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Dr. Sharmila Majumdar was the esteemed guest of honour and presented the topic “Women’s intimate Hygiene”

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The new world situation caused by the coronavirus pandemic (COVID-19) requires special attention due to the confinement, social distance and hygiene measures recommended for its control, as well as the health, social and economic consequences after de-escalation of the measures mentioned to return to normalize life.

In each region of the world, the infection with COVID-19 has come at a different time, with a different incidence and with different governmental measures, but in society there will be significant social effects on sexual health, in couple relationships, in family relationships, in social relations and in mental health, as well as there will be economic difficulties due to the loss of many jobs, which will be the main sources of concern.
Sexual health and rights are an important public health problem that requires specific attention in times of pandemic and, therefore, the World Association for Sexual Health wants to focus our attention on their protection and on promoting gender equality and respect for sexual diversity.

We must remember that sexual health is defined as a state of physical, mental and social well-being in relation to sexuality that requires a positive and respectful approach to sexuality and sexual relations, as well as the possibility of having pleasant and safe sexual experiences, free from all coercion, discrimination and violence (WHO, 2002).

In the same way that diseases affect women and men differently, the pandemic situation increases existing inequalities between women and girls, as well as discrimination of minority population groups by any condition (functional diversity, LGTBIQ population, immigrants, etc.).
In times of crisis, such as the quarantine situation, women and girls are at increased risk of intimate partner violence, sexual abuse, and family violence as a result of increasing tensions in the home from confinement. They also face increased risks from other forms of gender violence, including sexual exploitation and abuse in these situations.

Women represent the largest workforce in the health and care sector in the world. Therefore, they are more exposed to having more health problems by being in the front line of action. Similarly, it is important to guarantee continuity of care in the event of an interruption or alteration of sexual health care services due to the diversion of resources to face the infection and the lack of health supplies due to shortages.

Providing mental and psychosocial health support for individuals, families, the community, and the staff who serve basic services is critical to maintaining health and rights. Surveillance and response systems must take into account aspects such as sex, gender, age, risk factors for health reasons, employment status and pregnancy status.

WAS collaboration and alliances with WHO, UNFPA and other United Nations agencies to support Ministries of Health and other Ministries related to pandemic control are essential to ensure correct information on precautions to avoid infection and potential risks associated with sexual activity and the risks of increased violence against women, children and the most vulnerable population groups. It is also important for WAS to advise on seeking health care and psychosocial aids.

It must be pointed out that individual protection protects others from getting sick, that life must go on and that sexuality is an inseparable and essential part of human beings.

Furthermore, the World Association for Sexual Health urges all states and nations to ensure that everyone’s human and sexual rights are recognized and respected, and that the rights and access to sexual and reproductive health services are not violated by new policies or measures to manage the pandemic. Human, sexual, and reproductive rights, equality, and a free and just society should not be sacrificed in the process.

Dr Sharmila Majumdar
MS Human Sexuality, PhD cbt
Fellowship from Ichan school of Medicine, Mount Sinai, USA
Director and Chief Sexologist
Sexual and mental health clinic , Avis Hospital

Consult Online – Click Here

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There is no cure, so the focus is on protecting children.
Pedophilia, the sexual attraction to children who have not yet reached puberty, remains a vexing challenge for clinicians. Classified as a paraphilia, an abnormal sexual behavior, researchers have found no effective treatment. Like other sexual orientations, pedophilia is unlikely to change. The goal of treatment, therefore, is to prevent someone from acting on pedophilic urges – either by decreasing sexual arousal around children or increasing the ability to manage that arousal. But neither is as effective for reducing harm as preventing access to children, or providing close supervision.

The exact causes of pedophilia have not been conclusively established. Some studies of pedophilia in child sex offenders have correlated it with various neurological abnormalities and psychological pathologies

• No intervention is likely to work on its own; outcomes may be better when the patient is motivated and treatment combines psychotherapy and medication.
• Parents should be aware that in most sexual abuse cases involving children, the perpetrator is someone the child knows.

Nearly all people with pedophilic tendencies are male. Studies of child molesters have reported that only 1% to 6% of perpetrators are female. Co-occurring disorders, such as personality disorders or mood disorders, are common in people with pedophilic tendencies. And about 50% to 70% of people with pedophilic tendencies are also diagnosed with another paraphilia, such as exhibitionism, voyeurism, or sadism.

