SEXUALITY

It is a broad topic with different sub-topics. Consult your physician for more detailed information you deem necessary.

1. Orgasm

It is an event related to the movement of the brain and body together. It happens differently in men and women. While the woman has several successive orgasms, the man must pass at least half an hour between two orgasms. Orgasm; It may begin with sexual stimuli (including sight, hearing, touch, smell, and fantasy) in the brain. There is no orgasm when the brain and body impulses do not act together. Women can experience orgasm through thinking. orgasm in women;
 

  • arousal phase
  • plateau phase
  • organic phase
  • dissolution phase

can be analyzed in four stages. In addition, orgasmic disorders;
 

  • random orgasm
  • Cortal anorgasm
  • early orgasm

can be divided into 3 groups. Not having an orgasm is called anorgasmia. It can cause a person to lose their self-esteem and confidence and cause depression. Not every relationship can be an orgasm. It’s normal. Lack of orgasm can cause sexual reluctance. Decreased interest in your partner can also interfere with orgasm. Such people may experience orgasm with another partner or masturbation. It would be wrong to conclude that not having an orgasm will definitely cause unhappiness in women. However; Having an orgasm will help couples have a more enjoyable life. Orgasmic disorders may be due to organic causes with a rate of less than 5%. Neurological disorders, neurological drug use, diabetes, alcoholism can give negative results. Moreover; psychological factors, namely trauma, having a problematic childhood, problematic and traumatic sexual experiences in adolescence, and sexual identity conflicts can negatively affect the experience of orgasm.

In order for couples not to adversely affect their anorgasmia life, it is recommended that they apply to the relevant centers and persons without making it a matter of pride.

2. Hymen

It is referred to as Hymen in the medical dictionary. Its physiological purpose and function have not been elucidated to date. Despite this, it is thought to prevent the entry of microorganisms and foreign bodies into the vagina during the embryonic period. The hymen has been discussed more in societies from a sociological point of view rather than physiology. It has sociological importance to varying degrees in every society. It is examined in the recognition of children exposed to sexual violence and abuse in developed societies. In developing societies (including our country) today, it refers to pure, untouched, that is, virginity. It has a sociological function rather than a physiological and anatomical one.

When the hymen is examined anatomically, it is seen that it does not have a specific structure. Just at the entrance of the vagina, 1-1.5 cm. It is inside and attached to the labia minora. It is considered as one of the external genital formations. Outward facing leather; The inward-facing posterior surface resembles a mucosa. Rarely, it may not be congenital. The hymen, which is hard during childhood, stretches and changes due to the secretion of estrogen hormone in adolescence. The shape, thickness and flexibility of the hymen differ in every woman. The shape and structure of the hole in the middle of the vagina that allows menstrual blood and vaginal secretions to flow out is used to determine the types of hymen. Types ;
 

  • Annular Hymen
  • Crecentric Hymen
  • Septal Hymen
  • Cribriform Hymen
  • Imperforate Hymen
  • Microperforated Hymen
  • Multiparous Hymen

analyzed in seven groups. The character of the hymen hole and free edge can also be classified according to the thickness and strength of the membrane.

The hymen is usually torn with the first sexual intercourse or the introduction of a foreign body. There is a small amount of bleeding. The tears scar within a few days and there is no more bleeding. Sometimes bleeding may occur in a few intercourse after intercourse. Sometimes the free edge of the hymen is not straight and there are notches, although there is no association. 20% of women have these notches.

Usually, the rupture of the membrane occurs because the hole is smaller than the diameter of the penis. However; Since there are holes that are wide enough for the entrance of the penis, the hymen may not be torn and bleeding may not occur despite many intercourse. Such dice are called duhule available dice. 26-41% of women have a membrane suitable for intercourse.

Whether the first intercourse is painful or not also depends on the slow and gentle behavior of the man, sometimes there can be serious pain. Generally, there is no discomfort. However, the behavior and approach of the man is extremely important.

The amount of bleeding in the rupture of the hymen is usually small and stops spontaneously in a short time. Sometimes the vein is exposed behind the hymen and the bleeding does not stop. Sometimes tears may occur at or inside the vaginal entrance and there may be severe non-stop bleeding. In these cases, surgical intervention and suturing may be required. Stitches do not repair the hymen. Although the hymen is torn, bleeding may not occur, and although it cannot be torn, bleeding may occur as there may be tears or abrasions on the outer parts.

The hymen can also deteriorate without intercourse or without a larger object entering the hole. eg. Riding a horse or a bicycle, activities that require wide opening of the legs, or accidents and trauma can cause hymenal deterioration. Once broken, the hymen does not repair itself. It is not clear when it was torn after 7-8 days. Pregnancy, including ectopic pregnancy, can occur as sperm can enter without breaking the hymen. Speculum examination and curettage can be performed without damaging the hymen in people with suitable membrane structure. Vaginal cultures can be taken from virgins who may have a discharge problem.

