A Guy's Guide to Body Image

Al's friend Rachel invited him to go to the lake for the day with her family. Rachel thought Al was fun to be around — plus he was cute. Rachel really hoped he'd say yes.
Al turned Rachel down. He liked Rachel, too, but was self-conscious about taking off his T-shirt. He worried that her family and others at the lake would see what he saw when he looked in the mirror — a scrawny excuse for a man. Al hadn't gone to the pool in more than a year because he was so self-conscious about his appearance.
The Truth About Guys
Many people think of guys as being carefree when it comes to their appearance. But the reality is that a lot of guys spend plenty of time in front of the mirror. It's a fact — some guys care just as much as girls do about their appearance.
You may hear a lot about being a tough guy, but how often do you hear that being a guy is tough? Guys might think that they shouldn't worry about how they look, but body image can be a real problem for them. Unlike girls, guys are less likely to talk to friends and relatives about their bodies and how they're developing. Without support from friends and family, they may develop a negative self-image. The good news is that self-image and body image can be changed.
Why Is Body Image Important?
Body image is a person's opinions, thoughts, and feelings about his or her own body and physical appearance. Having a positive body image means feeling pretty satisfied with the way you look, appreciating your body for its capabilities and accepting its imperfections. Body image is part of someone's total self-image. So how a guy feels about his body can affect how he feels about himself. If he gets too focused on not liking the way he looks, a guy's self-esteem can take a hit and his confidence can slide. (The same thing can happen to girls, too.)
How Puberty Affects Body Image

