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]]>UM can have detrimental effects on the psyche of the individual partners, it can lead to low self-esteem in individuals, blames games can result in frequent fights among partners, extra marital affair, fights within family or both the families. Also in a place like India predominantly for not being able to conceive and give birth to a child, frustration, depression, and if appropriate help isn’t available, it may lead to annulment of marriage and divorce.
Various factors are responsible for this condition, many a times individuals may not seek help at the right time from appropriate person due to lack of awareness and taboo to talk about sex life and shame it will result in after discussion.
There can be several reasons for UM: psychological, organic or even both at the same time.
In a developing country like India, most individuals have nil or inadequate (may not know ‘how to proceed’) or even negatively presumed knowledge about sex (especially in females that intercourse will be very painful); so many individuals are unable to have sex after marriage. The only way they can get this information is from the net, but a lot of this sexual information comes from unreliable pornographic sites, which often end up confusing the couple even more. Some may have a negative image about sex (based on the early teachings by their family or religion, but fail to understand that it’s an important and integral part of marriage), hence may not indulge in and nor allow the partner to proceed.
Women rose to place most of their self-esteem and identity in virginity can have a tough time.For them taking on a new role as a married woman and a new identity as a sexual human being, is difficult. In the conservative middle-Eastern societies and in the developing countries, couples are strongly prevented by religious rules and cultural taboos from sexual experiences before wedding.
For some the performance anxiety; the intense social pressure to accomplish hasty coitus with an unfamiliar woman (some men having had no social contact with their new bride), and in the presence of relatives waiting nearby for evidence of the bride’s virginity and confirmation of coitus; may lead to unsuccessful attempts. Sources of performance anxiety includes fear of sexual failure, fear of mistakes, sexual myths about sexual performance, demand for sexual performance, fear of being rejected by the partner, living in the same house with family/ lack of privacy and misconceptions and beliefs about sexuality. Unreasonable expectations, traumatic early sexual experiences, restricted foreplay, impaired self-image and poor communication, also may contribute to performance anxiety.
The current competitive lifestyle, working couples are under constant tremendous work pressure to meet deadlines leading to excessive mental stress and fatigue. They are practically available for each other only on weekends and that too, if one of them has different work schedule then it’s really difficult to spend time together. This results in “no mood tonight”, “have had a hard day, want to sleep”, “am tired, have to complete project, and get back to work early” and such other excuses and situations, affecting their sex-life. This also increases performance anxiety and later due to avoidance behaviour, partners enter a vicious cycle where they lose sexual interest altogether.
It’s hard to get to the truth in the first few minutes of a hurried consultation, and requires a lot of gentle and careful probing. Patients need to be able to be trust the doctor, before they are willing to volunteer such sensitive information.
Sexual dysfunction like erectile dysfunction, premature ejaculation, performance anxiety in males and vaginismus in females has been predominantly reported in several studies and reviews over the years. Vulvodynia, an often unbearable pain when the genitals are touched is also one possible reason.
Little research has been conducted about UM. A trend that is seen in these studies is that in western countries lately there have been lesser reported cases of unconsummated marriage compared to eastern developing countries. Also a positive trend visible is: increased reporting among people in developing countries, this could be attributed to the fact that discussing or seeking help for sexual problems may no longer be a stigma.
It’s essential to assess and evaluate both the partners and their sexual history along with their current relationship & psychiatric history well in combination with physical examination and diagnostic testing. The socio-cultural and psychodynamic factors pertaining to the failure to consummate the marriage should be investigated in detail and addressed. An empathetic attitude by Qualified Sexologist is required, so that patients know that they are not being judged as incompetent nincompoops. Educating a couple to take their time, experience sexuality and intimacy rather than view it as a performance or a test, or as a task you either pass or fail, often takes the pressure off.
Premarital sex education can prevent UM arising due to wrong/inadequate knowledge of sex. Frequent meetings during courtship can lead to better understanding and comfort level between couples, thus preventing the condition. Couple counselling on sex and physical relationships including sex education can be availed after marriage.
Marital therapy is done to resolve interpersonal issues, make each other understand faulty behaviour, to work hard to strive the relationship, develop trust and emotional bonding, to spend quality time together eventually to save the relation. Behaviour therapy where first couple should be encouraged to explore their own sexuality. Once they are comfortable with their own sexuality, gradually they can progress to having intercourse.
