Sexuality is an important aspect of one’s life through youth to one’s death. Sexuality can be described as how a person experiences and expresses oneself as a sexual being. Two important concepts when talking about sexual health are gender identity and sexual orientation. Gender identity refers to one’s own perception of being a male or a female despite his/her biologically determined (based on genes) sex; usually biological male identifies himself as a man and vice versa.   

 

However some individuals might be uncomfortable in identifying with their biological sex, which can cause them extreme distress. Though the reasons for the latter discrepancy is not very well described, ‘feeling uncomfortable’ in a situation with regard to a biologically assigned sex is beyond the control of the individual. They often feel that they are in the ‘wrong body’. These people may suffer from a condition known as ‘gender dysphoria’.   

 

Sexual orientation describes one’s preference of sexual attraction. If it is towards the opposite sex, then they are referred to as heterosexuals and if it is towards the same sex, they are referred to as homosexuals. It is important to understand that homosexual practices are also normal and healthy sexual behaviours, and they should not be discriminated against. The brain of a homosexual is ‘wired’ to be aroused by the same sex partner in the same way that a brain of a heterosexual is ‘wired’ to be aroused by an opposite sex partner. Neither can change it on his will/ mind power! Therefore, one should not enter a marriage just to please the elders, if he or she is homosexually oriented. This will cause unnecessary trouble for both partners.   

Due to the immense development of human brain during evolution, and social changes, which took place in parallel, human sexuality is different to that of animals’ in many ways. Sexual feelings and acts are subjected to intense control of our brains, and if the circumstances are not appropriate, these feelings are suppressed. This is one such difference from animal sexual behaviour.   

 

On reaching adolescence, one starts to experience sexual feelings, which depend on increasing levels of sexual hormones in the blood. It is normal to have these feelings, and it is not something to feel guilty about or be embarrassed.   

 

Having sex is an act which gives humans great pleasure. As far as the development of the brain is concerned, it is developing until the age of 23-24 and the last parts to develop are those which are responsible to delay impulsive acts. In other words the brain during one’s late teens and early twenties is like a vehicle without breaks! Therefore, before giving into urges (having urges is completely normal) one should think whether he/she is ready for the consequences of having sex; pregnancy, acquiring sexually transmitted diseases. Using a condom in a proper way, will help avoid both. 

 

 

 

No one can force one to have sex saying things like ‘the relationship will be over if it does not happen’. Similarly, photographing or filming the partner when naked or the act of having sex should never be done. This is because one can use these explicit material to blackmail the other. No one should be allowed to touch one’s body without his/ her consent.   

 

 

1. ‘ Masturbation weakens one’s body’   

Masturbation is a natural sexual behaviour which is practised by both men and women. If someone engages in masturbation it is an indication of his/ her mental and sexual well-being, but not engaging in masturbation itself is not indicative of an illness.   

 

2. ‘The first sexual encounter is painful for a woman’   

This is a widely prevalent myth about sex which makes young women apprehensive of the first sexual encounter. The first sexual encounter is not painful and if a woman is extremely frightened of having sex, she may be having a condition called vaginism, which is a treatable mental illness.   

 

3. ‘A woman bleeds during the first sexual intercourse’   

The above myth was widely prevalent in Sri Lanka a few decades ago, and many youth do not believe this now. But there is a minority who still look for blood stains after having sex with their partner. If and when bleeding happens, it is due to breaking of the hymen, which is a tiny membrane in the vagina. In some women this can be absent or it may have torn during sports or it may not break during intercourse. People who believe in this myth-that if she does not bleed during the first intercourse -consider the woman ‘as having bad character’ and insult her, often for rest of her life. If this is analysed further, the question which invariably should be asked is ‘if there is anything called ‘good character defined by whether someone had sex before marriage or not’, isn’t the same notion applicable for men as well?’   

 

 

Having sex is not only for child bearing. This is another difference with regard to sexuality of humans when compared with animals. According to Oxford Textbook of Psychiatry ‘human sexuality is more about fertilizing relationships than eggs!’. Deriving sexual pleasure has become the major need of sexual intercourse/ sexual act. In the modern social context it is advisable that the woman should not get pregnant just after getting married. It is always healthier to have some time to get used to new challenges of married life before thinking of pregnancy.   

 

Over the past few decades there has been a huge transformation in social circumstances and technology. These changes have affected feelings and thoughts of the modern men and women equally. Sexuality of humans is greatly affected by such changes. The impact can be both positive and negative depending on how the couple adjust to these changes. Five senses play a major role in human sexual behaviour. The stimuli one receives through eyes, nose, ears, skin (touch) and tongue can either arouse or suppress one’s sexual desire. Similarly, previous sexual experiences, beliefs and myths about sex can affect one’s sexual arousal positively or negatively. 

 

 

 

 

At the beginning of a relationship it is common to face many challenges. It is essential to talk openly about one’s sexual needs and desires/preferences with the sexual partner and explore what gives more pleasure to each other. It is equally important to respect the partner’s likes and dislikes and build up mutual understanding. These measures greatly improve the quality of sex life and keep boredom away, especially in long term relationships. It has been proven that couples who have good sexual relationships, also have satisfactory overall relationships. Like every other aspect of life, the quality of sex life will also improve with experience.   

 

The quality of one’s sex life greatly affect one’s general well-being as well. Sexual intercourse is one of nature’s way of giving ecstatic pleasure. Oxytocin, hormone widely known as ‘love hormone’ is released in excessive amounts during sex and contribute towards pleasure experienced and also towards emotional bonding and trust between the couple. Furthermore, during sex the part of the nervous system which helps humans to relax, the parasympathetic nervous system, are fully activated. This aids good cardiovascular health.   

 

Women need more time to reach reasonable sexual stimulation. Therefore, it is important that the couple engage in foreplay for an adequate time before intercourse. Attempting to penetrate before the woman is ready can be a painful experience to her as there would be no adequate lubrication in the vagina.   

 

Though, it is talked more about internal and external genitalia (ovaries and vulva in women and testicles and penis in men), when it comes to sex, it is not inaccurate to say that the brain is the main sexual organ in humans. Therefore, it is very important to have a ‘clear mind’ to experience maximum sexual pleasure. Having sex while trying ‘natural means’ of contraception or having sex fearing that others would know are very common, but easily rectifiable anxieties which can distant pleasure obtained from sex.   

 

Poor overall relationship between the couple, mental health problems and mental illnesses greatly affect the sexual well-being. The lack of rest reduces the desire for sex. Abuse of substances like alcohol, cigarettes and cannabis also reduces sexual desire and it can lead to sexual impotence as well. In addition, poorly controlled physical illnesses like diabetes can lead to problems in one’s sex life.   

 

It is imperative that one should meet a psychiatrist, rather than obtain information from the uninformed or the internet, or believing in myths, when encountered with a problem in sex life.   

 

(Our source person Dr. Dewasmika Ariyasinghe (MBBS,MD-Psych) is a Senior Lecturer at the Department of Psychiatry, Faculty Of Medicine and graduated from the University of Peradeniya. She is a Honourary Consultant Psychiatrist at the Teaching Hospital in Peradeniya)