Although body image is just one part of our self-image, during the teen years, and especially during puberty, it can be easy for a guy's whole self-image to be based on how his body looks. That's because our bodies are changing so much during this time that they can become the main focus of our attention.
A change in your body can be tough to deal with emotionally — mainly because, well, your body is yours and you have become used to it.
Some guys don't feel comfortable in their changing bodies and can feel as if they don't know who they are anymore. Being the only guy whose voice is changing or who's growing body hair (or the only guy who isn't) can also make some guys feel self-conscious for a while.
Some guys go into puberty not feeling too satisfied with their body or appearance to begin with. They may have wrestled with body image even before puberty started (for example, battles with weight or dissatisfaction with height). For them, puberty may add to their insecurities.
It Could Be in Your Genes
It can be tough to balance what you expect to happen to your body with what actually does happen. Lots of guys can have high expectations for puberty, thinking they'll develop quickly or in a certain way.
The best way to approach your own growth and development is to not assume you'll be a certain way. Look at everyone in your family — uncles, grandfathers, and even female relatives — to get an idea of the kinds of options your genes may have in store for you.
When Everyone Else Seems Bigger
Not everyone's body changes at the same time or even at the same pace. It can be tough if all of your friends have already matured physically and are taller and more muscular. Most guys eventually catch up in terms of growth, although some will always be taller or more muscular than others — it's in their genes.
It's natural to observe friends and classmates and notice the different ways they're growing and developing. Guys often compare themselves with other guys in certain settings, and one of the most common is the locker room. Whether at a local gym or getting ready for a game at school, time in the locker room can be daunting for any guy.
Try to keep in mind in these situations that you aren't alone if you feel you don't "measure up." Many guys feel exactly the same way about their own bodies — even those whose physiques you envy. Just knowing that almost everyone else will go through the same thing can make all the difference.
You could try talking to a trusted male adult — maybe a coach, a doctor, a teacher, or your dad. Chances are they went through similar experiences and had some of the same feelings and apprehensions when their bodies were changing.
Picture Perfect?
Guys put enough pressure on themselves, but what about the pressure society puts on them to be perfect?
It used to be that only girls felt the pressure of picture-perfect images, but these days the media emphasis on men's looks creates a sense of pressure for guys, too. And sometimes (actually many times) that "as advertised" body is just not attainable. The men you see in those pictures may not even be real. Magazines and ad agencies often alter photographs of models, either by airbrushing the facial and muscular features, or by putting a good-looking face on someone else's buff body.
Building a Better Body Image
So in the face of all the pressure society places on guys — and guys place on themselves — what can you do to fuel a positive body image? Here are some ideas:
Recognize your strengths. Different physical attributes and body types are good for different things — and sometimes the things you did well as a kid can change during puberty. What does your body do well? Maybe your speed, flexibility, strength, or coordination leads you to excel at a certain sport. Or perhaps you have non-sports skills, like drawing, painting, singing, playing a musical instrument, writing, or acting. Just exploring talents that you feel good about can help your self-esteem and how you think of yourself.
A good body doesn't always translate into athletic success. Too often, the way guys see their body image is closely associated with their performance on a sports field or in the gym. The upside to this is that if you're good at a team sport, you might have a pretty good view of your body. But what if you don't like team sports or you got cut from a team you really wanted to make? In these cases, it helps to look at individual accomplishments.
If you don't like team sports, that's OK. Try finding another form of physical activity that really gets you going. Depending on your interests and where you live, that may be mountain biking, rock climbing, dancing, yoga, or even jogging. This will help you stay in shape and help you to appreciate skills may not have realized you had in a team environment.
If you like team sports but didn't make a particular team, don't let it get you down. Use this as an opportunity to discover what you're good at, not to lament what you aren't best at. Maybe try out for another team — so soccer wasn't for you, but maybe cross-country running will be.
If none of these appeal to you, continue to practice the sport you were cut from and try again next year. The people around you probably won't remember that you didn't make the team — not being picked was a much bigger deal to you than it was to them.
Look into starting a strength training program. Exercise can help you look good and feel good about yourself. Good physiques don't just happen — they take hard work, regular workouts, and a healthy diet. There's no need to work out obsessively. A healthy routine can be as simple as exercising 20 minutes to 1 hour three days a week. Another benefit to working out properly is that it can boost your mood — lifting weights can lift your spirits.
Don't trash your body, respect it! To help improve your view of your body, take care of it. Smoking and other things you know to be harmful will take a toll after a while. Treating yourself well over time results in a healthier, stronger body — and that contributes to a better body image. Practicing good grooming habits — regular showering; taking care of your teeth, hair, and skin; wearing clean clothes, etc. — also can help you build a positive body image.
Be yourself. Your body is just one part of who you are — along with your talent for comedy, a quick wit, or all the other things that make you unique. Your talents, skills, and beliefs are just as much a part of you as the casing they come in. So try not to let minor imperfections take over.
While it's important to have a positive body image, getting too focused on body image and appearance can cause a guy to overlook the other positive parts of himself. If you're like most guys who take care of their bodies and wear clothes that look good, you probably look great to others. You just might not be aware of that if you're too busy being self-critical.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: November 2006

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All About Menstruation

Menstruation (a period) is a major stage of puberty in girls; it's one of the many physical signs that a girl is turning into a woman. And like a lot of the other changes associated with puberty, menstruation can be confusing. Some girls can't wait to start their periods, whereas others may feel afraid or anxious. Many girls (and guys!) don't have a complete understanding of a woman's reproductive system or what actually happens during the menstrual cycle, making the process seem even more mysterious.
Puberty and Periods
When girls begin to go through puberty (usually starting between the ages of 8 and 13), their bodies and minds change in many ways. The hormones in their bodies stimulate new physical development, such as growth and breast development. About 2 to 2½ years after a girl's breasts begin to develop, she usually gets her first menstrual period.
About 6 months or so before getting her first period, a girl might notice an increased amount of clear vaginal discharge. This discharge is common. There's no need for a girl to worry about discharge unless it has a strong odor or causes itchiness.

