From orgasms to contraceptives: Three doctors on common misconceptions about sex
“There was once a woman who told me she hadn’t had an orgasm in her 30 years of marriage,” says Dr Marina Varghese, a Kochi-based gynaecologist. The woman was shocked to learn that a man simply performing the in and out motion during sex would not lead to an orgasm.
With all the information related to sex and sexual health available at the click of a button on the internet, you would believe that people are better informed these days.
But that, like the many perceptions that exist about sex, is simply not true.
TNM spoke to three professionals who discussed the biggest misconceptions and queries people have about sex today, which cut across a number of topics – including, masturbation, contraception, sexually transmitted diseases and experimentation.
Chennai-based Dr Narayana Reddy has been consulting in sexual medicine for over three decades now. The maximum number of questions he gets relates to masturbation.
“People have held misconceptions about masturbation for hundreds of years, regardless of how educated they are,” he says. “It is mostly men who are concerned about the loss of semen – whether through masturbation or ejaculation in their sleep. They believe that they will run out and then won’t be able to father children.”
Dr Aruna Muralidhar, a senior consultant obstetrician-gynaecologist at Fortis La Femme in Bengaluru, says that doubts about masturbation are especially common among the younger crowd, who want to know if it’s normal. “As long someone is not addicted to it, it is a completely natural and harmless thing to do,” she says.
Dr Aruna says that this is another topic of concern for youngsters and young couples. “Many of them are not aware of the range of contraceptives available, apart from the birth control pill and condoms. There are hormone tablets, shots and contraceptive devices like intra-uterine devices (IUDs) as well,” she explains.
Another major misconception she has noticed is about hormone-based contraception and the belief that it is dangerous.
Dr Narayana observes that many women wrongly believe that once they start on the daily birth-control pill, they will never be able to conceive, even after they stop taking the pill.
“And those who are on the pill don’t realise that they aren’t protected against sexually transmitted infections (STIs) unless they use condoms,” Dr Aruna says.
There are also people who continue to go by ‘natural methods’ such as pulling out and not ejaculating in the vagina, and the safe period method, where the couple does not have sex when the woman is in her ovulation period.
Doctors say that these methods, though popular, are still unsafe. Dr Aruna believes that a combination of condoms and the birth control pill is the best way to avoid unplanned pregnancies and protect against STIs.
The elusive orgasm
Both Dr Marina and Dr Narayana have seen a number of women who have never experienced an orgasm after years of sexual activity.
“Up to 92% women do not achieve orgasm through penetrative sex alone, especially when the man is on top, because the clitoris is not being stimulated,” Dr Narayana points out.
“In a number of cases, there hasn’t been enough foreplay, which means there’s no lubrication. This makes sex much less pleasurable and quite painful for the woman,” Dr Marina says.
Dr Narayana also blames porn for distorting the reality of sex. “An orgasm is actually very brief and very intense. But in pornography, it is shown as some sort of prolonged experience, which is not true. This leads to frustration in both partners, who may think they are not performing well or experiencing enough pleasure.”
The common misconception here is that women orgasm when their vagina is pleasured, but, in reality, it is the clitorus that needs to stimulated.
“People also tend to think of the orgasm as a must-end result for sexual activity. But that is not always the case. There are many ways to make sex pleasurable and not all of them involve an orgasm,” Dr Aruna points out.
Experts have noticed a rise in the number of people coming to them with queries about sexual experimentation, especially when it comes to anal and oral sex.
Dr Narayana has also noticed that while men especially desire trying these after watching porn, their women partners may be reluctant to do so for two reasons. “One, they have been culturally conditioned into viewing these acts as things that respectable women do not do. And two, they may themselves think of them as dirty or disgusting,” he explains.
According to Dr Aruna, another misconception is that only gay men indulge in anal sex.
The experts also say that while there are precautions to be observed while trying anal and/or oral sex, there’s nothing harmful about them. “You have to be tested for STIs and also wear condoms because you may come in contact with faecal matter. The E. coli bacteria can travel into the man’s urethra and cause infections,” Dr Narayana warns.
“There is also the concern of tears in the anal sphincter if the sex is too rough, which can be painful. And these tears can also result in infections,” he adds.
“Ultimately, neither anal nor oral sex are perverted behaviours. You should be careful about health risks. But as long as there is no injury or coercion involved, there is nothing wrong in two consenting adults participating in it,” Dr Aruna says.
Sexually Transmitted Infections
When you say STI, most people tend to think of HIV, Dr Aruna notes. “But there’s a whole gamut of STIs like chlamydia and gonorrhea which are non-symptomatic, but may cause problems like infertility issues later,” she says.
She also points out that contrary to the perception that anal and oral sex are ‘safer’ in terms of avoiding STIs, it is not true as bodily fluids are exchanged in these too.
Dr Marina has also noticed that most women come to her when their infections have worsened and home remedies like washing their vaginal area with salt water and Dettol water has not worked. “These home remedies have no authenticity. What they don’t understand is that there are already some normal bacteria in the vagina, which keep it healthy. It is only when something upsets that balance that pathological bacteria enter,” she explains.
“And many times, while their male partners may not show symptoms, they can be carriers. So the couple has to be treated, not just the woman. We also have to tell the couple to maintain good personal hygiene to avoid infections,” Dr Marina adds.
Fertility and sexual disorders
Dr Narayana notes that both men and women expect an “erection on demand” – where a man should have an erect penis as soon as they think about or initiate sex. “But it doesn’t work like that. Men may require both mental and physical stimulation – sex is a psychosomatic experience after all. And when they do not get an erection immediately, they, and even their women partners, harbour the myth that they cannot have sex or are impotent, which wreaks havoc in their sex lives and intimacy,” he says.
He points out that people often do not differentiate between virility and fertility. “I get concerns from people that they are not having enough sex, so they may not be able to get pregnant. But there is no ideal number of times you should be having sex in a given period. And the frequency of sex is not related to impotence,” Dr Narayana clarifies.
Another query Dr Aruna gets from couples trying to conceive is about the best position to have sex in.
“But there’s no such thing as an ideal position to have sex,” she laughs. “Women don’t have to shut their legs and lay there to ‘hold’ the semen or stop it from leaking out. Sperms are quite clever – once they are in, they will find their way.”