Sexual and Relationship Health

1. Sexual and Relationship Health Donna Vandergrift Associate Professor, Psychology

2. Today • Sexual Health from a different perspective. • It is clear that knowledge and confidence in communication empowers women to make better choices related to their sexual and relationship health. • It is my goal, then, to empower you with knowledge.

3. What is Sexual Health? • Sexual health is a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled. • World Health Organization (2002)

4. What is Sexual Health? • Sexual health is defined as an approach to sexuality founded in accurate knowledge, personal awareness, and self-acceptance, where one’s behavior, values and emotions are congruent and integrated within a person’s wider personality structure and self-definition. Sexual health involves an ability to be intimate with a partner, to communicate explicitly about sexual needs and desires, to be sexually functional (to have desire, become aroused, and obtain sexual fulfillment), to act intentionally and responsibly, and to set appropriate sexual boundaries. Sexual health has a communal aspect, reflecting not only self-acceptance and respect, but also respect and appreciation for individual differences and diversity, and a feeling of belonging to and involvement in one’s sexual culture(s). Sexual health includes a sense of self-esteem, personal attractiveness and competence, as well as freedom from sexual dysfunction, sexually transmitted diseases and sexual assault/coercion. Sexual health affirms sexuality as a positive force, enhancing other dimensions of one’s life. Robinson et al. (2002)

5. Knowledge • When trying to understand human sexuality, scientists look for evidence in many different areas. • Evolution • Chemical and Biological • Sociocultural • Psychological

6. Why do we have sex? • Procreation • Pleasure • Something Else??

7. Procreation • Christopher Ryan has suggested that humans and bonobos are promiscuous breeders. • Humans and bonobos have sex about a 1000x per birth. (Other primates have sex about 10x per birth.) • Sexual behavior that cannot lead to pregnancy. • Sex after childbearing years.

8. Pleasure • Researchers Cindy Meston and David Buss recently asked 400 students about their reasons for engaging in sex. • 237 different reasons for sex, including "I wanted to give him an STD,” "I felt sorry for him", "To punish myself", and "I lost a bet.“ • Masturbation

9. What else could it be? • E.O. Wilson suggests we need to understand that human sexuality is first a bonding device and only secondarily procreation. • Human sexuality is about maintaining complex human connections not as much about reproduction.

10. Stages of a relationship • Lust, Attraction, and Love (Helen Fisher, Rutgers University) • Research on how human hormones regulate lust, attraction and long-term bonding...much of it is biological. • The conclusion? • We have a lot less control over who we’re attracted to and who we fall in love with than we think.

11. Stage 1: Desire & Lust • Testosteroneand Estrogen • These hormones regulate the reproductive system but also become activated when you find someone attractive. • (This is why birth control pills can affect your sex drive.)

12. Stage 2: attraction • Love-Struck Zombies • Dopamineworks to control our reward and pleasure centers. (Addiction!) • Adrenalinemakes your heart race, your body sweat and your mouth dry up when you go on that second date.  • Serotoninmakes us a bit OCD; this is why we can’t think of anything but a new partner. 

13. Stage 3: Attachment • Oxytocinand Vasopressin = Commitment. •  Vasopressin led to a decrease in devotion to their mates and in protecting them against new suitors.  • Oxytocin = long-term bonding, devotion and a desire to protect one’s family. • Oxytocin also prevents men in monogamous relationships from being physically close with other women.

14. Sex and the Big ‘O’ • Chemical Connection • Oxytocin • Phenylethylamine/Dopamine • Endorphins • Adrenaline • Testosterone • Prolactin • Serotonin

15. Sex and the Big ‘O’ • Oxytocin • During sex (but drops off quicker in men after orgasm) • Contractions • Phenylethylamine • Causes release of dopamine – Reward center & focus • Found in chocolate • Endorphins • ACH & DA • Euphoria, sleepiness • Adrenaline • Heart racing • Causes refractory period in men

16. Sex and the Big ‘O’ • Testosterone • Fuels sex drive • Rush of confidence after sex (esp for men) • Prolactin • Rises sharply after orgasm • Disengages the mind after sex • Serotonin • Released after orgasm • Mood enhancer

17. the Big ‘O’ • Statistics • World Record - In 2009, Deanna Webb, at the Masturbate-a-Thon rubbed out 222 orgasms for a world record. The year before the male title came (pun totally intended) with just 31. • 48% of women have faked one….34% of men have too. • 75 % of men always reach orgasm during sex, only 29 % of women report the same. 10-15% of women don’t orgasm.

18. the Big ‘O’ • Statistics • Many women are unable to climax through vaginal intercourse (up to 80%), instead they need clitoral stimulation. • 75 % of men know where the clitoris is. • Only 70% of women know where it is.

19. the Big ‘O’ • Statistics • According to research scientists at Indiana University, women actually experience better orgasms with age. As far as the findings go, 61% of women ages 18 to 24 report having had an orgasm the last time they had sex, while 65% of women in their 30s and 70% of women in their 40s and 50s reported the same.