Sexual dysfunctions like Vaginismus & low desire in females & Erectile Dysfunction and premature ejaculation, low desire in males and infertility due to UM should be treated.
In conclusion, identification of the etiological factors of UM may be essential for the proper management to achieve a successful outcome. In addition to proving explicit sex education and behavioural counselling, Sexologist often find prescription medicines useful.
Conclusion
It’s time for unconsummated marriages to come of the closet!
Dr. Sharmila Majumdar
Make an Appointment at the Sexual & Mental Health Clinic, Avis Hospital, Jubilee Hills, Hyderabad
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]]>The post Fertility and Infertility appeared first on Dr. Sharmila Majumdar - Sexologist Psychoanalyst in Hyderabad.
]]>About one in nine couples experience fertility difficulties. There are many reasons for this, some relating to the male partner and some to the female partner. If you suspect an infertility problem , talk to your Sexologist, infertility specialist who will guide you through the steps of an infertility investigation.
For people who have been diagnosed with cancer, fertility preservation is an important consideration if there is a chance that their cancer treatment may affect their fertility. Increasingly, fertility preservation is now also being used for non-medical purposes. Egg freezing for social reasons has seen a rise in demand in recent years.
Most people take their fertility for granted and do not expect to have problems conceiving. However, one in nine couples experience fertility difficulties.
If you have been trying to conceive for a year or more, it is time to seek medical advice. If you are over 35, you should see a doctor if you have been trying to conceive for six months or more.
The first point of contact should be your general practitioner (GP) who will start an infertility investigation. This involves a detailed medical history and a physical examination of both partners and some basic tests to make sure that the woman is ovulating and that the man produces sperm. If everything seems in order, your GP may advise you to keep trying for a little longer before consulting a fertility specialist. However, if your test results indicate a problem, your doctor will refer you to a fertility specialist without delay. The fertility specialist will do more tests to establish the cause of infertility and determine the type of treatment you may need.
There are many reasons why pregnancy does not occur. About one-third of infertility cases are due to male factors and one-third due to female factors. Sometimes both partners have a fertility problem. In about 20 per cent of cases, there is no apparent cause of infertility, so-called unexplained or idiopathic infertility. As more couples delay childbearing age-related infertility is becoming more common.
A diagnosis of infertility often comes as a shock. It is unexpected and unwelcome and emotionally challenging. Unlike other adverse life events, which may have a clear resolution, infertility is uniquely distressing because it can last for many years and the outcome is uncertain. Some people find it helpful to discuss their feelings with a psychologist or counsellor. Others feel better if they take action by starting treatment.
Once the cause of infertility has been pin-pointed, your doctor will discuss treatment options with you. These will vary depending on the cause of infertility but will most likely involve some form of assisted reproductive treatment. You need a referral from your GP to see a fertility specialist. Your GP may recommend a fertility specialist, unless you have a preference for a particular ART clinics or individual fertility specialist.
The chance of ART treatment working has greatly improved since the late seventies when the first IVF baby was born. Although your chance of having a baby with ART depends largely on factors that are beyond your control, there are some things that you can do to improve the odds. The lifestyle factors that influence the chance of natural conception for both men and women also affect your chance of ART success.
It is useful to understand how eggs and sperm are normally formed, and how conception occurs to understand the causes of infertility and how they are targeted in ART.
The hormones which control the production of sperm and eggs are called gonadotropins. There are two types of gonadotropins: follicle-stimulating hormone (FSA) and luteinising hormone (LH). In men, they stimulate the testicles to produce sperm and testosterone. In women, they act on the ovaries, where the eggs develop. The female sex hormones, oestrogen and progesterone, are produced by the ovaries when eggs mature and are released (ovulation).
The production of sex hormones and the release of an egg is known as the menstrual cycle. It is counted from the first day of the period until the day before the start of the next period. In an average cycle of 28 days, ovulation happens on day 14. However, and it is important to note that, ovulation occurs earlier in women with shorter cycles and later in women with longer cycles.
Sperm are produced at the rate of about 300 million per day. They take some 80 days to mature. Each sperm has a head, which contains the genetic material, and a tail, which propels it up through the vagina, uterus, and Fallopian tubes where the conception occurs when an egg and a sperm come together. At ovulation, an egg is released from the ovary into the fallopian tube. If sperm is present at that time, the egg can be fertilised. The fertilised egg then starts to divide and becomes an embryo. After ovulation, the ovary produces progesterone which prepares the lining of the uterus – the endometrium – for the growing embryo. If an embryo does not form or attach to the endometrium (implantation), the level of progesterone drops and the next period starts.