Baby girls are born with ovaries, fallopian tubes, and a uterus. The two ovaries are oval-shaped and sit on either side of the uterus (womb) in the lowest part of the abdomen called the pelvis. They contain thousands of eggs, or ova. The two fallopian tubes are long and thin. Each fallopian tube stretches from an ovary to the uterus, a pear-shaped organ that sits in the middle of the pelvis. The muscles in a female's uterus are powerful and are able to expand to allow the uterus to accommodate a growing fetus and then help push the baby out during labor.
As a girl matures and enters puberty, the pituitary gland releases hormones that stimulate the ovaries to produce other hormones called estrogen and progesterone. These hormones have many effects on a girl's body, including physical maturation, growth, and emotions.
About once a month, a tiny egg leaves one of the ovaries — a process called ovulation — and travels down one of the fallopian tubes toward the uterus. In the days before ovulation, the hormone estrogen stimulates the uterus to build up its lining with extra blood and tissue, making the walls of the uterus thick and cushioned. This happens to prepare the uterus for pregnancy: If the egg is fertilized by a sperm cell, it travels to the uterus and attaches to the cushiony wall of the uterus, where it slowly develops into a baby.
If the egg isn't fertilized, though — which is the case during most of a woman's monthly cycles — it doesn't attach to the wall of the uterus. When this happens, the uterus sheds the extra tissue lining. The blood, tissue, and unfertilized egg leave the uterus, going through the vagina on the way out of the body. This is a menstrual period. This cycle happens almost every month for several more decades (except, of course, when a female is pregnant) until a woman reaches menopause and no longer releases eggs from her ovaries.
How Often Does a Girl Get Her Period?
Just as some girls begin puberty earlier or later than others, the same applies to periods. Some girls may start menstruating as early as age 10, but others may not get their first period until they are 15 years old.
The amount of time between a girl's periods is called her menstrual cycle (the cycle is counted from the start of one period to the start of the next). Some girls will find that their menstrual cycle lasts 28 days, whereas others might have a 24-day cycle, a 30-day cycle, or even longer. Following menarche, menstrual cycles last 21–45 days. After a couple of years, cycles shorten to an adult length of 21–34 days.
Irregular periods are common in girls who are just beginning to menstruate. It may take the body a while to sort out all the changes going on, so a girl may have a 28-day cycle for 2 months, then miss a month, for example. Usually, after a year or two, the menstrual cycle will become more regular. Some women continue to have irregular periods into adulthood, though.
As a girl gets older and her periods settle down — or she gets more used to her own unique cycle — she will probably find that she can predict when her period will come. In the meantime, it's a good idea to keep track of your menstrual cycle with a calendar.
How Long and How Much?
The amount of time that a girl has her period also can vary. Some girls have periods that last just 2 or 3 days. Other girls may have periods that last 7 days or longer. The menstrual flow — meaning how much blood comes out of the vagina — can vary widely from girl to girl, too.
Some girls may be concerned that they're losing too much blood. It can be a shock to see all that blood, but it's unlikely that a girl will lose too much, unless she has a medical condition like von Willebrand disease. Though it may look like a lot, the average amount of blood is only about 2 tablespoons (30 milliliters) for an entire period. Most teens will change pads 3 to 6 times a day, with more frequent changes when their period is heaviest, usually at the start of the period.
Especially when menstrual periods are new, you may be worried about your blood flow or whether your period is normal in other ways. Talk to a doctor or nurse if:

* your period lasts longer than a week
* you have to change your pad very often (soaking more than one pad every 1–2 hours)
* you go longer than 3 months between periods
* you have bleeding in between periods
* you have an unusual amount of pain before or during your period
* your periods were regular then became irregular