Most psychotherapies used to treat pedophilia incorporate the principles and techniques of cognitive behavioral therapy. The focus of therapy is to enable the patient to recognize and overcome rationalizations about his behavior. In addition, therapy may involve empathy training and techniques in sexual impulse control. Most important behaviour therapy used is Relapse prevention

• Relapse prevention is intended to help the patient anticipate situations that increase the risk of sexually abusing or assaulting a child, and to find ways to avoid or more productively respond to them

• testosterone suppression offers advantages such as the need for follow-up visits (which aids in monitoring behavior). It may take 3 to 10 months for testosterone suppression to reduce sexual desire.

• SSRIs may be a useful adjunct to other treatments, because they not only subdue sexual ruminations and urges but also help with impulse control.

Finally I’m in favor of treatment to spare kids the physical and psychological trauma. It doesn’t matter whether it is nature or nurture unless it helps in quality treatment.

Dr Sharmila Majumdar
MS Human Sexuality, PhD cbt
Fellowship from Ichan school of Medicine, Mount Sinai, USA
Director and Chief Sexologist
Sexual and mental health clinic , Avis Hospital

Consult Online – Click Here

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Q: Are we even wanting sex in these covid-19 days?
A: It’s hard to know yet. While some people may turn to sex for comfort or as a temporary distraction, these are unforeseen times and we don’t have much data. Depression and anxiety have a negative effect on libido. Some people are out of work, too, and unemployment can affect sexual desire. The kind of worry people are experiencing crosses so many domains: Job security, health, friends’ and family’s health, and the ability to have access to medical care, to name a few.

Q: What is considered ‘safe sex’ right now?
A: Your risk for infection with the coronavirus starts as soon as someone gets within 6 feet of you. (And of course, if you do have sex, your risk for pregnancy and sexually transmitted diseases remains the same, and the previous definition of “safe sex” still applies)
You’ve read this elsewhere: COVID-19 is transmitted by droplet nuclei, tiny specks of infectious material far too small to see. They are sprayed from the nose and mouth by breathing, talking, coughing and sneezing.
A person contracts the virus sharing the same airspace – a 6-foot radius, the distance droplet nuclei are believed to travel (although with coughing they may travel farther) — and inhaling the infectious particles. Or the droplet nuclei land on an object or surface, making it infectious. Touch that surface and then your face and the chain of transmission is complete.
If you do have sex with someone who is infected with the coronavirus, there is nothing we can recommend, be it showering head to toe with soap before and immediately after sex, or using condoms, to reduce your risk of infection. We don’t know if the coronavirus is present in vaginal secretions or ejaculate, but it has been identified in stool.

Q: Who are the safest partners?
A: It’s best to limit sex to your spouse who should also be following recommendations for hand hygiene and social distancing. The World Health Organization currently lists the risk of household transmission as 3% to 10%, but this is based on preliminary data. We don’t know what role kissing or sexual activity plays in transmission.
The idea of limiting sexual contact to your husband and social distancing in general is about ending the chain of transmission to your household should one person become infected.
If your Spouse is sick with symptoms of COVID-19, or has been exposed, definitely don’t have sex. They may be too fatigued anyway, but your risk of being infected will likely go up in close, intimate contact. Sleep in separate bedrooms if possible.
If you have more than one bathroom, designate one for the sick or exposed person. Try to stay 6 feet apart and be fastidious about disinfecting surfaces. If they were exposed, living as separate as possible in your home for 14 days is adviced.

Q: What if I’m in a new relationship and had planned to get other STD testing done?
A: Many labs are overwhelmed with coronavirus testing, so you may not get results for some STDs — like gonorrhea, chlamydia and herpes — as fast as before. Given the short supply of test kits for COVID-19, so sampling kits for genital infections may be in short supply.
Ask your doctor because workflows may vary locally and may change day to day. But if you are at risk of an STD, you should still seek out a test as soon as possible.

Q: What if I don’t have a Husband ? Am I now celibate?
A: Yes, I’m sorry to say, those are the recommendations. For now. But this doesn’t mean you can’t meet people online — start talking on the phone, have video chats, if that’s your thing.
And if someone you meet online is encouraging you to meet in person? That not only tells you how they view their own safety, but, even more important, how they view yours.

Q: What about sex toys?
A: Sex toys aren’t likely to be a method of coronavirus transmission if you have been using them alone. However, if you shared your toys within the past 72 hours, make sure they are disinfected and wash your hands afterward as the virus may stay active of some surfaces for up to three days.
And do not clean sex toys with hand sanitizer or use hand sanitizer immediately before masturbating, because it can be very irritating to the vagina or rectum.