A few days after implantation, the embryo starts to produce Human Chorionic Gonadotropins (HCG) – the hormone that gives a positive pregnancy test reading.
Dr. Sharmila Majumdar
Chief Consultant Sexologist
Sexual and Mental Health Clinic
Avis Hospital, Jubilee hills
Next to Chiranjivee Blood Bank
Hyderabad 500033
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]]>Among the male factor infertility, erectile dysfunction was found to be the top ranking cause accounting for 79.37% followed by premature ejaculation 12.01%, lack of sexual desire 3.92%, homosexual orientation 2.79%, sexual aversion disorder 1.31% and disorders of sexual preference 0.61%.
Vaginismus is believed to be a psycho-physiologic disorder due to fear from actual or imagined negative experiences with penetration and/or organic pathology. Women with vaginismus have also been noted to have a lack of sex education. Vaginismus was 63.9% , ED 11.9% , PME 8.3% , low male sexual desire 2.7%, low sexual desire in female 13.9% among the female infertility causes. The underlying unconsummated marriage which is a cause of infertility is largely treatable. Adaptation to the situation usually occurs and associated factors add to the primary cause. Treatment of the underlying dysfunction can challenge the relationship.
Sexual dysfunction is a common problem which leads to inter-personal problems and marital discord. defined as recurrent or persistent involuntary spasm of the with coitus and causes distress and interpersonal difficulty.
Treating vaginismus merits a two-front approach which includes behavioral sex therapy techniques and relational intervention. When appropriate, the behavioral intervention consists of prescribing dilators (from smallest to largest) that the wife is to use in the privacy of her own home to gradually desensitize herself to penetration (the fourth and usually largest dilator is roughly the size of a penis). While the husband may be called upon to help his wife insert the dilators (depending on his wife’s comfort level), for the most part his job is to ease off the pressure for her to perform, be supportive, and try to understand his role in the marital dynamic (usually an enabling one) and the associated symptom.
Ascribing to a psychodynamic model of treatment, is helpful for a couple to understand where their symptom came from, but I’ll admit this is not always necessary for them to achieve a positive outcome. Nevertheless, employing the psychodynamic systems approach to uncover any conflicts that might be behind or exacerbating the vaginismus. These underlying causes may include prior sexual abuse, chronic control struggles experienced in the family of origin, negative messages or beliefs about sex emanating from the family of origin, religious values that conflict with sexual pleasure, to name a few. I also pay close attention to the couple’s interactional style in order to assess whether it, too, is a contributing factor.
Both [primary and secondary conditions] are psychologically based. It’s a physical condition, but it’s a psychological condition as well. To treat it correctly, you need to treat both the physical and psychological aspects.
While there are many hypotheses on possible causes, its actual etiology is unknown, probably in part due to the fact sufferers are so reluctant to come forward. It’s a really complex thing, and while it is influenced by many things – there are lots of hypotheses – the big link, for primary vaginismus anyway, seems to be strong correlation between being raised in a religious environment. This may be due to several factors including lack of information, insufficient premarital education, a cultural context strongly proscribing sexual behavior, and the expectation that intercourse take place immediately after the wedding, necessitating a radical shift from sexual abstinence to sexual intercourse.
Often the anxiety resulting from repeated attempts at intercourse contributes to the sexual dysfunction. One or both partners may be anxious that penetration will be painful, that there will be bleeding, or that the woman will get pregnant. While a certain amount of anxiety surrounding sexual activity is normal, when one or both partners are overly anxious, sexual function can be affected in the following ways: The male partner may have difficulty maintaining an erection strong enough to allow penetration or he may lose his erection just prior to intercourse. Anxiety may contribute to premature ejaculation, also just prior to reaching penetration. Anxiety may prevent the woman from relaxing enough to allow penetration. She may close her legs or contract her vaginal muscles. This presentation is referred to as vaginismus, defined as the persistent or recurrent difficulty of a woman to allow vaginal entry of a penis, a finger, and/or any object, despite her expressed wish to do so. While anxiety may indeed be a factor contributing to and perpetuating many sexual problems, there are many components to sexual problems, including physiological ones. Therefore, each partner in a couple presenting with an unconsummated marriage should undergo a physical exam.
