So you know all about AIDS, condoms and the morning after pill. But is this superficial knowledge enough to save you from a fatal STD or cancer of a sexual organ? On the eve of World AIDS Day (December 1), HAIMANTI MUKHERJEE probes, well, deep into some important issues of sexual health that no one seems to talk about

Can oral sex make me pregnant?” The question had silenced a room full of friends on a cold, winter night, the year we finished Class XII. We were at a friend’s farmhouse far, far away from city limits. I could hear a coffee cup shatter to pieces, as my best friend Payal started giggling, followed by the deafening sound of laughter from all over the room where we had all huddled up for a great weekend. “Yeah, yeah… Just look into Ravi’s eyes and you may end up pregnant,” muttered Payal. Ravi was the object of my affection at 18 and yes, he was there too. Darn, so much for a genuine question, thought a very embarrassed me. What happened next? Hmm… Well, just in case someone, somewhere is still wondering, oral sex CANNOT make you pregnant. But does that mean it’s totally safe? “No,” quips gynaecologist Dr Geeta Chadha. She deals as much with the umbilical cord as with all the half-baked—or even wrong—notions that women have about their bodies and sex even in this age of the Internet and satellite TV. “Oral sex can definitely give you herpes, among other sexually transmitted diseases (STDs),” she says.



Well, I hadn’t thought of that even at 31. I haven’t ever visited a gynaecologist. Neither have any of my friends or colleagues—men or women, married or single. Gynaecologists/sexologists are to be visited only when you have some infection, get pregnant or miss your period. Well, you couldn’t be more wrong. Gynaecologist Ranjana Sharma explains: “Cases of cervical cancer have risen considerably among women over the past few years. The HPV virus, which is sexually transmitted, is a positive factor in cervical cancer. What most women and men don’t understand is that wearing condoms or going for thorough and regular internal check-ups is mandatory, not just to avoid pregnancy but a whole lot of other complications which can be fatal!”

Knowledge = Wisdom? No!

The advantage of living in our times is that you can Google away your worries and have your smallest doubts laid to rest without even talking to anyone. You have five-minute solutions to skin problems, tips to avoid hangovers, prescriptions to deal with migraine, ulcers, even heart problems. Since lifestyle diseases are on the rise all over the world, we know that a regular check-up is a must even without any visible signs of trouble when it comes to your heart. But do we take the same amount of care when it comes to our sexual health?

“No,” says Dr Chadha. “Seeking a gynaecologist or sexologist is thought to be mandatory only when someone comes up with a problem or has some infection and also when women get pregnant. Not before that. I don’t have many women seeking help just because they have become sexually active or want to know their bodies better.”

Adds sexologist Dr Arpit Jain, “If people seek guidance proactively, half the problems wouldn’t be there. But where are the people?”

Experts note that cases of cervical cancer have risen considerably among women over the past few years. The HPV virus. which is sexually transmitted. is a positive factor in cervical cancer. Therefore, a thorough internal or sexual examination should he mandatory for a whole lot of reasons other than pregnancy alone.

Says Meenakshi, who works with an NGO dealing with AIDS patients,“Considering that STDs and reproductive tract infections (RTIs) are as much an urban phenomena as rural, not taking care of your sexual health is potentially dangerous—even fatal—in this age of liberalisation when people are experimenting much more, have multiple partners and marry pretty late.” Just gathering theoretical knowledge about STDs and RTIs obviously does not help or result in being proactive. But what is it that stops people from seeking help when it comes to sexual health or even talking about it? Why can’t the topic be broached and counselling be sought just like in the cases of ulcer, migraine or even cancer?

What Is Sexual Health?

The reason is rooted in the very definition of sexual health. “I would describe sexual health as an individual’s need to be free from sexual myths, misconceptions and anxieties that often paralyse sexual responses, leading to sexual problems,” says sexologist Dr Prakash Kothari. “For a man, it’s proper erectile function; for women, lubrication, good anatomy, psychology and good ambience—sexual health is all this and more,” he adds.

According to the definition on the World Health Organisation web site, “Sexual health is influenced by a complex web of factors ranging from sexual behaviour, attitudes and societal factors, to biological risk and genetic predisposition.”

In a conservative country like ours, where sex is still a hush-hush topic, looking after sexual health is obviously not a priority. If people are frightened to even broach the topic of sex with friends, forget parents, how can they take sexual health seriously? Photographer Neel addresses the problem well: “Fear of prejudice is what keeps people away from seeking medical help in sexual matters. Sex is a dirty word in this country. You will get a lot of sympathy from people if you are diagnosed with cancer but when it comes to a sexual disease, and I’m not talking about an epidemic like AIDS but even a simple infection transmitted sexually, your family members/friends will look at you in a different way,” he says. “And let’s face it. No matter how tough or courageous we pretend to be, no one wants to be looked at differently.”