Cramps, PMS, and Pimples
Some girls may notice physical or emotional changes around the time of their periods. Menstrual cramps are pretty common — in fact, more than half of all women who menstruate say they have cramps during the first few days of their periods. Doctors think that cramps are caused by prostaglandin, a chemical that causes the muscles of the uterus to contract.
Depending on the girl, menstrual cramps can be dull and achy or sharp and intense, and they can sometimes be felt in the back as well as the abdomen. These cramps often become less uncomfortable and sometimes even disappear completely as a girl gets older.
Many girls and women find that over-the-counter pain medications (like acetaminophen or ibuprofen) can relieve cramps, as can taking a warm bath or applying a warm heating pad to the lower abdomen. Exercising regularly throughout the monthly cycle may help lessen cramps, too. If these things don't help, ask your doctor for advice.
Some girls and women find that they feel sad or easily irritated during the few days or week before their periods. Others may get angry more quickly than normal or cry more than usual. Some girls crave certain foods. These types of emotional changes may be the result of premenstrual syndrome (PMS).
PMS is related to changes in the body's hormones. As hormone levels rise and fall during a woman's menstrual cycle, they can affect the way she feels, both emotionally and physically. Some girls, in addition to feeling more intense emotions than they usually do, notice physical changes along with their periods — some feel bloated or puffy because of water retention, others notice swollen and sore breasts, and some get headaches.
PMS usually goes away soon after a period begins, but it can come back month after month. Eating right, getting enough sleep, and exercising may help relieve some of the symptoms of PMS. Talk to your doctor if you are concerned about your premenstrual symptoms.
It's also not uncommon for girls to have an acne flare-up during certain times of their cycle; again, this is due to hormones. Fortunately, the pimples associated with periods tend to become less of a problem as girls get older.
Pads, Tampons, and Liners
Once you begin menstruating, you'll need to use something to absorb the blood. Most girls use a pad or a tampon. But some use menstrual cups, which a girl inserts into her vagina to catch and hold the blood (instead of absorbing it, like a tampon).
There are so many products out there that it may take some experimenting before you find the one that works best for you. Some girls use only pads (particularly when they first start menstruating), some use only tampons, and some switch around — tampons during the day and pads at night, for example.
Girls who worry about leakage from a tampon often use a pantiliner, too, and some girls use liners alone on very light days of their periods.
Periods shouldn't get in the way of exercising, having fun, and enjoying life. Girls who are very active, particularly those who enjoy swimming, often find that tampons are the best option during sports.
If you have questions about pads, tampons, or coping with periods, ask a parent, health teacher, school nurse, or older sister.

Reviewed by: Mary L. Gavin, MD
Date reviewed: May 2007
Originally reviewed by: Neil Izenberg, MD

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Why Does A Lover Pull Away after Sex?

Dopamine. It's at the core of our sexual drives and survival needs, and it motivates us to do just about everything.Gone with the Wind This mechanism within the reward center of the primitive brain has been around for millions of years and has not changed. Rats, humans - indeed, all mammals - are very similar in this respect.
Dopamine is behind a lot of the desire we associate with eating and sexual intercourse. Similarly, all addictive drugs trigger dopamine (the "craving neurochemical") to stimulate the pleasure/reward center. So do gambling, shopping, overeating and other, seemingly unrelated, activities. Go shopping: dopamine. Smoke a cigarette: dopamine. Computer games: dopamine. Heroin: dopamine. Orgasm: dopamine. They all work somewhat differently on the brain, but all raise your dopamine.
You get a bigger blast of dopamine eating high-calorie, high-fat foods than eating low-calorie vegetables. You may believe that you love ice cream, but you really love your blast of dopamine. You're genetically programmed to seek out high-calorie foods over others. Similarly, dopamine drives you to have sex over most other activities. With dopamine as the driving force, biology has designed you to engage in fertilization behavior to make more babies, and urges you to move on to new partners to create greater genetic variety among your offspring.
Your primitive brain accomplishes these goals of more progeny and promiscuity by manipulating your brain chemistry, and thus your desires and thoughts. High levels of dopamine increase sexual desire, encouraging you to behave recklessly. The thrill of a new affair and the rush from using pornography are examples of high