Physical presentations of the female partner that might prevent intercourse can include sexual pain disorders such as localized vulvodynia, also known as vulvar vestibulitis syndrome. This fairly common condition is characterized by pain with touch at the entry to the vagina, which can prevent intercourse. A woman’s hymen may be a barrier to intercourse. Some women have a very thick hymen, or a septate hymen, which is a thin piece of membrane running vertically which separates the vagina in to two sides. While most of these conditions can be addressed with sexual counseling and physical therapy, including use of vaginal dilators, in most cases a septate hymen needs to be repaired surgically.
Frequently, lack of knowledge about sexual anatomy and physiology may contribute to a situation whereby attempting intercourse feels awkward and un-natural. Often all that is needed is some basic anatomical information and positioning advice. For example, a couple may report that the woman’s vagina feels dry and excess friction prevents intercourse. In this case, the couple may be advised to ensure that intercourse take place when the woman is sufficiently aroused after plenty of exciting foreplay. Over the counter lubricants may be very helpful. While some people are physically active, very aware of their bodies, and comfortable with movement, other people are less so and may simply have not figured out how their bodies move in order to comfortably find a position for intercourse. One or both of the partners may have mobility problems or difficulty getting in to or maintaining a position. A woman may have difficulty keeping her legs open or a man may not be able to hold his weight up on his arms. In these cases as well, consultation with a physical therapist may be helpful in providing exercises and positioning advice.
While behavioral solutions may be found for many couples, it is important to note that couples in unconsummated relationships, particularly of long standing duration, may benefit from couples therapy directed by a competent Sexologist. A doctor working with such a couple may wish to gain understanding in how the couple presents and organizes around the problem: How is the presenting problem perceived by each partner? Is there attribution of blame? What is the significance of the dysfunction itself and how is that perceived by the couple? Who is aware of this situation and in what way is outside intervention (community, parents, and religious leader) perceived in assisting or perpetuating this condition? Identifying the various factors contributing to the condition and dealing with them with physical, psychosexual, and couples therapy, may be the key to consummation and the commencement of a satisfying intimate life.
Women don’t talk about it. They learn to live with it. I’ve seen cases where women have been married or in relationship for up to 12 years and only present themselves to the sexologist or a doctor when they want to have children. So we are talking about people who are raised in conservative faith, who may not have looked at their anatomy in the mirror. They haven’t touched themselves, they haven’t looked at themselves – they may view the entire thing as being dirty. In terms of the secondary form, this is a result of some kind of trauma or sexual issue, and can be triggered by something later on.
Most women who experience vaginismus choose to live with it rather than come forward and have it treated. Even those in long-term relationships may try to conceal what is happening from their partner or forgo sexual relations all together. If they don’t do that, they cut that part of intimacy out of their relationship altogether and choose to shut down any intimate feelings they might have. They end up having a very different kind of relationship. What is important to say is there is a cure and they can be helped. That’s the message that needs to get out there. Treatment for vaginismus have included systematic desensitization along with insertion of graded dilators/fingers, drugs like anxiolytics, botulinum toxin injection, and sex therapy. And in the Indian scenario where the talk about sex is taboo and limited among partners it becomes very essential to first improve their communication so as to improve the sex related issues. eclectic approach involving education, graded insertion of fingers, Kegel’s exercises and usage of anaesthesia with vaginal containment was tried.
The best approach in terms of a cure is to seek both psychological and physical treatment. For the psychological side of things, it is recommended to seek out a competent female sexologist. Physically, many women are taught how to use vaginal dilators in conjunction with relaxation techniques.
With vaginal dilators, basically how they work is you start off very very small, and then, using relaxation techniques, slowly work your way up in terms of size. It’s imperative these women have a gentle introduction and remember they are in control of the situation. There is also something called saturation therapy which is often undertaken with their partner. Using dilators, they are able to discuss their mental state and what their thoughts are at any stage. There has actually been incredible results with that. Something like 90 percent of participants report sexual success afterward. there has been some preliminary research done into the effectiveness of Botox, but states at this stage, the research is still too new to offer any kind of conclusive evidence.
If you think you or your partner might have vaginismus, it’s extremely important to understand treatment is available, and, better yet, comes with a high level of success rates. The first step is to see a competent female sexologist. It is one of those things that, when it presents, it is pretty obvious it is on a psychological basis. A sexologist may double-check everything is okay, but typically what they will find is anatomically they are fine and everything is in order and working – the cause stems from a psychological basis.
