Sexual Health Information

1. Premature ejaculation

  • How long should I last to not qualify for premature ejaculation?

Premature ejaculation is defined when the ejaculation within 10 seconds to 1 minute of penetration. The range for it is if you ejaculate between 30 secs- 1 min, then it is mild. If you ejaculate between 15 and 30 seconds, it is moderate. Ejaculation before 15 seconds or before penetration is severe premature ejaculation.

  • What is the normal time for erections to last?

There is a big cultural difference in this case. Anything lasting more than a minute can safely be considered normal.What causes premature ejaculation?

Sometimes, it could be because of societal expectations or unrealistic expectations from porn. These place unrealistic demands on the man and due to this pressure, he may ejaculate faster. Sometimes, there are actual medical causes for this. This is identified by nocturnal testing.

  • How do I treat premature ejaculation?

If there are medical causes of your premature ejaculation, these symptoms will be present right from the time a person becomes sexually active. This will require a doctor’s consult and medication. However, if you are facing this only recently, it could have a psychological cause like performance pressure or some anxiety. It would be better to get fully assessed by talking to a sexologist or psychologist. Some tips and techniques can be applied to work on the anxiety.

  • Can my partner help in any way?

There are some techniques like the stop and start technique and the squeeze technique which your partner can do to help you delay the ejaculation. They can also help with the performance pressure by involving more in the foreplay and qualitative aspects of sex.

2. Masturbation

  • Is masturbation harmful?

Masturbation is a safe sexual practice which one can do with oneself, it is not harmful. However, some people tend to use sex toys and other objects for masturbation. If they are not familiar with the use of these objects, they can hurt themselves.So, make sure that you are not making use of any objects that you do not understand. The most common masturbation method for men is stroking the penis and for women, it is touching the clitoris and the area around it.

  • Will it drain my energy?

Masturbation involves the use of some of your muscles and often results in ejaculation. This can be tiring for the time being but you will recover your energy soon. However, excessive masturbation can make you feel routinely tired.

  • Will it affect my sexual performance later?

Normal amounts of masturbation do not affect your sexual performance. However, excessive masturbation can lead you to feel swollen and tired and so you may not feel like indulging in sex with your partner. Also, masturbation tends to be faster and stimulating as compared to sexual contact with your partner. Therefore, if someone masturbates too much, then they may not orgasm during sex or not find it as interesting.Therefore, finding a balance between sex and masturbation is important.

  • How often can I masturbate?

There’s no set number as such. Teenagers and young men often masturbate once or more a day. What is important to remember is that you masturbate only when you naturally feel the desire and do not force yourself by watching porn repeatedly. Also, if you feel tired during the whole day due to excessive masturbation then that may require reduction. So, the key is to see if it doesn’t tire you out and that it is happening naturally.

  • When is masturbation unhealthy?

As pointed out in the answer above, if you are forcing yourself or doing it so much that you feel tired all the time, then it is unhealthy. If you feel that you masturbate only because you are sad, lonely, or bored, even that could be a problem. Masturbation should not become a regular form of escape from unhelpful feelings.

  • Should I masturbate to porn?

Using porn once in awhile is not problematic. However, there should not be such over-dependence on porn that sexual pleasure or satisfaction becomes impossible without it. Porn may also be harmful because of the unrealistic expectations it sets regarding how we should look and feel during sex and how long orgasms should last. Some porn also tends to be inappropriate and violent and can affect your mental health badly.

  • If I masturbate too much, how do I reduce it?

There are many ways to reduce masturbation. The first step is to make a record of how often you do it, and then setting weekly reduction targets. Then, you can find activities to replace the urge when you feel like masturbating. Activities like strenuous exercise, meeting people, going for a walk etc – can provide the necessary stimulation and also keep your mind away from sexual thoughts. Sometimes, repetitive masturbation can be compulsive because of some past trauma or incident. In such a case, you would need to work through your issues with the help of a therapist/psychologist.

  • Is it okay to masturbate even if I’m a relationship?

This depends on whether you just use masturbation as a healthy way to have sexual pleasure on your own, or whether it reflects some disturbance in your sexual life. Just like we want some me-time despite being in a relationship, similarly, enjoying yourself every now and then is alright. But if you escape into masturbation because your sexual life with your partner is not going well enough, then it could be a problem.

  • Should I tell my relationship partner about my masturbation?

This is a decision you need to take based on your partner’s understanding of sex and masturbation. Do you think they will understand that they will not be replaced by masturbation?

Or do you think they are likely to take it personally? Moreover, what is your motive in telling them? Is it just honesty? Or is it more of an indirect way of saying that you are not enjoying the sex life as it currently is? Clearly, there is no right answer to this and depends completely on your relationship with your partner and the reasons for wanting to tell him/her.

  • What is mutual masturbation?

