intelligence, to make a correct choice between operating codes of heterosexuality and homosexuality and to recognize and understand those men and women with sex desires and urges which are deviant”. In fact, it has been observed that in countries where proper sex education is given, the number of cases of unwanted pregnancies and venereal diseases have reduced considerably.

What is most important for parents to remember while giving sex education?

It is important to encourage the child’s question as a constructive curiosity and answer truthfully at a level appropriate to his age. It may happen that when a child asks a question, the parents might not know the answer or, because of their own values, they are unable to reply. At such moments, one may admit “That’s a very good question but even I do not know the answer... well, let’s find out.” Such parents have a better chance of bringing up their children to respect them than those who are not responsive to their children’s sexual needs and curiosity; in other words, those who are not approachable. There are some children who never seem to ask questions. It would be an error to assume that since no questions are asked, no answers need to be given.

“Where did I come from?” What is the answer to thin question?

When a child asks this question ‘Where did I come from?’ one can begin by saying “You came from a place, inside mummy’s body.” If the child can trust you not to be too rigid or hostile in your response to his questions, he will look upon you as a source of wisdom and guidance. Additional information relevant to the question asked may be given as he/she grows and is ready for knowledge suited to that period of development.

What is the right time to start sex education?

There is no right or wrong time to start sex education. It can be started any time after the mind is receptive to conceptual inputs. Even, as the child develops education appropriate to his age may be imparted. Without conscious volition parents are providing sex education to the child from the moment he/she is born. The way the parents hold and touch the child during infancy and the way they both interact with the child and with each other lays the foundation for his future sexual learning. Making the child feels loved and lovable has a profound influence in shaping future attitudes towards sex and sexuality. The way in which the parents relate to each other, their interactions and the day to day life in the family will influence the individual’s sense of self-esteem, body image, gender role, family roles as well as the capacity for love, intimacy and sharing.

How should one go about giving sex education?

All children are normally curious about everything including sex. If a youngster does not ask sex-related questions, it is because he/she is given to feel that his/her parents would be uncomfortable in the face of these questions and either would not answer or would not tell the truth. If the parents are comfortable about sex, it should be relatively easy to find an appropriate opportunity to let the youngster know [hat this is not a forbidden area. For instance, if someone is pregnant; if a female dog has pups; if there is evidence of night emission (wet dreams) the parents could assure the child that its curiosity about these is quite normal. Sometimes a newspaper with an illustrated article on how babies are made or a birth control advertisement could become a potential source for discussion. Parents should strive to achieve a good rapport with their children and promote a healthy and comfortable parent-child relationship, thus becoming “Approachable Parents.”

What is Sex Education?

Sex education ideally involves education about the anatomy and physiology of the human reproductive system, conception, contraception, psycho-sexuality, sexual differences and the constituents of love as they relate to sexual behavior, and is not merely a discussion on how babies are made. It provides a background in which an individual develops into a healthy, responsible adult capable of using the innate sex instinct to the fullest potential, without being obsessed by it. It enables one to recognize and be comfortable with one’s sexuality.

Why is formal Sex Education necessary today?

Recently, due to the principally career oriented approach for economic independence the average age of marriage is delayed. Also with improvement in nutrition and health care, the average age of onset of puberty is earlier and the average life span is extended. Thus, the average potential sexual career of an individual is extended.

The social environment today, though orthodox and prudish, provides constant sexual stimulation. This conflict between sexual drives and social norms generates a tremendous amount of anxiety and sexual frustration, which may find expression as, increased promiscuity, casual sexual relationships, unwanted teenage pregnancies and an alarming increase in the incidence of sex crimes and sexually transmitted diseases. Rampant myths and misconceptions about sex further complicate the situation. This social problem can only be resolved through comprehensive sex education, which can increase social awareness and improve the social environment. Sex education should be formally incorporated into health education programs.