Well-balanced sexual life is a part of pleasurable, fulfilled life that affects one’s physical and mental health in a positive way. Sexuality means all physical and mental processes with direct or undirect connection to the individual and social aspects of sexuality.
Sexuality has strong biological basis that provides the fundamentals of learnt sexual behaviour that is affected by many psychosocial and sociocultural factors. Healthy sexual life has strong connections with the quality and functioning of a relationship.
Definition of sexual health
According to the definition of the World Health Organization (WHO) sexual health is an integral part of overall health, well-being and quality of life. Sexual health requires a free and respectful approach to sexuality, ensuring the harmony in individual and social well-being, enriching personal and social life.
The definition of sexual health includes three fundamental factors:
- enjoyment and control of sexual and reproductive behaviour, in harmony with social and individual ethic;
- exemption from fears, shame, guilt, prejudice and other mental factors that may block sexual response and harm sexual relationships;
- exemption from organ dysfunctions, illnesses and deficiencies that may hinder sexual and reproductive functions.
The definition claims that sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality, and not merely the absence of disease, dysfunction, or infirmity. For sexual health to be attained and maintained, sexual rights of all people must be respected, protected and fulfilled. Sexual health assumes the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
WHO published a recommendation on sexual health in 2020. According to the paper, everyone must have a right to the followings, without any coercion, discrimination and violence:
- highest level of sexual health and services supporting it;
- obtaining information on sexuality;
- sexual education;
- respect of body integrity;
- choosing a partner;
- sexual activity or abstinence;
- sexual relationships with consent;
- marriage with consent;
- choosing the time of voluntary childbearing;
- satisfying, safe and pleasurable sexual life.
A child’s sexual development after birth is influenced by the interaction of different psychological and cultural factors with individual biology. The surroundings, the impact of close circles (family, friends from the same age, school) and further circles (cultural values, characteristics of community etc.) and their interactions shape sexual development beside genetic and hormonal factors.
The main fields of sexual behaviour are gender-role behaviour, erotic behaviour and reproductive behaviour. The learning of gender-role behaviour starts during infancy. Learning erotic behaviour or sexual behaviour (in the narrow sense) starts later but still in childhood. Reproductive behaviour starts with puberty.
Physiology of sexual response
Sexual response happens under the control of the cooperation of the nervous system’s different parts and has a four-stages cycle: desire, arousal, orgasm and resolution.
Desire is the urge to make sexual contact. Arousal is the phase of sexual readiness, where blood flow is increasing in the genitals. This leads to erection in men and in women to swelling of clitoris, increased blood flow in vaginal walls and vaginal lubrication. Orgasm is the climax of sexual arousal. In this phase semen ejaculate from the penis or the muscles around the vagina contract rhythmically. Men and women also experience contractions of muscles in the pelvis and the tone of skeletal muscles increases, too. Resolution comes with the feeling of well-being and the relaxation of muscles after the orgasm.
Several conditions and circumstances may endanger sexual health. The cause of sexual dysfunction may be physical, mental, or both. Relatively common examples are sexually transmitted diseases, unwanted pregnancies, starting sexual life too early, violence between partners, cultural traditions causing genital mutilation or the lack of information.
Sexual dysfunction may affect any stage of the first three of the sexual response cycle. Some people face sexual dysfunctions all their life. In other cases, before dysfunction occurs, sexual function was normal (acquired type). Dysfunctions may affect all areas of sexual functions (generalized type) or may appear only in specific situations (situational type).
Sexual dysfunctions include the dysfunctions of desire (libido), arousal and orgasm, sexual pain disorders (dyspareunia) and sexual dysfunctions caused by general health state, illnesses, and drug use.
Preserving sexual health
The goal of sexual health prevention is preserving sexual life and personal relationships associated with it. It has great importance to draw the attention of the inexperienced and uneducated young that sexual activity may be a source of mental problems, violence, sexually transmitted diseases; and unwanted pregnancy at early age may be a serious problem, as well.
Sexual education and providing information on sexuality has important role in preserving sexual health. Education should cover the topics of sexuality, such as sexually transmitted diseases, contraception, safe sex and the use of condoms. It also should inform about preserving healthy sexual relationships and taking responsibility.
Sexual psychology is a branch of psychology examining the gender characteristics of sexual behaviour and studies the determinant factors in relation to genders. It pays attention to the physical and mental needs that define behaviour and the conditions of their fulfilment (e.g. possibilities and abilities of orientation, choice and implementation). A sexual psychologist specialist offers help to gain and preserve healthy and balanced relationship and psychosexual function, and also to avoid problems or their aggravation.
In case symptoms related to sexual health do not need further medical attention, a sexual psychologist can help the client with counselling. The goal of counselling is to explore the psychological background of the problems and to help preventing it to reappear, or gain the ability to deal with it. The counsellor’s tools are psychoeducation, developing self-knowledge and communicational skills along with the use of other psychological methods developed for treating sexual dysfunctions.
If needed the therapist helps and complements the work of urologist, andrologist and gynaecologist with the tools of psychology. Expert knowledge ensures that the sexual psychologist is able to give lectures and practical sessions on the topics of family life and sexual education in schools, educational consultancy offices or at other venues.