Humans, however, don't have a period of "heat" followed by a long period of indifference to sex. Unlike all other mammals, we have the potential for on-going, dopamine-driven sexual desire. Yet we, too, self-regulate. An "off switch" kicks in after too much passion.
Two events happen simultaneously. Dopamine plummets and prolactin soars. Dopamine is "go get it!" and prolactin is "whoa!" This mechanism shifts your attention elsewhere: to hunting and gathering, taking care of babies, building shelters, and so forth. Without this natural, protective shutdown, you would pursue sex to the exclusion of all other activities. When rats were wired so that they could push a lever in their cages to stimulate the nerve cells on which dopamine acts, they just kept hitting the lever until they dropped - not even pausing to eat or investigate potential mates. Dopamine is highly addictive; the rise in prolactin puts the brakes on.
This event (drop in dopamine and rise in prolactin) is the cause of the emotional separation that so often follows in the days or weeks after a passionate encounter.
Feelings & behaviors associated with various dopamine levels Excess Deficient "Normal"
Anxiety Anhedonia - no pleasure, world looks colorless Motivated
Psychosis Inability to "love" Feelings of well-being, satisfaction
Aggression No remorse about personal behavior Pleasure, reward in accomplishing tasks
Schizophrenia Depression Healthy libido
Addictions, Compulsions Addictions (seeking relief from depression) Good feelings toward others
Paraphilias (Sexual Fetishes) Low libido Maternal/Paternal love
Unhealthy risk-taking Erectile dysfunction Healthy risk taking
Gambling Lack of ambition and drive Sound choices
Impulsive sensation-seeking ADD? Realistic expectations
Compulsive activities Social anxiety disorder ---
--- Sleep disturbances, "restless legs" ---

As you can see from this chart, a balanced level of dopamine is necessary for good mental health. When dopamine drops, you feel like something is dreadfully wrong. Too much dopamine also leads to reckless behavior and restless anxiety, which can be quite severe. These uncomfortable feelings are then projected onto your partner. Bingo! Suddenly, he or she doesn't look so appealing. This is a very uncomfortable cycle to experience in your intimate relationship. During the "hangover," or "low-dopamine" portion of the cycle, you may feel abandoned, or as if someone is demanding things from you in ways that you cannot tolerate. Or you may desperately seek new highs (alcohol, sweets, new partners, pornography, and so forth) to raise your dopamine levels again.
Perhaps you can see how this cycle of highs and lows, or attraction and repulsion, can make your relationship feel more like a roller-coaster ride than a romantic fairytale. It is like starting and stopping in heavy traffic. It shows up in lovers' lives as intense attraction, followed by behaviors that tend to separate them. (Prolactin can promote separation, too, as we'll see in a moment.)
The point is that conventional sex can play havoc with your neurochemistry. Much of the time, your dopamine levels will be uncomfortably high or uncomfortably low.
This is why the ancient Taoists and other sages throughout history have recommended making love without conventional orgasm. By avoiding the extreme highs that over-stimulate the nerve cells in the primitive brain, you also avoid the temporary lows that accompany recovery. You keep your dopamine levels within ideal ranges. This produces a sense of wellbeing, which promotes harmony in your relationship.
disharmonyDopamine is not the only culprit that contributes to the behaviors and mood swings that separate intimate partners emotionally. Prolactin, the neurochemical that shoots up after orgasm, is associated with many of the very symptoms that long-term couples complain of in their relationships. (See chart below.)
Prolactin's effects can linger. For example, cocaine blasts the brain with high levels of dopamine, and prolactin rises during withdrawal. Indeed, addicts going through withdrawal required two weeks for their prolactin levels to drop to normal. After mating, female rats show surges in prolactin for up to two weeks - even if they don't get pregnant. Finally, prolactin is associated with the stress of feeling hopeless. As partners grow distressed and discouraged by the puzzling highs and lows in their relationships, their higher prolactin levels can compound their distress. They forget what it feels like to be in balance, and gradually lose their natural sense of wellbeing.
couple shoutingBoth low dopamine and high prolactin make your world look bleak - and increase your craving for better sex or new partners who would raise your dopamine levels (and set you on another addictive cycle of highs and lows). Together these neurochemicals probably account for the "end of the honeymoon," which nearly all couples experience within a year of marriage.
Symptoms associated with excess prolactin Women Men
Loss of libido Loss of libido
Mood changes / depression Mood changes / depression
Hostility, anxiety Impotence
Headache Headache
Menopausal symptoms,
even when estrogen is sufficient Infertility
Signs of increased testosterone levels Decreased testosterone levels
Weight gain Weight gain
Intercourse may become painful because of vaginal dryness Peripheral vision problems
Infertility, irregular menstruation Gynecomastia (growing breasts)
Peripheral vision problems ---
There are at least three source of emotional friction related to these brain chemistry shifts. (1) Partners get out of sync. Dopamine levels rise in one while the prolactin levels are still high in the other. You may desperately want sex, while your partner has no interest at all. 2) Partners project their state of mind onto each other. When you feel rotten, or "hungry," or just plain "off," it's normal to find fault with the person closest to you. It honestly seems like you'd feel fine if he'd just be more generous, or she would just stop shopping for more and more shoes and make love. sulking couple cartoon(3) Partners' brains get rewired over time, away from love and toward defensiveness. The part of your primitive brain that is designed to react to snakes and predators is now being activated by your partner. Certainly your partner didn't threaten to poison you, but sex with your partner later made you feel bad at a subconscious (neurochemical) level. Actually, of course, you hurt yourself by letting biology tell you how to have a good time in the bedroom. Your subconscious, however, feels that your lover is the culprit.
Virtually no one identifies this hidden, biological source of distress. Instead, the part of your brain that analyzes looks for other explanations. You know, for example, that you don't feel right. Your partner is acting weird. You're upset, and your honeymoon has ended. Maybe you write your uneasiness off as a mood swing, or get a prescription for an antidepressant. Or maybe you feel that your partner is somehow to blame for the fact that you feel rotten. "If only he would help more around the house." "If only she would stop badgering me." couple kissing in bed And so on. Yet, when you try to fix each other, you're addressing symptoms and ignoring the deeper problem - these neurochemical shifts.

