Sexuality

Are you ready to have sex??

It seems that for many people it is easier to have sex than it is to talk about sex. Because of the extreme degree of intimacy that having sex produces, it is important to be prepared for the consequences of a sexual relationship.

Ask yourself these questions. They may help you decide. If you're still unsure, find a friend who has had a healthy relationship and to whom you can freely talk.

*Do I really want to have intercourse or any other type of sexual activity?

*Am I being pressured to have sex?

*Do I know ways of expressing my feelings without engaging in sexual intercourse?

*Is there anything about my partner that I mistrust or disrespect?

*How will I feel about myself & my partner after having sex?

*Will I lose my partner if I don't have sex with him/her?

*Am I having sex to prove something to myself, my partner, or friends?

*Do I care enough about my partner to become involved in a sexual relationship?

*Have I thought about methods of contraception, decided which is best for me and discussed it with my partner?

*Have I thought about protection for STDs, decided on a method and discussed it with my partner?

*Do I know how my partner feels about entering into a sexual relationship?

*Do I feel comfortable with my beliefs & values associated with sexual activity?

*How much of a commitment does a sexual relationship mean to me? What does it mean to my partner?

*Is my current relationship emotionally intimate and open?

*Can I tell my partner if I'm scared or if something hurts?

*Will I feel comfortable being naked with my partner, touching his/her body, and allowing him/her to touch me?

Sexually Transmitted Diseases (STD's)

Facts: STD's are the most common communicable disease of young people (5-10 million persons under age 25 infected per year in the U.S.).

STD's can lead to serious health problems such as sterility, heart disease, arthritis, nervous system damage, harm to fetus/baby.

Common STD's

CHLAMYDIA

• Female symptoms: inflammation of the cervix
• Male symptoms: infection of urethra (mucous discharge from penis, pain with urination)
• Symptoms appear 1-5 weeks after contact
• Symptoms similar to mild gonorrhea
• May have no sign or symptoms of infection
• Diagnosis only through chlamydia test
• Long term effects: PID, arthritis, eye infection, newborns subject to eye infection, pneumonia, death
• Treatment: antibiotics
• 4,000,000 new cases annually

GONORRHEA

• Symptoms may appear in 2-8 days
• Sometimes no symptoms present
• Female symptoms: burning or painful urination, pus-like discharge, stomach pain, fever
• Male symptoms: white discharge, painful/burning urination, itching, burning
• Long term effects: heart disease, arthritis, sterility, blindness, can be passed to infant in birth-resulting in blindness, thus all babies treated at birth with eye drops
• Treatment: antibiotics
• 3,000,000 new cases per year

PELVIC INFLAMMATORY DISEASE (PID)

• Symptoms: stomach pain, tenderness, fever, chills, elevated white blood cell count, pain with intercourse, vaginal discharge
• Often caused by chlamydia or gonorrhea
• Long term effects: sterility, pelvic abscess, chronic infections, early hysterectomy, depression, ectopic pregnancy
• Treatment: antibiotics, sometimes hospitalization
• 225,000 hositalized per year in the U.S.
• 1,000,000 new cases per year

GENITAL HERPES

• Virus for which there is NO CURE
• Symptoms: blister like sore or sores on, in, or around genitals or anus. Symptoms come and go.
• Long term effects: severe damage to newborns, depression, emotional problems
• Herpes 1 can mutate to Herpes 2 under certain conditions
• Can get Herpes 1 on genitals and Herpes 2 on mouth
• 500,000 persons affected annually
• Estimated that 30,000,000 are infected in U.S., many with no symptoms at present time

CRABS/PUBIC LICE

• Symptoms: itching, discomfort, nits or adult lice clinging to pubic hair
• Treatment: prescription or over the counter shampoos or lotions
• Common among college students
• Can be easily transmitted as the lice can live on towels or warm, moist places

SYPHILIS

• Symptoms: appear 10 to 90 days after contact, canker sores which may develop into rash, sore throat, swollen glands
• Long term effects: can affect heart, spine and brain, severe threat to fetus, can also cause crippling
• Treatment: antibiotics
• 100,000 new cases per year, most on college campuses

GENITAL WARTS (Human Papillomavirus Virus)

• A highly contagious virus for which there is NO CURE but there is a vaccination called Gardasil recommended for girls ages 9 years to 26 years old.
• Symptoms: warts in, on or around the genital or anal area, can grow very large, but usually are small and flat
• Treatment: wart removal compound, surgically removed, burned off, frozen, laser removal, etc., but frequently they grow back in 6-9 months
• Long term effects: linked to development of genital cancers in both males and females
• 3,000,000 HPV cases diagnosed per year

HEPATITIS B

• Symptoms: loss of appetite, fever, fatigue, jaundice, pain in liver area, may have no symptoms
• Long term effects: cancer of liver, even death, and transmitted to new born
• No specific treatment exists
• Vaccine is available.  Consider the combination Hepatitis A & B injection which is available at the Student Health Center.
• 200,000 new cases annually

Why are STD's so prevalent in spite of medical technology?

