ASK THE DOCTOR - How and When Should we Educate Children about Sex?

How and when should we educate children about sex? How much do we tell children? If we tell them too much too early, will it not cause any harm to their psychology? Will it not encourage them indirectly to experiment and become sexually active? Kindly answer this important question in detail.
- N P

It is extremely important to help children feel comfortable about their sexuality from the very beginning. This will prepare them and make it easier for them to ask any question about sex without inhibitions throughout their lives. As they grow, parents and teachers can give them correct and useful information to help them make healthy and responsible decisions about their sexuality. Invariably parents are concerned that telling children too-muchtoo-soon will harm them in some manner, or will provoke and encourage them to become sexually active early in their life. It is necessary to understand that education and information do not encourage children to be sexually active prematurely. On the contrary, children make better decisions about sex when there are no restrictions on what they can ask and talk about at home and when they have all the necessary information they need.

Furthermore, this makes them better equipped at protecting themselves against sexual abuse, incest, molestation, sexually transmitted infections and unwanted pregnancy. However, there is information that is more apt for children at particular ages. For instance, five-yearold child should know the correct names for his/her body parts, including sex organs, and that his/her genitalia is a ‘private’ part which should never be touched by anyone. Such training at an early age can help to prevent sexual abuse, which is widespread in the society today. Kindly note that it is not necessary to have a major discussion with your children each time they ask a question related to sex. It is necessary to listen to them carefully. They may just need the answer to one question right now; and that is perfectly all right. Be certain that you are answering the question specifically, rather than lecturing or talking in general terms. You can always clarify decently if you are not sure what your child is asking. Make sure that they know that they are most welcome to ask follow-up questions.

ASK THE DOCTOR - What is Meant by ‘Cervical Erosion’?

What is meant by ‘Cervical erosion’? Kindly give reasons and treatment for the same.
- K. Androth

Cervical erosion (also known as Cervicitis) is often caused by infection, but also sometimes by a foreign body (IUD string, Tampon etc) or chemicals. It causes heavy vaginal discharge, sometimes with foul odor. The discharge may range from yellow, gray, brown to even green, occasionally with a tinge of blood. Pain may be experienced during intercourse or when the cervix is touched with a tampon. It is advisable to ascertain the cause of the infection, which could be Bacteria (Gonorroea, Chlamydia etc), Fungus or Trichomonas Vaginalis infestation. The PAP Smear test should also be done to rule out any precancerous condition. Once the cause is identified, specific treatment can be administered. In cases where the condition persists, ‘Electro or Diathermy Cauterization’, laser or cryosurgery may be considered, which destroys the abnormal tissue on the surface and induces healing and growth of new tissue.

ASK THE DOCTOR - Male Sexuality and Female Sexuality?

Can you describe the difference between male sexuality and female sexuality?
- Miranda

Male sexuality is body oriented. Men get sexually attracted to the body of a woman. They need not have any love for her. That is why men go to prostitutes and are interested in seeing the woman’s anatomy displayed in ads, movies, magazines etc. As against this, female sexuality is very heart oriented.

The woman gets sexually attracted to a man only when she loves him. Just a handsome, muscular look may draw her attention but is not enough for her to get sexually aroused or attracted to the man. It is said that ‘man gives love to get sex and woman gives sex to get love’.

However, it may be noted that all men do not have male sexuality in them, they could be having female sexuality i.e. such men would be heart oriented and sensitive. They would need love as a base for a sexual relationship. Likewise, all women do not have

female sexuality within them. Such women would be body oriented and get sexually attracted merely by the physique of the man. (thus the presence of gigolos i.e. male prostitutes and magazines displaying the bare male anatomy)

ASK THE DOCTOR - Fibrous Cavernositis

Kindly explain about the condition ‘Fibrous Cavernositis’ of penis. I have not been able to find any information about this condition anywhere. Kindly give treatment options for the same.
- Dr N Kulkarni

‘Fibrous Cavernositis’ (also known as plastic induration of the penis or Peyronie's disease), is characterized by the formation of a plaque or hardened scar tissue (fibrosis) beneath the skin of the penis that causes pain, curvature, and distortion, usually during erection. The treatment choices for patients with ‘Fibrous Cavernositis’ are very limited. The objective of treatment is mainly to maintain normal sexual function and relieve pain. Invariably, surgery is the only effectual treatment, and as Fibrous Cavernositis may simply resolve by itself, doctors often suggest waiting for one or two years before going for this option. The non-surgical treatment should be implemented within six months of the onset of the symptoms and before the plaque has calcified. Para-aminobenzoate tablets (B- complex substance) and Vitamin E capsules can be taken for few months. A calcium channel blocker such as verapamil, an enzyme (collagenase) that breaks down connective tissue, and steroids such as cortisone can be injected into the plaque or delivered by ‘iontophoresis’. Iontophoresis is a painless method of delivering medication to localised tissue using an electrical current.

ASK THE DOCTOR - ‘Is Loss of Semen Harmful?’

Is it harmful in any way to lose semen is sleep or through masturbation? Does it affect the sexual or physical health of a man? Please answer in detail.
- Javed

Semen is simply a mixture of the products of three glands. Secretions of the seminal vesicles constitute 60 per cent of semen, and the secretions of the prostate gland constitute 30 per cent of the semen. Sperms constitute only 10 per cent of the semen quantity. These glands function throughout your life and continue to be capable of producing their secretions. Some boys worry that if they ejaculate too often, they will reduce the amount of semen in their body. They worry that they may run out of semen and won’t have enough when they need it. This can NEVER happen. A man will make sperms and semen from the start of puberty till his dying day.