20. Sex and the Big ‘O’ • The G-spot is real • After years of fumbling around, a team at the University of L’Aquila finally found it in 2008. • Front side of the vagina, not far from the belly button. • G-spot is also right around the crura, or the deep part of the clitoris.

21. locating the Grafenberg spot

22. Sex and the Big ‘O’ • The A-Spot • The "A" stands for anterior fornix erogenous zone. • It is believed to increase lubrication and stimulate intense orgasmic contractions.

23. The female internal reproductive system (side view).

24. Health Benefits • Pain killer • Cure for hiccups • Boost to immune system (so does kissing) • Clears up sinuses • Happiness enhancer • Better sleep • Better memory

25. Emerging Adults • National survey of unmarried 20-29 year olds, 65% of men but only 41% of women agreed that there are people they would have sex with even though they have no interest in marrying them. • In the national Clark poll, 52% of young men ages 18-29 agreed that “It is okay for two people to have sex even if they are not emotionally involved with each other”, compared to 33% of young women. • Men have a more recreational attitude towards sex, whereas young women are more likely to enjoy sex if it is in the context of an emotionally intimate relationship.

26. Emerging Adults • Young adults frequently regret the decision to have sex the first time. • They suggest that they failed to appreciate the possibility of pregnancy and the necessity of contraception. • Those that make the decision in a careful thoughtful manner and at a later age are much more likely to have no regrets. • Women especially state that having their first intercourse experience in a loving relationship is extremely important. • 50% of women said the main reason for their first experience what love as compared to 25% of men.

27. Emerging Adults • Among unmarried 18-23 year-old Americans, only 72% used any kind of contraception in their most recent experience of sexual intercourse, according to a national study. • More generally, only 51% say they use contraception “all the time,” whereas 37% report using it “most” or “half ” or “some of the time,” and 12% “none of the time.” In sum, half of the unmarried 18-23-year-olds who are sexually active are risking an unintended pregnancy.

28. Emerging Adults • There are lots of reasons why don’t they use contraception more consistently, according to a wide range of studies. • Many women have negative physical or emotional responses to the pill’s hormonal effects. Condoms are viewed as reducing sexual pleasure, especially by young men, and they may not be available when the mood strikes. • Sex in emerging adulthood is more likely than adult sex to be unplanned and infrequent, and both these factors work against consistent contraceptive use. • A substantial proportion of emerging adult sex takes place under the influence of alcohol, and that is not the best condition for taking the precautions necessary to avoid pregnancy.

29. Emerging Adults • Unintended pregnancies are relatively high in the United States as compared to similar countries around the world. • One key reason seems to be the distinctly American ambivalence about non-marital sex. • In other countries, the believes tend to fall into two categories…strongly prohibitory or acceptance as normal and healthy. • These mixed messages make communications and decisions difficult.

30. Pregnancy Rates

31. Pregnancy Rates • One-third of all unintended pregnancies are to young women in their twenties. Eighty-six percent of pregnancies among unmarried women in their twenties are unplanned. • Women in their twenties account for 57 percent of abortions in the U.S and have the highest abortion rates of any age group - 29.4 abortions per 1,000 women aged 20--24 years and 21.4 abortions per 1,000 women aged 25--29 years.  • Unintended pregnancy among young women in their twenties affects women of all races, education levels, and income levels.

32. Fertilization 1 5 14 28 • Egg is viable for • 24 hours • Sperm is viable for • 3 to 5 days • “Unsafe period” is from • day 9 to 15 if ovulation occurs on day 14 • day 7 to 17 could be unsafe

34. Fertilization

35. Contraception Hormone Contraception • Synthetic Estrogen: • Stop the pituitary gland from producing follicle stimulating hormone (FSH) and luteinizing hormone (LH) in order to prevent ovulation. • Support the uterine lining (endometrium) to prevent breakthrough bleeding mid-cycle. • Synthetic Progestin: • Stop the pituitary gland from producing LH in order to prevent egg release. • Make the uterine lining inhospitable to a fertilized egg. • Partially limit the sperm's ability to fertilize the egg. • Thicken the cervical mucus to hinder sperm movement.

36. Contraception Types of Hormone Contraception • The combination pill which contains estrogen and progestin • The progestin-only pill (known as the minipill) • Combo pills are significantly more effective than progestin-only pills and have the added benefit of less breakthrough bleeding. However, some women cannot tolerate estrogen and prefer the progestin-only pill. • The combination formula is also available as a patch and a vaginal ring. • The progestin-only formula is also available in intramuscular shots, an implant, and in intrauterine devices.

37. Contraception Other Types

38. Healthy Sexuality Wendy Maltz developed the CERTS model for healthy sex. • CONSENT • EQUALITY • RESPECT • TRUST • SAFETY

39. Healthy Sexuality • Practice good communication • Strengthen trust • Develop your own sexual identity • Learn about sex and sexuality

40. Questions?

41. The female internal reproductive system (front view).