By Dr. Sonia

Sexual Health

For years, I have been working as a gynecologist whose clinical focus is pelvic and sexual health, and I consistently receive several questions regarding sex health. I receive requests concerning sexual health from both patients wanting expert counsel and interested friends looking for trustworthy information. Surprisingly, the number of queries I receive concerning sex often outnumbers those about more complex medical concerns. Some of these questions are easy, while others fall into the complexities of human sexuality. While I aim to offer complete answers, the reality is that the field of sexual health is enormous and ever-changing, with always more to learn. My goal for this investigation is to throw light on some of the secrets of sex and inspire others to embrace a more in-depth understanding of their sexuality. I am lucky to have a network of colleagues and patients who continually add to the expertise obtained through my medical life. Many of you have probably considered similar subjects but have been hesitant to speak up. Here are the three most commonly asked questions about sex health.

Does size really matter?

This question consistently appears in my inbox – hundreds of times. When it comes to whether penis size matters, the answer is simple. The relevance of penis size, like any other physical trait, varies from person to person. When choosing a spouse, some people emphasize attributes such as being skinny or possessing a beautiful automobile, while others value penis size. For others, size may influence their opinion of beauty or sexual compatibility. Medically, the size does not matter for fertility or orgasm. For vagina owners with pelvic floors, a larger-sized phallus can sometimes be met with discomfort, but that usually resolves. Regardless of size, individuals are fully capable of achieving orgasm and contributing to reproductive processes. If there is continued pain, it’s obviously important to get checked out by your doctor. It’s no secret when it comes to discussions about men’s health, the topic of penis size often takes center stage. From locker room banter to online forums, the fixation on size can lead to various insecurities and misconceptions. However, what many fail to realize is the connection between penis size and pelvic floor health. The pelvic floor plays a crucial role in men’s overall well-being, yet it’s an area often overlooked or misunderstood. It’s composed of muscles, ligaments, and tissues to provide support to the bladder, bowel, and, yes, the penis. Dysfunction in this area can lead to a range of issues, including erectile dysfunction, urinary incontinence, and even pelvic pain.

So, how does penis size relate to the health of the pelvic floor? It’s not so much about the size itself but rather the strength and function of the pelvic floor muscles. Just like any other muscle group in the body, the pelvic floor muscles require proper conditioning and maintenance to function optimally. Data suggests that men with weaker pelvic floor muscles may experience difficulties in achieving and maintaining erections. These muscles play a vital role in controlling blood flow to the penis during arousal. Additionally, weak pelvic floor muscles can contribute to premature ejaculation and urinary issues. While the size of the penis doesn’t directly correlate with pelvic floor health, addressing pelvic floor muscle strength can positively impact sexual performance and overall well-being. Pelvic floor exercises, commonly known as Kegels, can help strengthen these muscles and improve control over ejaculation and erectile function. Furthermore, maintaining a healthy lifestyle can also contribute to pelvic floor health. Regular exercise, a balanced diet, and proper hydration can support muscle function throughout the body, including the pelvic floor, for both men and women. Remember, it’s not just about size—it’s about strength and function.

How do I achieve orgasm during sex?

I receive numerous questions regarding orgasm, but how to achieve orgasm during sex outnumbers all. When answering this question, I always advise people to remember that everyone’s experience is unique. Some people find it easy to achieve orgasm, but others find it more difficult. Approximately 15% to 20% of women report having difficulty orgasming with penetrative sex alone. Understanding what causes orgasms in women and how to incorporate that into sexual activity with a partner may be a voyage of discovery. In our society, romantic ideas are typically more acceptable than sexual ones, which can lead to arousal and climax.

While it is frequently portrayed as the ultimate goal of sex, it is essential to remember that a variety of stimuli may induce orgasms, and focusing simply on intercourse may not be the most successful technique for everyone. Finally, the key is open communication with one’s relationship, experimentation, and a desire to investigate what works best for both parties. It’s also crucial to remember that there is no one-size-fits-all technique to attaining orgasm, and putting pleasure and connection first in sexual experiences is critical.

Pro Tips

Communication is Key:

Open and honest communication with your partner is essential. Discussing your desires, preferences, and any concerns can create a safe and supportive environment for exploring sexual pleasure together.

Explore Your Body:

Understanding your own body and what feels pleasurable is crucial. Take the time to explore yourself through masturbation. Discovering your erogenous zones and what stimulation works best for you can enhance your ability to achieve orgasm during sex.

Foreplay Matters:

Foreplay plays a significant role in arousal and can significantly increase the likelihood of achieving orgasm during sex. Engage in activities that build anticipation, such as kissing, caressing, and sensual touching. Experiment with different techniques, and pay attention to your partner’s responses.

Can I get pregnant during my period?

This is one of the most troubling questions for women. The menstrual cycle, with its various stages and hormonal fluctuations, can sometimes be confusing, especially when it comes to understanding fertility and the potential for pregnancy. Understanding the Menstrual Cycle is an excellent first step. The menstrual cycle is divided into several phases, with menstruation marking the beginning of the cycle. During menstruation, the lining of the uterus sheds, resulting in vaginal bleeding. This phase typically lasts from three to seven days. Ovulation is the process in which an egg is released from the ovary and is available for fertilization. Ovulation usually occurs around the middle of the menstrual cycle, approximately 14 days before the start of the next period. The fertile window, when pregnancy is most likely to occur, typically spans a few days before and after ovulation. Sperm can survive in the female reproductive tract for several days after ejaculation, waiting for an egg to be released during ovulation. The exact lifespan of sperm varies but can range from three to five days under optimal conditions.

To answer the age-old question – while the likelihood of getting pregnant during menstruation is lower compared to other times in the menstrual cycle, it is not impossible. Factors such as irregular cycles, shorter menstrual periods, and early ovulation can increase the risk of pregnancy during menstruation. Additionally, if sperm is present in the reproductive tract before ovulation occurs, fertilization can occur once an egg is released. One thing to keep in mind is that every individual’s menstrual cycle is unique, and factors such as cycle length, hormone levels, and fertility can vary from person to person. While some individuals have regular and predictable cycles, others may experience irregularities that make timing ovulation more challenging. In short, the likelihood of getting pregnant during menstruation is lower compared to other times in the menstrual cycle, but it is not zero.

By staying informed and proactive about reproductive health, individuals can take control of their fertility and make choices that align with their goals and preferences. Understanding our bodies and cycles is key to empowering ourselves in the context of both our pelvic and sexual health.  I always encourage my patients to ask questions and come to their appointments ready to discuss.  I hope this helped shed some light on frequently asked questions in women’s health!