“The big thing about it is it’s treatable, and it is possible to lead a really fulfilled life. Don’t suffer in silence. We can definitely help. We see this, deal with it, and we have success with it.” – at our Sexual & Mental Health Clinic, Avis Hospital in Hyderabad.
It’s time for the unconsummated marriages to come of the the closet and treat their condition for a satisfactory married life and have healthy children subsequently.
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]]>Sperm problems will contribute to about 40% of infertility cases. The normal working of the male reproductive system involves first the production of sufficient numbers of functional sperm cells and then the delivery of these sperms to the ejaculate. Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form.
Dysfunction of the female reproductive organs is also apparent in around 40% of infertile couples. The most common identifiable causes of female fertility problems are outlined below:
Ovulatory dysfunction (or anovulation) where an egg is not released from the ovary every month, is the single most common cause of female infertility. Predominantly anovulation is caused by hormonal imbalances such as Polycystic Ovarian Syndrome (PCOS) but ovarian scarring and premature menopause can also result in failure to ovulate.
Tubal disease comprising anything from mild adhesions to complete blockage of the fallopian tubes, prevents fertilized eggs from travelling from the site of fertilization to the uterus. It may also prevent the sperm from reaching the egg. Normal uterine implantation can therefore not occur. The main causes of tubal infertility are pelvic infections caused by bacteria such as chlamydia, previous abdominal disease or surgery and ectopic pregnancy.
Endometriosis is characterized by excessive growth of the lining of the uterus. These endometrial cells can extend as far as the outside of the fallopian tubes, the ovaries and the bladder. As they respond to hormones the same way as they would do in the uterus, that is by growing and shedding cyclically, endometriosis can cause both fallopian tube and ovarian scarring.
Some people may not have difficulty conceiving, but have suffered from miscarriages. This is obviously extremely distressing for the couples involved. Our miscarriage clinic can help investigate these issues and attempt to help couples with any future pregnancy.
The following other factors may also be responsible for infertility in a smaller proportion of cases:
Please do consult a competent sexologist for unexplained infertility problems. Dr. Sharmila Majumdar also sees patients suffering from unexplained Infertility at our ‘Sexual & Mental Health Clinic’, Avis Hospital in Jubilee Hills, Hyderabad.
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]]>Let’s take a look at a few of them:
Pleasuring yourself is the ultimate form of safe sex. There is no way for you to catch an STD – sexually transmitted disease, or for it to cause any sort of mental health problem. The only risks involved are allergic reactions to lubricants or toys and a feeling of guilt or shame due to societal pressure. It lowers the chances of you having an orgasm during sex.
Single people as well as people in committed relationships masturbate. While it can lead to problems in a relationship depending on your partner’s views about it, it does not amount to cheating on him or her.
Pleasuring yourself does not reduce your chances of getting pregnant or getting someone else pregnant. However, for men with a low sperm count, restricting ejaculations while trying to get their partner pregnant is a good idea. The only way it could be a problem is if partners who share sex toys do not keep them clean and pass on STDs through them.
Erectile dysfunction has a number of psychological and biological causes, such as heart disease, stress and obesity but masturbation is not one of them. Eating certain foods can help control the urge to masturbate.
Touching your genitals is very unlikely to damage them. The sex organs are designed to withstand friction and hence are very tough organs. The maximum damage that can be caused by masturbation is a little chafing. Using lubricant can prevent this from occurring.
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]]>Today, there are approximately 30 STIs. A few can be fatal. Many women are living in fear of what their future may hold as a result of STD infection. It is estimated that 1 in 5 Indians between the ages of 15 and 55 are currently infected with one or more STDs, and 19 million Indians are newly infected out of which 63% are in people less than 25 years.
This epidemic is a recent phenomenon. However, most of these diseases were not around 20 to 30 years ago. Prior to 1960, there were only two significant sexually transmitted diseases: syphilis and gonorrhea. Both were easily treatable with antibiotics. In the sixties and seventies this relatively stable situation began to change. For example, in 1976, chlamydia first appeared in increasing numbers in India. Chlamydia, particularly dangerous to women, is now the most common STD in the country. Then in 1981, human immunodeficiency virus (HIV), the virus which causes AIDS, was identified. By early 1993, between 4 and 5 million Indians were infected with AIDS, over 12 million were infected worldwide, and over 160,000 had died in India alone. Over 10% of the total Indian population, 30 million people, are infected with herpes.