• Embarrassment, fear and guilt prevent diagnosis & treatment
• No symptoms or disappearing symptoms
• Doctors do not routinely check for STD's
• Increased use of birth control pills
• Lack of information and knowledge

Are women on the pill more susceptible to STD's?

Wome on the pill are more susceptible to STD's or yeast infections because the pill changes the level of PH in the vagina. Precautions: wash hands, wear cotton underwear, don't wear tight underwear, don't douche, don't leave anything in vagina over 24 hours, change tampons frequently.

Who is at risk?

Anyone sexually active with another person, especially persons having sex with multiple partners!

STD action steps:

1. Stop having sex
2. Go to doctor, STD clinic, or health center
3. Make sure partner is treated (This step is essential because of serious health problems, reinfection and spreading of STD's to others).

Prevention:

• Discuss sexual history
• Be responsible for YOURSELF
• Abstain from sexual intercourse
• Wear a latex condom with spermicide every time
• Combine latex condom, spermicide and diaphragm for double protection

For more information on STD's please feel free to call Student Health Promotion at 237-3933.

METHODS OF CONTRACEPTION

BIRTH CONTROL PILLS

• Block egg production
• .5% failure rate

  Advantages:

  • Easy to use
  • Does not interrupt sex
  • More regular periods
  • Lowers chances of cancers

  Disadvantages:

  • Does not protect against STD's
  • Can interact with other drugs (use backup method)
  • Women must remember to take it everyday

  Side Effects:

  • Nausea
  • Bloating
  • Weight gain
  • Spotting
  • Mood swings
  • Vaginal infections

  Serious Complications:

  • Blood clots
  • Liver tumors
  • Heart attacks
  • Strokes
  • High blood pressure
  • WOMEN ON THE PILL SHOULD NOT SMOKE!

DEPO-PROVERA

• Failure rate: .3%
• Deep intramuscular injection of 150 mg of DMPA, given every 3 months
• Cost: averages about $ 65 for three months or $260 per year (plus exam fees, etc.)

  Advantages:

  • 2 week grace period
  • Very effective
  • Long term contraception
  • Low risk of ectopic pregnancy
  • May use without partner knowing about it
  • Fewer seizures

  Disadvantages:

  • Return of fertility slow
  • Menstrual cycle disturbance
  • Weight gain
  • Breast tenderness
  • Bone density decreases
  • Depression
  • Depression, weight gain, breast tenderness and menstrual disturbances may continue for 6-8 months after discontinuation

DIAPHRAGM

• 94% effective
• There are a variety of sizes available.
• Must be used every time you have sex (and fresh spermicide must be applied each time).
• The diaphragm can be inserted 6 to 8 hours before sex

CERVICAL CAP

• 84% effective in women who have had a child (91% in those who have not).
• There are a variety of sizes available.
• Must be used every time you have sex (and fresh spermicide must be applied when inserted).
• The cervical cap provides continuous protection for up to 48 hours.

CONDOM

• Latex barrier placed over male's penis
• 12% failure rate w/ typical use; 3% failure rate w/ perfect use
• Nonoxynol 9 spermicide recommended as it kills HIV/STD's

  Advantages:

  • Protection against STD's
  • Does not affect future pregnancy

  Disadvantages:

  • Condoms can break or be damaged if not used properly
  • Some persons have allergic reactions to latex or spermicide
  • Some men report lack of sensation
  • Disrupts intercourse (before & after)
  • Must be used correctly and consistently

FEMALE CONDOM

• Soft, loose fitting polyurethane sheath, shaped like a tube, which fits in vagina, much like a diaphragm, with rings at both ends
• One ring is inserted into vagina over cervix, while other ring fits outside of vagina
• Failure rate: 21% typical use; 5% perfect use.

