Sexual education.

Sexuality, sexually transmitted diseases (STDs) how to protect yourself from STDs, contraceptives.

 

Sexuality

Sexuality plays a crucial role in human development. It all starts with fundamental values like respect, care, love, and protection. Sexuality is a wide-ranging concept encompassing a person’s beliefs, attitudes, behaviors, appearance, and emotions. It is more than just sex; it involves reproduction, contraception, STD prevention, hygiene, healthy relationships, responsible sexual behavior, anatomy, physiology, and pregnancy. Regrettably, this topic remains taboo and closed off even today. Yet, discussing it openly from an early age is incredibly vital. Sexuality begins at birth and continues throughout life. 

The following stages of sexuality can be identified:

The neonatal stage begins at birth, and during this time, parents lay the foundation for a child’s understanding of their sexuality. Parents influence the child’s perception of their own body through their actions, care, respect, and tenderness toward the child’s body. How they handle touch, hugs, and caresses is crucial, being mindful not to cause discomfort and being gentle. Taking care of the child’s genital area with sensitivity is also important, avoiding excessive touching or kissing. This approach helps instill in the child that their body deserves respect, care, and love. Consequently, they learn that such an attitude should be expected from both them and others as they grow, and it is something they should reciprocate in their interactions with others. 

Ages 1 to 3 – This phase is when a child starts to explore. This exploration typically follows a sequence: hands, feet, progressing upward from feet to the genital area, and eventually focusing on recognizing the head. It is essential to respond calmly to a child’s exploration, particularly when exploring their genital area. It is advised not to abruptly halt or forcefully pull their hand away, especially with rough or sudden movements. Throughout this process, referring to body parts by their accurate names is valuable, emphasizing the significance and naturalness of all body parts, including the genitals. 

Preschool period – During the preschool years, children enter a phase of curiosity and questioning. Providing accurate answers to their queries is vital, primarily for building their confidence. The questions children pose can be quite diverse, but during this stage, they start showing an interest in their origin and how things work. Considering their age is essential when responding to their inquiries, but it is also important to offer truthful information. While children might not fully comprehend certain details immediately, eventually, they will grasp the correct information. Being dishonest could lead to a breakdown of trust if they discover the falsehood later. 

School period- This phase can be termed a “secret period,” characterized by fewer, or even the absence of, questions from children.

Adolescence period- Physiological and psychological changes mark adolescence. Detailed descriptions of these changes can be found in the subsequent section of the website. 

Sexually transmitted infections and methods of safeguarding against them.

The decision to engage in sexual intercourse is personal, and the timing varies for everyone. When there is a clear mutual agreement, sexual activity can provide pleasure and foster intimate connections. However, it is crucial to recognize that it also carries the risk of transmitting sexually transmitted diseases and unintended pregnancy. It underscores the significance of being emotionally and physically prepared before engaging in sexual activity and being well-informed. 

Sexually transmitted infections, known as STDs, spread through sexual contact, blood, and breast milk. They result from approximately thirty different viruses, bacteria, and germs. Understanding that most STDs can be treated is essential, and contracting one does not imply a fatal outcome. To avert undesirable outcomes, it is advisable to engage in protected sexual intercourse. 

 Transmission Methods of Sexually Transmitted Diseases:

  • Any form of unprotected sexual activity: oral-genital, oral-anal, vaginal-penile, vaginal-vaginal, anal-penile.
  • Microorganisms responsible for STDs can also be transmitted through blood and tissue transplants.
  • Transmission can occur from a mother to her baby during pregnancy, childbirth, and even through breast milk. 

Symptoms of STDs:

Most STDs exhibit subtle or no noticeable symptoms. This underscores the significance of regular screenings. It is important to note that the presence of an STD cannot be confirmed solely through external examination. Moreover, an individual can transmit the infection to others even without symptoms.

When dealing with sexually transmitted infections, the following are some prevalent indicators:

  • Unpleasant genital odor
  • Itching in the genital area
  • Blisters or sores around the genitals
  • Pain while urinating
  • Pain during sexual intercourse
  • Flu-like symptoms
  • Fatigue
  • Irregular menstruation and uncommon bleeding (for women)
  • Testicular or vaginal discomfort
  • Abnormal discharge from the vagina (women) or urethra (men)
  • Abdominal pain

These symptoms might manifest shortly after an infection, some time or several years later. Importantly, it is worth noting that these symptoms are not exclusively indicative of a sexually transmitted infection; they can also be linked to other health issues.

Common STDs in Armenia are:

In Armenia, prevalent STDs include: 

  • Chlamydia: This bacterial infection can affect the urinary tract if left untreated. Antibiotics are effective in treating it.
  • Genital Herpes: Caused by herpes simplex viruses, the two common types are HSV-1 (oral transmission, resulting in blisters) and HSV-2 (genital transmission).
  • Trichomoniasis: This infection, caused by a parasite, can be treated with antibiotics.
  • Gonorrhea: A bacterial infection that affects mucous membranes; it is transmitted through oral-genital and genital-genital contact. Antibiotics are usually effective.
  • Syphilis: Caused by bacteria, it presents as ulcers in the genitourinary tract, mouth, or rectum. Untreated syphilis can lead to severe complications and death.
  • Hepatitis B: This viral infection affects the liver and can lead to cirrhosis or tumors. It spreads through sexual contact and blood, but vaccination can prevent it.
  • Human Papillomavirus (HPV): Transmitted through sexual contact, causing genital warts and potentially cervical cancer in women.
  • HIV (Human Immunodeficiency Virus) destroys immune system cells and can lead to AIDS. HIV has a latent period before symptoms show. It is transmitted through sexual contact, blood, and more. ARV pills can manage it, reducing transmission risk.
  • AIDS (Acquired Immunodeficiency Syndrome): The advanced stage of HIV weakens the immune system. ARV treatment reduces viral load and transmission risk. HIV is present in body fluids, but transmission risk from fluids like saliva and sweat is low.