Mutual masturbation is a practice where two or more people masturbate together in each other’s presence. They may also make use of pornography. This is different from regular sexual contact as the participants do not please or touch each other but only themselves. Couples tend to use this practice in order to make things different or exciting.

3. Delayed Ejaculation

  • What is the normal time window for an ejaculation?

Ejaculation before 1 min after penetration is qualified as premature ejaculation. Anything more than one min can be normal ejaculation. However, if it exceeds more than 25 – 30 mins, it is delayed ejaculation. It should be happening 75 % to 100 % of the times and for more than 6 months.

  • What causes delayed ejaculation?

There could be many reasons for delayed ejaculation. Sometimes, it is caused due to side effects of other medication. At other times, it could be due to sexual trauma, anxiety, drug use or surgery. Sometimes, the fear of making the partner pregnant can also contribute to this.

  • What can I do to reduce delayed ejaculation?

The doctor you go to will typically try to establish if the cause is medical or psychological. If you are able to ejaculate with protected sex, then it is mostly likely the fear of pregnancy that is causing delayed ejaculation. Also, if you indulge in excessive masturbation, then sexual contact with your partner may not match up to the speed and friction levels. In this case, reduction of masturbation and different ways of masturbation are advised. Other treatments include different types of foreplay in order to increase arousal and use of devices like PVS (penile vibratory stimulator).

  • What can my partner do to help?

Your partner can help by easing your anxiety related to performance or pregnancy. They can also help by dressing up in enticing ways or using different stimulating techniques. Using different kinds of foreplay can also help.

4. Lack of interest (male/female)

  • I do not feel like having sex with my partner, but with other people

This could be indicative of a sexual and emotional distance from your partner. If the relationship is not going too well or there are too many fights or misunderstandings, it can also lead to a lack of interest in sexual life. It could also be that sexual life has become boring due to the lack of excitement or experimentation. To handle this, you will need to have a chat with your partner about your feelings, and see what you can both do as a couple for this. You can take the help for a couples’ counselor or a sex therapist for the same.

  • I have never felt like having sex

There are some people who are asexual, that is, they do not feel like indulging in sexual acts with themselves or with other people. There is nothing abnormal about this, this is just a preference. If you feel this way, then you might want to talk to a therapist about your feelings. Because most people do not feel like you do, getting accepted by them may be a hard task for you. You can disclose your feelings to trusted friends and therapists and plan your steps forward.

  • I don’t feel like having sex after a particular event (e.g., death of someone, partner cheated, some incident at office or in the family)

Often, stress can lead to lack of sexual interest. The reason for this is that our hormones might be in overdrive due to stress and we may be feeling exhausted. At that time, it is difficult to find interest in sex. However, if this persists for a long period of time, it could be an acute stress reaction and you may need the help of a psychologist or psychiatrist to resolve this.

5. Orgasm related

  • I don’t particularly orgasm all the time, Is this normal?

Yes, not having an orgasm does not have to be a problem. There are many people who do not orgasm during sex but can still have sexual pleasure. There is more to sex than orgasms. However, if you find yourself worrying over orgasms, you can talk to a sex therapist or a counselor.

  • What is normal orgasm for males/females?

For men, orgasm means the ejaculation of sperm from the penis due to muscle contractions. This is achieved by stroking the penis or by various sexual positions with a partner. For females, things work slightly differently. The orgasmic organ for women is the clitoris, not the vagina. Muscle tension builds up in the female body, due to arousal and foreplay and when the clitoris is stimulated enough, the muscle tension is released in the form of contractions. For about 25% of the women, the orgasm can happen through penetrative sex alone, but for the rest, some sort of clitoral and other stimulation is required along with it.

6. Dissatisfaction with amount of semen

  • I feel like I have less semen than necessary. Is this possible?

The normal amount of semen is between 2 ml to 3.7 ml. Most of the times, you can get checked for this by giving a semen sample for testing. Sperm counts less than 15 million per release could be a cause of concern. You can contact your local pathology labs for more information.

  • What should I do if have tests which indicate I have less semen count?

Based on the cause of this, the treatment can be sought. There are some lifestyle factors like smoking, drinking, job type and sexual habits which can affect sperm count. Some medications or hormonal imbalance may also cause low sperm count. To counter this, you can see a doctor and find out the cause. Medications, sex therapy, and surgery are some of the common treatments.

7. Dhat syndrome

I feel like I am losing semen in my urine. Is that possible?

No, this is a cultural syndrome experienced in some parts of India. The person feels that they are using semen during urination, but there is no well-found evidence of this. However, this syndrome is often associated with guilt about sexual acts as well as anxiety or depression. You can get help from a psychologist or sexologist regarding this.

8. Pain (male/female)

  • I experience pain during sex, what should I do?