Q: Is it safe to buy new sex toys?
A: it appears that a lot of vibrators are on sale. Is this a good time to take advantage of a deal and the extra time on your hands? Paying electronically is safer than an in-store purchase: Paying online means no one is physically handling a credit card or cash. Does your online purchase of a nonessential, a vibrator is a “want,” not a “need” put someone else at increased risk? Workers at large warehouses where social distancing isn’t possible may be at increased risk, especially if they don’t have sick pay, so taking time off if exposed isn’t possible

Q: What will safe sex look like in the future?
A: Right now the only safe sex is no sex with partners outside your household. If you or yours spouse are at high risk, should you take extra precautions to further reduce the risk of transmission — giving up sex and kissing, sleeping in separate bedrooms — in case one of you has an asymptomatic infection? Asking your doctor for guidance here is probably wise.
But what about when we emerge from our homes again — which may be some months away — and start thinking about in-person dating, and mating?
No one knows if we are all going to have the urge to have sex after this quasi-hibernation. One concern is a potential surge in risk-taking and STDs. in the immediate aftermath of this covid-19 pandemic. (After all, you can’t assume that if someone was celibate during the pandemic they don’t have an STD; most STDs don’t cause symptoms and could have predated the coronavirus.
If that all sounds bleak, well, it is. For now, the coronavirus probably means less sex overall, whether that’s because of no spouse or a drop in desire. Or both.
Hopefully, though, this is just for now. Because the more everyone commits to social distancing, physical distancing the faster we can all get back — and down — to business.

Dr. Sharmila Majumdar
Director and Chief Consultant
Sexual and Mental Health Clinic

Consult Online – Click Here

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• The spinster or confirmed bachelor who has many friends but avoids dating and being sexual with others, with or without excuses for this behavior.

• The hard-working husband who rarely gets home in time to see his wife awake, let alone to interact with her in any meaningful way.

• The dutiful mother who pours her entire self into childcare, neglecting the emotional and sexual needs of her husband.

• The serial dater who bounces from one intense yet unfulfilling relationship to another, never allowing anyone to get too close.

• The “annual” dater who gets into a relationship that seems promising, sabotages it when the connection starts to feel enmeshed, and then avoids dating and sex for many months afterward.

 • The modern couple – pairs who allow themselves to become more interested in and engaged with technology than each other.

• The sex addict who is hypersexual and highly aroused by casual sex, but quickly becomes bored, distant, and nonsexual when a relationship turns intimate.

• The abusive partner (physical, verbal, etc.) who uses anger and judgment to push others away.

• The man or woman who loves/chases an abusive partner.

• The addict (substance or behavioral) who escapes emotional connection (and therefore potential emotional discomfort) through use of intensely stimulating substances and/or behaviors.

Nearly always, intimacy avoidant adults have suffered chronic attachment trauma during childhood via repeated physical neglect, psychosocial neglect (emotional and cognitive unavailability), emotional abuse, physical abuse, and/or sexual abuse (overt or covert) perpetrated by parents, siblings, or other relatives. Chronic early-life attachment trauma can also occur at the hands of teachers, coaches, clergy, bullies, and others. It is possible for chronic attachment trauma to happen even when the individual is not directly victimized. For example, children who witness domestic violence may not have the abuse directed at them specifically, but they nonetheless suffer by living in a fear-based, unpredictable environment.

In treatment, it is important to ferret out intimacy avoidance patterns and their origins – most often some form of neglect, abandonment, emotional/ physical/sexual abuse, and/or emotional enmeshment (such as covert incest) by a parent or another primary caregiver. Childhood experiences that commonly contribute to intimacy avoidance include:

• Being raised by a smothering or narcissistic parent whose needs supersede those of the child.

• Being emotionally, physically, and/or sexually abused by a primary caretaker or sibling.

• Growing up in a home where there is persistent and profound mental illness, addiction, or both.

• Witnessing the emotional, physical, and/or sexual abuse of a primary caretaker or sibling.

• Growing up in a home where a sibling or parent has a profound emotional or physical impairment/illness (and there is no balance of attention and focus).

• Being physically, emotionally, and/or socially neglected or abandoned.

• Being treated as a parent’s confidante, companion, or surrogate spouse (covert incest).

• Needing (or being forced) to fill an adult’s role in the family, such as caring for siblings (especially in single-parent homes or addicted households).

• Being (or feeling) responsible for a troubled parent (an addict, an invalid, someone who is mentally ill).

Complicating matters is that fact that many intimacy-challenged survivors of chronic attachment trauma present with co-occurring issues – addictions, depressive disorders, anxiety disorders, anger management issues, chaotic lifestyles, and the like – that must be stabilized before underlying trauma can effectively be addressed. That said, education about early-life attachment trauma and its connection to present-day intimacy avoidance should begin early on, if for no other reason than the need for contextual analysis and shame reduction.