Whether the hymen is broken or not can be understood by examination. However, it can be difficult to decide on the hymen, which has a natural notch structure. The gynecologist may consider colposcopic examination appropriate. With bleeding, it cannot be understood whether the hymen is broken or not. The hymen can be repaired, although 100% bleeding cannot be guaranteed. Only the gynecologist or forensic medicine can understand the repaired hymen. The number of relationships is not important for repair. It can even be repaired for the woman giving birth. However; It cannot be completely repaired or restored. Although a new hymen is created with pieces taken from the vaginal wall, the wound can easily become infected. It is known that hymen repair greatly reduces first night murders.

3. Pregnancy and Sexuality

Sexuality, which is of great importance in life, is often adversely affected during pregnancy. In cases where everything is going normally, sexuality can be restricted in the last four weeks. The intercourse is not recommended in the last four weeks, as there is a possibility that some substances in the man’s ejaculation fluid may initiate uterine contractions. Sex is strictly prohibited in pregnant women with bleeding, a history of miscarriage, or at risk of premature birth. In pregnant women with a history of recurrent miscarriage and premature delivery, intercourse may be restricted in the first two months. In the presence of genital infection in men or women, intercourse should be prohibited until the infection treatment is completed. In the case of placenta previa, which is classified as risky pregnancies, it is inconvenient to have intercourse because of the risk of starting bleeding. Apart from these, there is no positive or negative effect of sexual intercourse in a normal course of pregnancy. However, especially in the stage of adaptation to the pregnancy process of mothers who have had their first pregnancy, there may be a coldness towards sexuality. Since pregnancy is a process that radically affects a woman’s life, sexuality and sexual life are often negatively affected. In addition to physical changes, women also experience psychological changes. It is necessary to show understanding and not to force a pregnant woman who avoids intercourse due to psychological fears.

4. Vaginismus

It is a situation that is of interest to psychiatry. It is the involuntary contraction of the muscles surrounding the vaginal entrance and does not allow penetration. The tampon also does not allow situations such as inspection. It can be seen in women of all age groups. Women with this problem do not have problems in terms of sexual desire and orgasm. As they wish, they can experience orgasm outside of sexual intercourse. There are two types, primary and secondary. In primary vaginismus, also called phobia, the person has never had sexual intercourse in his life. Secondary, on the other hand, is vaginismus that occurs later, despite having previously had a problem-free sexual intercourse. Indifference towards the partner and factors causing dyspareunia may affect secondary vaginismus.

The most important cause of primary vaginismus is fear. Although sexual intercourse is desired, subconscious fears prevent it. Trials get into a vicious circle. May cause erectile dysfunction in men. Treatment should usually be done by applying psychotherapy to the couples. However; It is necessary to make sure that the reasons that may be gynecological do not create this situation. In addition, the psychological support of the woman in this situation from her partner will also help the treatment. Explaining to the patient that this situation is not related to femininity will relieve the patient.

5. Advice for Those Who Want to Conceive

In short, if the following situations are taken into consideration, the probability of getting pregnant will increase.

  • Contraception should be discontinued 3 months before the planned time of conception.
  • You should have intercourse every other day at the most appropriate time for conception.
  • It is most appropriate for the man not to ejaculate for 48 hours before the first intercourse and between two intercourse, which is the most suitable period for pregnancy.
  • You should have intercourse early in the morning.
  • Lubricants should not be used.
  • Vaginal douching should never be done.
  • Appropriate positions should be preferred for pregnancy that provides the natural posture of the vagina.
  • Alternative sex methods should be avoided.
  • Do not have intercourse underwater.
  • 6. Painful Sex

It is temporary or permanent pain during sexual intercourse. Causes can be psychological or physical.

physical causes;
 

  • Infection in the genital organs
  • Scar tissue due to reasons such as previous surgery or radiotherapy
  • episiotomy scar
  • Fibroids or other uterine tumors
  • Endometriosis
  • Thicker than normal hymen
  • Injury to the urethrado (the part of the bladder that opens into the vagina)
  • Insufficient lubricity
  • Vaginal dryness due to hormone deficiency as after menopause
  • Orgasm
  • semen allergy
  • fungal infections
  • vaginal infections
  • allergic reactions
  • skin diseases
  • genital herpes
  • Trauma and irritations
  • Pelvic infections
  • Sagging of the uterus and bladder
  • Intra-abdominal adhesions
  • bowel diseases

Psychological reasons;
 

  • fear of being pregnant
  • Fear of physical harm to the baby during pregnancy
  • As a result of insufficient foreplay
  • Insufficient sexual experience and knowledge
  • Previous sexual injury or psychological trauma
  • Temporary aversion to partner

If dysparonia is not treated, it harms people. It interferes with the enjoyment of sexual experiences. In the long run, it damages one’s self-esteem. The main purpose of treatment is to reveal the psychological or physical cause and eliminate them.

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