But even with the prejudices, can we afford to be lackadaisical when it comes to our own bodies? “Sexual health is inseparable from general health,” says Dr Kothari. “Good emotional health, proper knowledge of sex education, adequate hormonal levels, good blood sugar and cholesterol levels are all part of sexual health and need to be taken care of, just like any other problem.”

Elaborates Dr Sharma, “If just theoretical knowledge about sex were enough, we would have had lesser cases of STDs. You will be amazed to know about the level of ignorance, even naivete, when it comes to sex,” she says. “I once talked to a woman, an educated one, well into her 30s, who hadn’t had vaginal sex but was still paranoid about getting pregnant,” says Dr Chadha.

On the contrary, there are cases where people have been too smart, averted penetration and opted for ‘safer’ options like oral or anal sex. Well, these may just result in various diseases like Hepatitis B, herpes, syphilis, AIDS, chlamydia, gonorrhea, trichomoniasis and cervical cancer.

Says Dr Chadha, “What people need to understand is that there are often no symptoms of STDs. The effects may show even two to three months after the act, both in men and women. But it’s more relevant for women because a larger area of the female sexual organs are exposed while having sex and also because these organs are deep inside the body. You may not even be aware of what’s developing inside, until it’s too late. And that’s really bad because some of these diseases are extremely painful.”

WHEN SHOULD I SEEK SEXUAL HEALTH COUNSELLING? When you attain puberty. Go for both social and medical counselling to understand the changes in your body and the natural sexual urges and desires like masturbation and physical attraction towards the other sex.

In case your contraceptive method fails, and also to know what the safe options are.

Certain lifestyle choices are also important for good sexual health. To know how to be physically fit and maintain personal hygiene. Both reed thin bodies and obese ones affect sexual health in different ways.

Both men and women need regular internal check-ups—including tests for blood sugar, cholesterol, liver and routine urine examinations—to rule out any infections in the body.

Pubescent girls should be taught about the period of menarche, that is the first menstrual cycle. For some, it can take a while before the cycle regularises. Don’t panic.

Almost one-third of sexual health problems are psychological and affect conjugal lives too. One needs to seek professional help before a problem leads to depression and affects a relationship deeply.

From Genuine To Bizarre

It’s not as if people don’t have questions or wouldn’t like to ask. We are astounded by some of the questions that readers send in to the section called ‘Sexpertise’ in What’s Hot. The queries range from genuine fears to bizarre ones—“What is a safe period?” “Is anal/oral sex safe?” “Does sex lead to weight gain?” “Can kissing make me pregnant?” “Will excessive masturbation weaken me internally?”

In the midst of a long working day, these queries may come as much-needed laughter therapy but the need for them to be answered cannot be denied. Neither can we ignore the lack of people willing to give a correct, informed answer. “Any question relating to sex becomes a moral issue with parents. Most of them even shy away from it. We cannot talk about the birds and the bees and expect people to develop a healthy attitude towards sex,” says psychiatrist Dr Jitendra Nagpal.

How a teenager/adolescent or even kids (yes, startling, but they begin early these days) look at sex or anything related to it, depends on how his/her family members look at it. Are they comfortable talking about sex? Says Dr Sharma, “In my experience, this generation is very smart. But more often than not, it’s the parents who aren’t in tune with the times. Anything to do with sex or sexual topics is strictly prohibited and they shy away from it at home. It’s confusing for the kids because they are looking at sex normally but their parents are giving them signals of the act being dirty and a topic not worth or even proper to talk about,” elaborates Dr Sharma. But she adds that she hasn’t lost all hope because in her monthly counselling sessions for Class XII students in a few schools in Delhi, she is bombarded with questions on sex. “It’s like opening the floodgates. From menstruation to masturbation, these students want to know all. Girls want to know about their menstrual cycles, the boys want to know whether masturbating is normal. I can go on and on…”

I once had a colleague who couldn’t go all the way with her beau because mommy dear—who was a gynaecologist—would do a thorough internal check-up every three months. While she had to go through this ‘horrible routine’, as she put it, she was also safe from any potential danger. But what about the rest of us? Isn’t it high time for men and women of all ages to seek help from a sexologist or gynaecologist on a regular basis? If there’s no one to talk to at home, it’s only common sense to head for the doctor’s chambers ASAP. There’s no fear of moral judgement there. Just leave all your prejudices and shyness outside and walk into the room with the courage to ask each and every question that has ever cropped up in your mind.

Oh, and if you’re still wondering about what happened on that cold, winter night far away from home… Well, the wine was just too potent and we all fell asleep… alone!