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The Big 'O' Isn't Orgasm

Researchers are always seeking answers to fundamental questions about illness: "What is the cause of cancer?" "How does stress damage your cells and organs?" "What causes plaque to build up inside your arteries?"
The flip side of such questions is "what is the mechanism by which love and affection positively affect health?" The answer to this question is oxytocin. Oxytocin is a hormone and neurotransmitter. Once believed to confine its effects to inducing labor and milk ejection, oxytocin actually has far-reaching effects on both sexes. You could not fall in love without it. These days it goes by nicknames such as "the bonding hormone," "the cuddle hormone," and even "the love hormone."
The primary conscious behavior or thought process that increases oxytocin is caring for another. Appreciation, generous touch, gratitude, and emotional connections with others also raise oxytocin levels. In addition, oxytocin appears to be behind many of the health benefits from meditation, massage and acupuncture. We see one of oxytocin's most powerful effects at birth - when the mother and father bond with their child. At that moment, oxytocin surges causing a rewiring of both parents' brains so that they will do anything for their little screaming creature. Under ordinary circumstances they remain permanently in love.

We all form similar connections with friends, lovers, cats, gurus, or even God. And the benefits to us of these deep connections are great. Oxytocin is the reason why people with pets tend to recover more quickly from illness, why married people tend to live longer, why support groups benefit those with cancer, addictions and chronic disorders, and why care-giving primate parents, whether male or female, live longer than the non-care-giving parents.
How can oxytocin produce such tremendous health benefits? The exact mechanism is not clear, but the key seems to be oxytocin's ability to counteract the effects of stress. To state this differently, if you listed all the conditions and diseases related to stress or aggravated by stress, you'd have to list nearly every known condition. By easing stress, oxytocin helps to heal them all.