ASK THE DOCTOR - Artificial Lubricants

Is it safe to use artificial lubricants with condoms during penetrative sexual intercourse?
- Imran

Condoms are made of latex or polyurethane. Most of the available condoms are pre-lubricated. For additional lubrication, waterbased or siliconebased lubricants are safe to use with condoms; however, oil-based lubricants are not safe as they weaken the latex and can damage the condom making it unsafe. Strictly avoid using petroleum jelly, cooking oil, butter, baby oil or sun tan oil as lubricant with condom during penetrative sexual intercourse.

ASK THE DOCTOR - Unsatisfactory Sex Life

I am a 40-year-old lady having undergone a tubectomy 16 years ago. For the last 10 years, my husband is not able to satisfy me due to lack of an erection and premature ejaculation. I have noticed that my vaginal opening is slowly narrowing due to the thickening of internal muscles and I also feel tenderness in my breasts. I definitely do not look for extramarital sex, despite my sexual urge which I have to control. What could be the physiological changes in my body?
- Suneeta

Unsatisfactory sex life may not cause any physiological changes in your body. It could disturb you emotionally (psychologically) and may cause some psycho-somatic symptoms, however, it depends on the intensity of your feelings of disappointment and deprivation. The changes that you have observed need to be examined and investigated. They could be due to hormonal changes in your body irrespective of the status of your sex life. They could also be due to approaching menopause. Get yourself examined by a gynaecologist for a clinical evaluation.If your husband is suffering from erectile dysfunction and premature ejaculation, I wonder why he is not getting himself treated. These are treatable conditions in a majority of cases, and he should approach a qualified sexologist for help.

ASK THE DOCTOR - ‘I Feel Guilty Indulging in Sex’

My husband and I have been married for about 17 years. We are both spiritually inclined. We read a lot of spiritual books and we also practice meditation together. Of late I feel extremely guilty every time we indulge in sex. The passion during lovemaking makes me feel like a beast. My husband also feels the same. We both try to control aggressive moments and actions during sex, but it becomes very difficult at times. I feel extremely low about myself at the end of the every sexual encounter. I think something is going wrong somewhere. Do guide us to understand what is happening to us?
- N Salaskar

You seem to have learned that spirituality and sexuality are in opposition. Many so-called spiritual streams regard ‘sex’ as an obstacle or a distraction on the spiritual path. This is a myth. Sex is one of the natural instincts in us, gifted to us unasked, by existence. It is as normal and healthy as other functions of the body. True spirituality teaches the seeker to accept all aspects of life. Life is an invaluable gift, to be accepted in totality. To reject or condemn any aspect of the gift of life is in a way trying to improvise over existential wisdom. The passion during lovemaking is as existential and divine as the desire to pray and meditate. You can’t reject one and accept the other. It is the same energy that manifests itself in both the expressions. Don’t fight with nature. Feel free to express yourself ‘naturally’ during lovemaking with your husband. It is a culmination of the love that exists between you and thus a divine act. Sharing of intimacy does not make you less spiritual. The self-condemnation and the guilt that you are experiencing are more harmful to your spiritual growth than the natural passion.

ASK THE DOCTOR - ‘Is There a Cure For My Sex Addiction?’

I am a 26-year-old depressed guy. I am frustrated with life and feel suicidal. The reason is that I am unable to get an erection and I failed to perform intercourse with three girls. They all left me due to this. I am addicted to pornography since I was 19. I have been masturbating like crazy since several years. Can I be cured of my problems? Is this ‘sex addiction? You are my last hope. Please answer fast.
- P K

Your extreme frustration and thoughts of suicide are serious signs that require urgent medical attention. Do consult a psychiatrist at your earliest. Masturbation per se does not affect the sexual capability of a person, however the ‘obsession’ of masturbation can affect your body-mind in many ways. You have admitted your addiction to pornography and being obsessive about masturbation. This behaviour falls under the category of ‘sex addiction’ which definitely can lead to sexual dysfunctions. Once you are settled with the acute nature of your frustration and suicidal thoughts, do consult a sex counsellor to get some help for your sex addiction.

ASK THE DOCTOR - ‘When and How are Sperms Produced?’

I teach biology in school for classes seven and eight. I also teach a chapter on the reproductive system. Students ask a lot of questions about sperms — when and how are sperms produced? Where are they produced? How do they look? How long do they live? etc. Kindly enlighten me on this matter.
- Manisha

Sperms are produced in the ‘seminiferous tubules’ of the testes. Each sperm is made up of an oval head, a middle piece and a tail. An average sperm measures 50 microns ie 0.05 millimetre. The sperm takes about 74 days to be formed in seminiferous tubules. Sperms have a life of about 25 to 40 days. Sperm production starts in boys at around 12 years of age and goes on for the rest of their lives. Normally, at least 20,000 mature sperms are produced every minute. Each millilitre of semen contains around 20 to 120 million sperms. In each ejaculation a normal male releases around 60 to 360 million sperms.

ASK THE DOCTOR - ‘What is Testosterone?’

I read in a British magazine that the hormone testosterone plays a major role in the sexual function of men as well as women. Is it completely true? Kindly throw some more light on this matter. What is testosterone?
- Mahinder

Testosterone is the principle biological determinant of the ‘sex drive’ in both men and women. It is also known as the male sex hormone; however, it is present in both sexes. In men, testosterone is responsible for the development and maintenance of the primary sexual characteristics as well as secondary sexual characteristics. It is also responsible for the sex drive (libido) and aggression. In a normal man, six to eight mg of testosterone is produced everyday. More than 95 per cent is produced by the testicles and the remainder is produced in the adrenal glands that are located just above our kidneys. In women, about 0.5 mg of testosterone is produced daily by the ovaries and the adrenal glands. In women, excess testosterone can cause growth of facial hair, make the voice lower, and breasts and genitals to shrivel and shrink. It may also cause acne to flare up.