After this initial “safety and stability” stage of treatment, coping skills for dealing with the desire to avoid and/or escape the oppressive sensation of emotional attachment via intimacy avoidance can be developed, usually in conjunction with the deeper therapeutic work of re-experiencing, processing, and resolving early-life attachment traumas. Usually, this type of long-term healing involves some combination of social skills training, cognitive therapies, group therapy, social learning, and perhaps medication, similar to the treatment of complex (multi-layered) trauma in general.

Make an appointment with Dr. Sharmila Majumdar, Director & Chief sexologist, Sexual and mental health clinic, Avis Hospital, Road 1, Jubilee Hills, next to Chiranjeevi blood bank, Hyderabad 500033

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If you’re not having the kind of sex you like and you feel too embarrassed to talk about it, then that’s your ownership, not your partner’s. Get up the guts and just say it. You can’t expect your spouse to read your mind.

If, despite your attempt to communicate your needs doesn’t yield any result it best to consult a professional sexologist and sort things out before the problem becomes chronic and drives a gap between your spouse and you.

Make an Appointment with Dr. Sharmila Majumdar at the Sexual & Mental Health Clinic, Hyderabad.

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1. Give them ownership of their body & tell them that no one has a right to touch them unless it’s okay with them. At ages 2- 3.25 they should know that their bodies belong to them and that they can reserve certain parts as ‘private.’ Even if it’s something like holding hands with someone or having a friend hug or kiss them, they know they have the right to say no if they don’t like it.
2. Use Appropriate Language – Teach them the correct names for their anatomy. I think it really helps them to have that knowledge in case they ever need to talk about anything.
3. Keep Conversation Light and Easy – One thing I find that helps is keeping these kinds of conversations serious but still unemotional (almost lighthearted) so that kids feel very comfortable talking about it and asking questions. And try to let these conversations happen naturally and work them into our everyday life. Like talking about it during potty or bath time.
4. Use the undergarment rule – In the guidance lessons in kindergarten classes children were told that if your undergarments covers it, it’s a private area and no one should be seeing or touching that area. Tell a grown-up if someone is touching you in the wrong places because it’s a Mommy and Daddy’s job to keep you safe. It’s a simplified version but easy for younger children to understand it. I recommend the line be ANY touch/space intrusion that makes the child uncomfortable. And we cannot forget that the mouth should be considered a private area, too.
5.  Explain what safe touch is & give them concrete examples – like getting a shot at the doctor’s office, or being pulled out of the street, etc.
6. Empower them to say NO – I also always stress that if someone touched children in a way they didn’t like to tell that person to stop … and to ALWAYS tell their parents about it. Keeping the lines of communication open, even with AND especially with, our private areas is of UTMOST importance!
7.  Help your child trust their feelings. Kids should be taught to trust their own feelings.
8.  Practice or Role Play – My kid and I practice what she should say (‘No, I don’t like that. STOP!’) and do (tell me or your father) if she is ever asked to show or are touched in the private areas.

I sincerely hope that these thoughts help to make this a more comfortable conversation for you and your kids which ultimately leads to fewer children being sexually abused.

Dr. Sharmila Majumdar

Make an Appointment with Dr. Sharmila Majumdar at the Sexual & Mental Health Clinic, Avis Hospital, Hyderabad

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When women with PCOS are trying to have a baby, intimacy can go from “the joy of sex to the job of sex,” since conceiving can often involve scheduling sex during the times they’re most fertile. Women also might be taking fertility medication that can affect their libido.

Having irregular bleeding while trying to have a healthy sex life can be stressful, because you never know when you’re going to have bleeding. Women with PCOS shouldn’t be afraid to seek help if they’re having trouble with their sex lives. Most women with PCOS only seek out medical or psychological help if they’re trying to conceive.

PCOS is a complex female health issue. It consists of many different health concerns and risks. If permanent diet and lifestyle changes are implemented, these risks and health issues may become obsolete. There are many ways to support the proper health of a woman’s body that is dealing with PCOS. Important key tips:

1. Make sure your doctor performs the correct tests and you get a proper diagnosis.
2. Follow a PCOS specific diet to help decrease insulin resistance, balance weight, and improve estrogen metabolism.
3. Promote hormonal balance and support regular ovulation through supportive herbs and supplements.
4. Support a proper inflammatory response.
5. Stick to your plan, believe in yourself, only you have the ability to change your circumstances! And quite likely conceive your bundle of joy.

Make an Appointment with Dr. Sharmila Majumdar at the Sexual & Mental Health Clinic, Avis Hospital, Hyderabad

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