HIV is not transmitted through:

  • Kissing, hugging, or shaking hands
  • Mosquito bites
  • Sharing household items

People living with HIV can lead fulfilling lives, have healthy children, and avoid infecting their partners through proper management.

Post-exposure HIV prevention involves taking specific medication within 72 hours after unprotected sex to prevent HIV infection. 

How do you protect yourself from sexually transmitted infections?

Reducing the risk of getting an STD involves various steps that couples should consider:

  • Condom Use: Consistent use of condoms (male or female condoms) prevents unwanted pregnancy and protects against sexually transmitted diseases.
  • Regular Medical Check-ups: Regular medical examinations facilitate early detection and treatment of STDs.
  • Monogamy: Being faithful to one partner free from STDs reduces risk.
  • Open Communication: Discussing sexual history with a partner promotes understanding and informed decisions.
  • Avoid Douching: Avoid douching after intercourse, as it can increase the chance of infection.
  • Oral Hygiene: Avoid brushing teeth before oral sex, as it can create conditions for infection transmission. Consider using condoms designed for oral sex.
  • Anal Intercourse Precautions: Anal intercourse requires preparation, starting with gentle entry and using specialized condoms with lubrication.
  • Post-Contact HIV Prevention: If unprotected sex occurs with a known HIV-infected person, post-contact HIV prevention within 72 hours is an option. Medication for this purpose can be obtained from the National AIDS Prevention Center (www.armaids.am)  

Contraceptives

Modern contraceptives serve two main functions:

  • Inhibiting Egg Cell Production: Certain modern contraceptives prevent the production of egg cells.
  • Preventing Sperm-Egg Interaction: Other contraceptives work by hindering the sperm from reaching the egg cell.

Condoms. Condoms come in two varieties: male and female. Made from latex, they are applied to an erect penis before sexual intercourse. Condoms act as a barrier, blocking sperm from entering the vagina, thus preventing pregnancy. Importantly, they are the sole method that protects against both pregnancy and the transmission of STDs. Other methods solely address preventing unwanted pregnancy. Condoms boast an effectiveness rate of approximately 99%.

Using a condom correctly involves these steps:

  • Check Expiration Date: Verify the condom’s expiration date before use.
  • Proper Application: Place the condom on the penis with the correct side facing out, then roll it down to the base of the penis.
  • After Ejaculation: After ejaculation, remove the condom carefully by holding the base of the penis.
  • Check for Damage: Examine the condom; it may be punctured or damaged in rare instances. If so, consider using other contraception methods, such as pills.
  • Single Use: Each condom should only be used once.
  • Avoid Using Multiple Condoms: Using more than one condom at once is not recommended, as friction between them can cause tearing. 

 Intrauterine device (IUD)

The intrauterine device (IUD), commonly called a “spiral,” is a small plastic coil placed within the uterine cavity to prevent pregnancy. Two types of IUDs boast a 99% effectiveness rate. 

  • Copper IUD: This device has copper wrapped around plastic. Copper impedes sperm movement, fertilization, and egg implantation in the uterine lining. Initially, its usage might lead to heavier and more painful menstrual cycles, but the body usually adapts over time. The copper IUD does not contain hormones. Its usage spans 10 – 12 years, and regular gynecologist visits are advised to ensure its correct placement.
  • Hormonal IUD: Releasing a small amount of progesterone hormone, this IUD prevents ovulation and thickens cervical fluid. It eases the menstrual cycle and can be used for up to 5 years.

 A doctor inserts an intrauterine device into the uterine cavity. Yearly check-ups are essential to ensure proper positioning, as the IUD can sometimes shift out of place. It is crucial to note that while the IUD is an effective contraceptive method, it does not offer protection against sexually transmitted diseases (STDs). 

 Contraceptive hormonal methods.

 There are several types of hormonal contraceptives: hormonal pills, injections, vaginal rings, and spermicide remedies.

 Contraceptive pills contain a small number of hormones (estrogen and progesterone) like those produced in a woman’s body. These hormones hinder egg maturation, making pregnancy unfeasible. They also thicken cervical mucus, obstructing sperm entry into the uterus and egg fertilization. Considering health contraindications, initiating pill usage under a doctor’s guidance is imperative.

Hormone injections encompass the same hormones but at a higher concentration. Administered by a healthcare professional, they can be given every three months.

 A vaginal ring, transparent and flexible, prevents pregnancy when inserted into the vagina. The woman inserts it and leaves it for three weeks before removing it for one week and then replacing it.

Spermicide methods involve substances like ointments, suppositories, or vaginal pills that neutralize sperm before they reach the uterus. For instance, spermicide creams or suppositories should be inserted into the vagina at least 15 minutes before intercourse and remain effective for an hour.

 There are additional contraceptive methods, although their effectiveness is limited. These include the withdrawal method and the calendar method.

 The withdrawal method involves the man pulling out his penis before ejaculating, preventing sperm from entering the vagina. However, its effectiveness is only around 75%. This is due to the challenge of controlling ejaculation timing, and sometimes, pre-ejaculatory fluid containing sperm can still be released. Furthermore, this method can diminish sexual pleasure since the man must withdraw before climax.

 The calendar method involves identifying the fertile days in the menstrual cycle to avoid intercourse during those times. However, its risk lies in the variability of menstrual cycles, leading to potential inaccuracies in identifying fertile days. As a result, this method might not provide reliable contraception.