Sexual health

The contraceptive pill

Contraception can be understood as the prevention of conception as well as the sexual-hygienic prophylaxis of diseases.

The most important contraceptive is the condom, which usually consists of a latex cover rolled over the erect penis to prevent both pregnancy and infection with sexually transmitted diseases. Condoms for women – femidoms and leak tissues – have not yet found widespread use. When used correctly, the safety of a condom is very high, although not as safe as hormonal contraceptives; however, it is the only contraceptive that can also largely prevent infection with HIV, gonorrhea and hepatitis B.

The best-known contraceptive is the contraceptive pill, which has been used most frequently as a contraceptive in industrialized countries since 1960. The hormone preparation, which is regularly taken orally and contains the female hormones oestrogen and progestin, offers very high protection when used correctly. Hormones suppress egg maturation, ovulation, and close the uterus to sperm by faking a pregnancy, so to speak. Protection against infection with diseases, especially AIDS, is not provided by the pill and is only achieved by the additional use of a condom.

In addition, there are a large number of other contraceptive methods and methods.

Sexually transmitted diseases

A condom
Those diseases that are mainly transmitted through sexual activities and are dealt with in venereology are called sexually transmitted diseases. These diseases are caused by unicellular organisms, bacteria or viruses. The “classic venereal diseases” such as syphilis, gonorrhea (“gonorrhea”), lymphogranuloma venereum (“venereal lymph node inflammation”) and ulcus molle (“soft chancre”), which were widespread in earlier times, have lost their importance. The greatest risks are AIDS/HIV, hepatitis B, genital herpes, chlamydia and trichomonade infections and various human papilloma viruses, which can cause cervical carcinoma in women, but also “benign” tumours such as condyloma.

Throughout Europe, a drastic increase in all sexually transmitted diseases is observed, as large sections of the population now believe that these diseases have been eradicated. Since HIV infection is still regarded as a marginal group problem, many people recklessly refrain from using a condom (see below).

Since infection can never be completely excluded, sexually transmitted diseases represent an inescapable basic risk for a sexually active person who has to accept them. The consistent use of condoms drastically reduces this risk, but hepatitis B is also transmitted by oral sex in so-called high-viremic carriers. Hepatitis B vaccination can significantly reduce the risk of infection with hepatitis B. Every year more people die of hepatitis B than of all other sexually transmitted diseases taken together.

If HIV infection is suspected, post-exposure prophylaxis is available for 24 hours after the event as a preventive, but also very unsafe treatment trial, which is accompanied by the long-term use of antiretroviral drugs.

Impact of sex on mental and sexual health

Sexual activity can lower blood pressure and general stress levels, regardless of age. It releases tension, lifts the mood and can cause a deep feeling of relaxation, especially in the postcoital phase. From a biochemical point of view, sex causes the release of endorphins and increases the content of white blood cells that strengthen the immune system. The inclusion of sexual activity in stress resistance has been confirmed in scientific studies: Subjects who had sex last night were able to respond better to stress situations the next day, showing significantly lower negative mood and stress and higher positive mood. If a person is regularly sexually active, they can cope better with stress situations.

Sexual disorders

Sexual medicine (“sexology”), which is closely linked to sexual research, deals with the maintenance and promotion of sexual health. In addition to disorders of gender identity (problems with sexual orientation, transsexuality) and socio-culturally determined sexual behaviour (paraphilia), the main areas are sexual dysfunctions and secondary sexual disorders. The latter are caused by somatic primary diseases such as metabolic diseases, cancer or neurological diseases (for example multiple sclerosis).
Sexual dysfunctions of men and women include erectile dysfunction, anorgasmia and vaginism.

The most common sexual disorder in men is premature ejaculation (lat. ejaculatio praecox), when the man is unable to control the time of ejaculation during sexual intercourse himself. Ejaculatio praecox is characterized by premature ejaculation, usually shortly after the introduction of the penis into the vagina, but often even before, since these men have already reached a level of excitement in which control is no longer possible. About 20 percent of all men report suffering from this problem. In the treatment of mild forms, the focus is on involving the partner, minimising the pressure to succeed (for example by temporarily banning sexual intercourse) or – in young men – delayed ejaculation after a recent orgasm.
Erectile dysfunction (“impotence”) is the long-term failure or maintenance of a penile erection. In the vast majority of cases, this serious disease is caused organically. Causes can be smoking, alcohol consumption, diabetes, high blood pressure, operations or injuries to the erectile tissue. Potency drugs such as Viagra, Levitra and Cialis can alleviate the symptoms and the psychological strain of those affected in certain cases.
Lack of libido is also referred to as frigidity, which can be caused in particular by a number of diseases and as side effects of drugs. In addition to somatic diseases such as cirrhosis of the liver, hypogonadism, eunuchism or testosterone deficiency in men, many psychological and psychosomatic diseases such as depression or anorexia are also the cause of libido reduction. Increased sex drive sometimes causes mania, mild hyperthyroidism, sex addiction and nymphomania.