  Advantages:

  • Does not interfere with future pregnancies
  • Offers some protection against STD's

  Disadvantages:

  • Some men say they can feel it and it is an unpleasant sensation
  • Some women may be allergic to the material

SPERMICIDE

• Foams, suppositories, jellies, creams, and films
• Inserted right before intercours--kills sperm
• Effective for very short time, so must be inserted right before intercourse
• 21% failure w/ typical use; 6% failure w/ perfect use

  Advantages:

  • With condom, can provide protection against STD's
  • Does not interfere with future pregnancy

  Disadvantages:

  • Interrupts sex
  • Can be messy
  • Some persons may have allergic reactions
  • Some women do not want to have to touch their genitals

Intrauterine Device (IUD)

Cost: family planning clinic: $200-$300, higher in private practice

• Experts think IUD works by preventing fertilized egg from attaching to the lining of the uterus
• Failure rate: .1 to 2.0 typical use; .1 to 1.5 perfect use

  Advantages:

  • Does not interrupt sex as IUD is always in place
  • Long term contraceptive
  • Can stay in place for 1-5 years
  • Easy to use method

  Disadvantages:

  • May be dislodged
  • Could puncture uterus
  • May be expelled
  • Must be inserted by a Physician
  • Can cause possible: discomfort, bleeding, and cramps
  • Can lead to PID, tubal pregnancy, or infertility
  • No protection from STD's
  • Possible risk of HIV (may create environment favorable for HIV)
  • Pregnancy complications
    • In general, recommended for women who have had children

RHYTHM

• Female charts menstrual cycle to learn when she's fertile, then avoids intercourse on the fertile days
• Charting is done by using calendar, temperature, and mucous methods
• Failure rate is 2% to 25% (according to Stanford University report).

  Advantages:

  • No side effects
  • No interference with future pregnancies
  • Acceptable to some religions

  Disadvantages:

  • High failure risk due to stress, fever, vaginal discharges, and irregular periods making charting difficult
  • No protection against STD's
  • Professional instructions required

Ortho Evra ("The Patch")

• "The Patch"  is a once-a-week birth control option that's as effective as the Pill. It is the first weekly, non-invasive form of reversible contraception that's 99 percent effective when used correctly. One of the newer ways to help you get the medicine you need is this transdermal - or "through the skin" - patch. The ORTHO EVRA birth control patch delivers hormones directly through your skin and into your bloodstream. This may help eliminate some of the disadvantages associated with other birth control methods
• The contraceptive patch contains hormones similar to those in birth control pills. Hormonal contraceptives are not for everybody. Most side effects of the contraceptive patch are not serious and those that are, occur infrequently. Serious risks, which can be life threatening, include blood clots, stroke or heart attacks and are increased if you smoke cigarettes. Cigarette smoking increases the risk of serious cardiovascular side effects, especially if you are over 35. Women who use hormonal contraceptives are strongly advised not to smoke. Some women should not use the contraceptive patch, including women who have blood clots, certain cancers, a history of heart attack or stroke, as well as those who are or may be pregnant. The contraceptive patch does not protect against HIV or other sexually transmitted diseases.
   

Vaginal Ring

• A Vaginal Ring is a thin, transparent, flexible ring that you insert into the vagina yourself to provide contraception protection. Leaving the Vaginal Ring in for 3 weeks, it slowly releases estrogen and progestin hormones into the body. These hormones stop ovulation and thicken the cervical mucus, creating a barrier to prevent sperm from fertilizing an egg. Worn continuously for three weeks followed by a week off, each Vaginal Ring provides one month of birth control. The Vaginal Ring is 98-99% effective as birth control. It does not protect against reproductive tract infections, including HIV/AIDS.
• Advantages
  • Easy to use.
  • Can be worn for three weeks.
  • Effects fertility one month at a time.
  • Does not interrupt sex play.
• Disadvantages
  • Does not protect against sexually transmitted infections, including HIV/AIDS.
  • Raised risk of heart attack and stroke.
  • Requires a prescription.

   

Look at:

• health risks
• cost
• frequency of intercourse
• effectiveness
• affects on future pregnancy
• prevention of STD's
• interruption of intercourse
• is method easy to use
• is method easy to remember
• do you need partner's cooperation
• is method embarrassing to either partner
• does method make periods more difficult
• does method cause you to enjoy sex less

• Women can get pregnant right after stopping the pill.
• Withdrawal is not a form of Birth Control.
• Douching is NOT a form of Birth Control--it can actually push sperm toward uterus.
• Women can get pregnant without having an orgasm.
• Women can get pregnant while standing up during sex.
• Women can get pregnant during their period.
• Women can get pregnant while breastfeeding.

• Discuss contraceptive methods BEFORE having sex!
• Listen--ask questions!
• Be honest and open about beliefs, feelings, etc. (If something grosses you out, SAY SO!!!)

For further information, contact the Student Health Center at 812-237-3883 to schedule a consultation.

Other resources www.indstate.edu/shp/resources.htm