In 1985, human papillomavirus (HPV), began to increase. This virus results in venereal warts and often leads to deadly cancers. In 1990, penicillin resistant-strains of gonorrhea were present in all fifty states.
By 1992 syphilis was at a 40-year high. As of 1993, pelvic inflammatory disease (PIV), which is almost always caused by gonorrhea or chlamydia, was affecting 1 million new women each year. This includes 16,000 to 20,000 teenagers. This complication causes pelvic pain and infertility and is the leading cause of hospitalization for women, apart from pregnancy, during the childbearing years.
Pelvic inflammatory disease can result in scarred fallopian tubes which block the passage of a fertilized egg. The fertilized egg, therefore, cannot pass on to the uterus and the growing embryo causes the tube to rupture. By 1990, there was a 400% increase in tubal pregnancies, most of which were caused by STDs. Even worse is the fact that 80% of those infected with an STD don’t know it and will unwittingly infect their next sexual partner.
Syphilis is a terrible infection. In its first stage, the infected individual may be lulled into thinking there is little wrong since the small sore will disappear in 2 to 8 weeks. The second and third stages are progressively worse and can eventually lead to brain, heart, and blood vessel damage if not diagnosed and treated.
Chlamydia, a disease which only became common in the mid-1970s, infects 20 to 40% of some sexually active groups including teenagers. In men, chlamydia is usually less serious; with females, however, the infection can be devastating. An acute chlamydia infection in women results in pain, fever, and damage to female organs. A silent infection can damage a woman’s fallopian tubes without her ever knowing it. A single chlamydia infection can result in a 25% chance of infertility. With a second infection, the chance of infertility rises to 50%. This is double the risk of gonorrhea.
The human papillomavirus, or HPV, is extremely common and rapidly growing. 46% of the sexually active coeds were infected with HPV. Another study reported that 38% of the sexually active females between the ages of 15 and 21 were infected. HPV is the major cause of venereal warts; it can be an extremely difficult problem to treat and may require expensive procedures such as laser surgery.
The human papillomavirus can result in precancerous condition or cancer of the genitalia. By causing cancer of the cervix, this virus is killing more women in this country than AIDS, or over 6,600 women in 1991. HPV can also result in painful intercourse for years after infection even though other visible signs of disease have disappeared.
And of course there is the human immunodeficiency virus, or HIV, the virus that causes AIDS. The first few cases of AIDS were only discovered in 1981.
While the progress of the disease is slow for many people, all who have the virus will be infected for the rest of their life. There is no cure, and many researchers are beginning to despair of ever coming up with a cure or even a vaccine (as was eventually done with polio). In 1992, 1 in 75 men was infected with HIV and 1 in 700 women. But the number of women with AIDS is growing. In the early years of the epidemic less than 2% of the AIDS cases were women. Now the percentage is 22%
Teenagers are particularly susceptible to sexually transmitted diseases or STDs. This fact is alarming since more teens are sexually active today than ever before. An entire generation is at risk and the saddest part about it is that most of them are unaware of the dangers they face. We must give our teenagers the correct information to help them realize that saving themselves sexually until marriage is the only way to stay healthy.
The medical reasons for teens’ high susceptibility to STDs specifically relates to females. The cervix of a teenage girl has a lining which produces mucus that is a great growth medium for viruses and bacteria. As a girl reaches her 20s or has a baby, this lining is replaced with a tougher, more resistant lining. Also during the first two years of menstruation, 50% of the periods occur without ovulation. This will produce a more liquid mucus which also grows bacteria and viruses very well. A 15-year-old girl has a 1-in-8 chance of developing pelvic inflammatory disease simply by having sex, whereas a 24-year-old woman has only a 1- in-80 chance in that situation.
Teenagers do not always respond to antibiotic treatment for pelvic inflammatory disease, and occasionally such teenage girls require a hysterectomy. Teenage infertility is also an increasing problem. In 1965, only 3.6% of the married couples between ages 20 and 24 were infertile; by 1982, that figure had nearly tripled to 10.6%. The infertility rate is surely higher than that now with the alarming spread of chlamydia.
Teenagers are also more susceptible to human papillomavirus, HPV. Rates of HPV infection in teenagers can be as high as 40%, whereas in the adult population, the rate is less than 25%. Teenagers are also more likely than adults to develop precancerous growths as a result of HPV infection, and they are more likely to develop pelvic inflammatory disease.