Males: There are many causes of pain during sex for men. It could be due to infection, tight foreskin, allergies, STDs like herpes or erectile dysfunction. To get further assessment of what exactly is the cause, you would have to see a urologist. Some common factors which help are lifestyle changes like weight loss, exercise, reduction of smoking and drinking and relaxation therapy. Female: There could be many factors responsible for this. Muscle spasms out of fear called vaginismus, can lead to pain. Other conditions related to fertilization of the egg, pregnancy, menopause, endometrial lining etc could all contribute to pain. To get help, it would be best to find out what exactly is causing pain for you. Then, you could get the relevant treatment.

  • I experience pain after sex. What can I do?

Pain after sex for women could indicate vaginismus, structural abnormality or some other medical concerns for women. Sometimes, it is also due to trauma or lack of lubrication. You would need to get assessed further in order to know what to do for each specific cause. For men, the cause of pain could be prostate gland problems, physical abnormalities of the penis like tight foreskin, infections or inflammatory bladder conditions or even anxiety and depression. Previous sexual assault, fear of intimacy or fear of impregnation could also contribute. You would need to get checked in order to deal with it further.

9. Fetish

  • I am not able to experience sexual pleasure in the absence of certain objects or articles of clothing. Is this normal?

The answer to this depends on whether your fetish or liking for the object makes it difficult for you to have a meaningful sexual relationship with a partner. Are you so distracted by it that you feel like spending time with that object even when you are supposed to be working or socializing? Then it could be a problem. You can talk to a psychologist about it. However, if the fetish does not interfere and your partner does not mind and neither do you get distressed, then it is alright.  

  • My partner has a fetish or obsession during sex that I am not comfortable with. What should I do?

You can try telling them that you won’t be able to participate. Many times, people with fetishes are still able to have a healthy sexual life without the object of fetish. You can try asking them to get help if it is making them compulsive and distracted. If however, nothing works, you may consider ending the relationship if the distress is too high.

10. Sexual problems as side effects of medication

  • What medications can cause lack of interest in sex?

SSRIs (selective serotonin reuptake inhibitors) and tricyclic antidepressants, both medications given to treat depression and anxiety, may often cause lack of interest in sex. Birth control pills, prostate enlarging drug Proscar and baldness medication Propecia have also found to have an effect. Further, anti-seizure medications, benzodiazepines (taken for anxiety), opioids (taken for pain relief), beta blockers (medication is taken for hypertension) and medical marijuana can also lead to low libido. (http://articles.mercola.com/sites/articles/archive/2014/04/09/low-libido.aspx)

  • What meds cause lack of arousal during sex?

Similar to the question above, antidepressants, anti-hypertension drugs and drugs are given for hormone regulation, may cause lack of arousal during sex.

  • What meds can cause pain during sex?

Some types of drugs used to treat allergies can lead to pain during sex. Also, a drug called tamoxifen which is used in breast cancer treatment can have this side effect. Talk to your doctor about this and ask for a change of medication if possible.

  • What meds can cause delayed and premature ejaculation?

Research so far suggests that too high an intake of alcohol, or illegal use of cocaine and amphetamines can lead to premature ejaculation. Some antidepressants, antihistamines (allergy medication) and gym supplements may also make it difficult to control ejaculation.

  • How can medication affect my sex life?

Dopamine, serotonin, and testosterone/estrogen are three chemicals that play an important role in one’s sexual life. Medications for psychiatric disorders, allergy, hypertension, and pain tend to have an effect on these chemicals, thereby having an inadvertent effect on your sex life. However, if you feel this is the case, you can get checked and talk to your doctor about changing your medication.

  • Can medication side effects cause impotency?

There have been linkages of medications causing erectile dysfunction in men. Some common medications that have these side effects are antidepressants, anti-allergy drugs, chemotherapy drugs and prostate cancer medication, hypertension medications, Parkinson’s disease medications and muscle relaxants.If you are on any of these and feel that it is leading to problems in your sex life, have a word with your doctor.

11. Pregnancy and contraception:

  • When is a fertile period to get pregnant?

A woman’s menstrual cycle lasts between 28 and 32 days on average. The beginning of each cycle is considered to be the first day of her menstrual period (menses). Ovulation itself generally occurs between day 10 and day 19 of the menstrual cycle or 12 to 16 days before the next period is due. Ovulation window of about 5 to 6 days in the best time to get pregnant.

  • What are the various methods to avoid pregnancy?

Condoms are the most common method with which people avoid pregnancy. Another way is to abstain from sex during the fertile pregnancy periods. Some couples also use the pull-out method, that is, the male pulls out before ejaculating. There are birth control pills and patches that the woman can use all-around the month, to prevent pregnancy. Women can also take birth-control injections that will have a hormone that prevents pregnancy. There are also vaginal rings and cervical cups which ensure that the sperm and egg do not fertilize. Female condoms are also an option. There are also emergency contraceptives that can be taken within 72 hours of intercourse. Lastly, there are birth control implants that can be planted under the skin which will prevent pregnancy by releasing hormones. These work for 3 years and will need to be replaced after that.

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