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What are the most effective ways to stay sexually healthy? What drives people to engage in sexually risky behaviour? How can you best protect yourself from a passion-induced lapse of judgement?
What is sexual health? Is it the same as reproductive health? Although they are connected, this article will focus only on sexual health. There are many other available resources on reproductive health.
The World Health Organization defines sexual health as a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity.
A more colloquially expressed definition could be: To be able to enjoy and continue to enjoy sex, and that enjoyment enhances mental and physical well-being.
As with all other types of health, sexual health education is essential for optimum sexual health. There is a difference between sex education and sexual health education. Sex education is about the processes of sex. Sexual health education is about the behaviours that maintain sexual health.
Ultimately sexual health is determined by behaviour (external and internal). What are the specific behaviours that determine sexual health? Here are just some.
- Negotiating with a sexual partner to practice safe sex.
- Establishing/ discussing the sexual health status of possible sexual partners.
- Getting tested for sexually transmitted infections (STIs).
- If sexually active with more than one partner, being tested regularly.
- Making thoughtful, well-informed, consensual decisions about sexual behaviours.
- Practising safe sex or maintaining sexual safety in the context of a long-term relationship, or relationships.
- Discussing sexual health issues with any partner.
- Conducting routine breast or testicular assessments.
- Discussing what brings sexual pleasure to each partner and accommodating those preferences if that is mutually agreed.
- Being willing, able and agreeing to discuss relationship issues.
- Accepting that what sexual health means changes with age and life circumstance.
- Accepting that sexual functioning issues will emerge and agreeing on how to deal with them in a constructive way.
- Accepting that sexual interests and appetites change with time, for both parties.
Once the appropriate sexual health education has been applied and the appropriate behaviours have become habitual, sexual health seems to continue unless something upsets it.
Across the globe, many people are not able to protect their sexual health because they do not have access to sexual health education, they are sexual health illiterate, and/or are subjected to all types of abuse and sexual violence. Maintaining sexual health involves having the skills and the capacity to comprehend and apply health information in a sexual context.
For example, it is not enough to know that HIV can be transmitted by having unprotected sex, the person also needs to have the desire to maintain their health and have the assertiveness, and power, to decline offers of, or forced, unprotected sex and be in a mental state to not allow sexual intoxication to overpower their normal sexual safety wisdom.
People who take narcotics or other mind-altering substances, including alcohol, are more likely to have negative sexual health events, such as engaging in risky sexual behaviour. Even well-informed and well-intentioned people can contract sexual diseases.
How many people have been infected by HIV after thinking ‘the risks are small,’ or after their partner told them: ‘I am HIV negative,’ when the person making the ‘clean’ statement had no means of knowing if they were negative or not?
How many people have caught HIV after thinking unprotected sex was ‘worth the risk’? or because ‘condoms don’t feel the same’?
How can people protect themselves against a brief, lust-induced, lapse of judgment? By reminding themselves that almost nobody catches HIV deliberately. Most HIV infections come from people deciding: ‘It will be OK.’ It wasn’t. When people are being self-responsible, they generally don’t take avoidable or unnecessary risks.
Physical, emotional, mental, social and relationship well-being all contribute to being in the right mindset to engage in good sexual health behaviours. Sexual health is more than just physical functioning; more than being aroused and able to perform.
In the study of sexual health, much focus is on disease and harm prevention. Little attention is given to enhancing sexual enjoyment or to the link between sexual enjoyment and wider physical and mental health. Few people would argue that healthy, happy sex is anything other than hugely beneficial in many other ways.
Sexually healthy people derive much from sex. Sex is emotionally satisfying. When people feel valued, appreciated, heard, respected, and admired (as they do in sexually healthy relationships), it has huge mental health benefits, and those, in turn, have substantial physical health benefits.
For example, the immune system seems to be strengthened, and stress levels are reduced. Sex builds and strengthens relationships. Sex plays a part in our engagement with society.
It is known that cuddles, hugs and other physical and emotional intimacy benefit our health. Oxytocin, the ‘cuddle hormone’ is released when we are physically intimate. When people have good sex, in the context of mutual respect, it seems to have many health benefits. Other health-beneficial hormones are also released during intimacy, such as serotonin, dopamine, and endorphins (endogenous opioid neuropeptides) – the body’s natural opioids.
Many therapists throughout history have advocated sex as therapy. Our genitalia are among the least important of the organs involved in healthy sex. The brain is the sex organ that brings the most pleasure. Most great sex happens in the mind.
Here are the warm, hard facts (should I be apologising for an unintentional pun?): the physical sensations in sex are very similar each time if the same kind of sexual activity is involved, but the emotional and mental components are what make the difference between social security sex (a little, but not enough to live on), and mind-blowingly good sex.
What makes for mind-blowing sex? Emotional, intellectual connection, excitement, anticipation, surprise, novelty, seeing the entire body, and mind as involved. Great sex, being sexually healthy at the highest level, is a whole mind and body experience.
Some people become sexually addicted. As with all addictions, sex addicts find themselves crossing the line between getting high and doing harm. Sex addicts are sexually unhealthy. People are addicted when they cease having control of their healthy desire, and the desire has unhealthy control over them.
That is, they are controlled by the object of their desire to the point where it damages their lives and health. Because sex addiction is mostly a secretive sexual health disorder, there are no reliable figures. The range of people thought to be sex addicts is from 3% to 10%.
At the other end of the scale, it might be worth noting that from the available historical records, around 2% of adults have been asexual throughout history. They have no interest in or desire to engage in sexual activity. To the 98% of the population who experience sexual desire, that can be difficult to understand: ‘How can one live without sex?’
Many asexuals are happy and well-adjusted, form strong attachments, have enduring relationships, and make massive contributions to society. That is, being sexually healthy can also include being entirely happy not to engage in any sex.
For most people having regular and enjoyable sex is a great life enhancer. Fortunately, we are moving past the time when sex could not be discussed. That is good news because the best way to help people maintain their sexual health (or any other form of health) is to have open and honest discussions about sexual health and happiness.
We can enjoy sex most if we see it as fun. Healthy sex is fun sex. Here are some comedic examples.
- ‘My wife is a sex object, every time I ask for sex, she objects,’ says Les Dawson
- ‘Children in the back seats of cars cause accidents, but accidents in the back seats of cars cause children.’ Unknown author.
- ‘Three people having sex is a threesome, two is a twosome. The next time someone calls you ‘handsome’, don’t take it as a compliment!’ The author denies it.
Professor Nigel MacLennan runs the performance coaching practice PsyPerform.