Apart from the increased risk from STDs in teens, teenage pregnancy is also at unprecedented levels, over 1 million pregnancies, and 400,000 abortions in 1985. Abortion is not a healthy procedure for anyone to undergo, especially a teenager. It is far better to not get pregnant. Oral contraceptives are not as effective with teenagers, mainly because teens are more apt to forget to take the pill. Over a one-year period, as many as 9 to 18% of teenage girls using oral contraceptives become pregnant.
Our teenagers are at great risk. In a society that has abandoned God’s design for healthy meaningful sexual expression within marriage, our children need to be told the truth about the dangers of STDs.
We must now take a hard look at the message of “safe sex” which is being taught to teens through the media across the country. Some people believe that if teens can be taught how to use contraception and condoms effectively, that rates of pregnancy and STD infection will be reduced dramatically. It is significant to note that condoms, the hero of the “safe sex” message, provided virtually no protection from STDs.
Will condoms prevent HIV infection, the virus that causes AIDS? While it is better than nothing, the bottom line is that condoms cannot be trusted.
Condoms do not even provide 100% protection for the purpose for which they were designed: prevention of pregnancy. One study from the School of Medicine Family Planning clinic reported that 25% of patients using condoms as birth control conceived over a one-year period. Other studies indicate that the rate of accidental pregnancy from condom-protected intercourse is around 15% with married couples and 36% for unmarried couples.
Condoms are inherently untrustworthy. The FDA allows one in 250 to be defective. Condoms are often stored and shipped at unsafe temperatures which weakens the integrity of the latex rubber causing breaks and ruptures. Condoms break 8% of the time and slip off 7% of the time. There are just so many pitfalls in condom use that you just can’t expect immature teenagers to use them properly. And even if they do, they are still at risk. In addition, programs that emphasize condoms tend to give a false sense of security to sexually active students and make those students who are not having sex feel abnormal. Hardly the desired result!
The list of damages from unmarried adolescent sexual activity is long indeed. Apart from the threat to physical health and fertility, there is damage to family relationships, self-confidence and emotional health, spiritual health, and future economic opportunities due to unplanned pregnancy. Condom-based sex-education does not work.
Diseases such as chlamydia, human papillomavirus, herpes, hepatitis B, trichomoniasis, pelvic inflammatory disease, and AIDS have joined syphilis and gonorrhea in just the last 30 years. There is no question that the fruits of the sexual revolution have been devastating. I have also shown how our teenagers are at a greater risk for sexually transmitted diseases than are adults and that sex-education based on condom use is ineffective and misleading. There is only one message that offers health, hope, and joy to today’s teenagers. We need to teach single people to save intercourse for marriage.
Sex is a wonderful gift, but if uncontrolled, has a great capacity for evil as well as good. Our bodies are not made to have multiple sex partners. We can avoid almost all risk of STD and out of wedlock pregnancy by saving intercourse for marriage.
Delaying intercourse until teens are older is not a naive proposal. Over 50% of the females and 40% of the males ages 15 to 19 have not had intercourse. While not a majority, they are living proof that teens can control their sexual desires. Current condom-based sex-education programs basically teach teenagers that they cannot control their sexual desires, and that they must use condoms to protect themselves. It is not a big leap from teenagers being unable to control their sexual desires to being unable to control their hate, greed, anger, and prejudice. This is not the right message for our teenagers! Teenagers discipline themselves for things they want, desire and are convinced about. We can discipline our teens in their sexual lives if they have the right information to make logical choices.
Saving sex for marriage is the common sense solution. In fact, it is the only solution. We don’t hesitate to tell our kids not to use drugs, and most don’t. We tell our kids it’s unhealthy to smoke, and most do not.
It is normal and healthy not to have sex until marriage. Sexually transmitted diseases are so common that it is not an exaggeration to say that most people who regularly have sex outside of marriage will contract a sexually transmitted disease. Not only is saving sex for marriage the only real hope for sexual health, it is God’s design. God has said that our sexuality is to blossom within the confines of a mutually faithful monogamous relationship. What we are seeing today is the natural consequence of disobedience. We need to re-educate our kids not just in what is best, but in what is right; and abstinence is right.
Dr. Sharmila Majumdar
Sr. Consultant Sexologist & Psychoanalyst
MS Sexuality, M.Phil Clinical Psychology, PhD Cognitive Behavior Modification
Certified from Mount Sinai School of Medicine, New York, USA.
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