Consider some of the other research on this important hormone:

* Oxytocin reduces cravings. When scientists administered it to rodents who were addicted to cocaine, morphine, or heroin, the rats opted for less drugs, or showed fewer symptoms of withdrawal. (Kovacs, 1998) Oxytocin also reduces cravings for sweets. (Billings, 2006)
* Oxytocin calms. A single rat injected with oxytocin has a calming effect on a cage full of anxious rats. (Agren, 2002)
* Oxytocin increases sexual receptivity and counteracts impotence. (Pedersen, C.A., 2002), (Arletti, 1997)
* Oxytocin counteracts the effects of cortisol, the stress hormone. (Legros, 2003) Less stress means increased immunity and faster recovery.
* Oxytocin appears be a major reason that SSRIs (like Prozac®) ease depression, perhaps because high levels of cortisol are the chief culprits in depression and anxiety disorders. (Uvnas-Moberg, 1999)

In addition to oxytocin's powerful effects on the body, it strongly affects your mind and behavior. It is nature's antidepressant and anti-anxiety hormone. It creates feelings of calm and a sense of connection, so it actually shapes how you view the world. The whole universe looks like a better place when you feel tranquil and loving. Oxytocin also reduces cravings, which makes it the key to healing addictions of all kinds. For example, rats addicted to heroin used less of the drug when experimenters raised oxytocin levels in their brains.
Have you heard the saying, "the more you give, the more you get?" Well, it applies to oxytocin, too. The more you nurture and connect with others, the more responsive your body and brain become to it. This makes it an unusual neurotransmitter. Compare it with substances like alcohol or caffeine. The more you use them, the greater the quantity you require to obtain the same effect. Oxytocin is the opposite. The more you give and nurture, the more strongly you respond.
You can't take a pill to obtain these benefits because oxytocin would swiftly breakdown in your stomach. Not even an injection would work because the body gets rid of it so quickly. The only artificial way to keep oxytocin up would be to receive a continuous IV, and still that would have no effect on your brain - which is where it must be released to affect social bonds. (Yes, there are oxytocin nasal sprays, but they are riskier and less specific in effect than learning to produce this neurochemical organically by choosing activities that produce it in ideal quantities and locations within your brain and body.)
Yet it is within your power to release oxytocin within your brain and body - short of having a child or an orgasm (see below). Consciously stick to behaviors that promote its production in areas of the body and brain that yield beneficial effects. couple in bedMeditate, nurture others, reach out to connect with people, and make love in a way thatkeeps your heart open. And avoid relationship distress.1
Because of oxytocin's roles in bonding and reducing cravings, we believe it is the key to authentic monogamy and, of course, peace between the sheets. That is, if you want to stay in love, you need to sustain the production of oxytocin. This happens effortlessly…until some point after conventional sex enters the equation.
Here's why. Falling in love calls forth a soup of neurochemicals, including oxytocin's bonding effects. However, as we've explained in other articles, conventional sex tends to over-stimulate the pleasure/reward center deep
within the brain. screaming lioness Specifically, a neurochemical called dopamine (ideal levels of which are also necessary forttraction between mates) drops after orgasm. Therefore bonds can erode. Low dopamine can also create psychological distress.
Over time, this roller coaster of highs and lows leads to subconscious defensiveness and emotional distance between partners. Once uneasiness enters your intimate relationship, the bond between the two of you tends to weaken. That is, you produce less oxytocin. So you can see how biology's agenda unravels your relationships over time despite oxytocin's bonding properties.
The situation is confusing, even to scientists, because levels of oxytocin (at least in the bloodstream) rise sharply in most of us at the moment of orgasm. However, research suggests that this 30-second surge of oxytocin may have little to do with emotional bonding, and more to do with inducing the contractions associated with orgasm (to move the sperm along). Oxytocin, remember, also produces birth contractions. Even if there is a corresponding surge of oxytocin in the brain at the moment of orgasm, it is obvious that people can have sex without bonding. Some get up and leave; others roll over and snore.
The best plan? Consciously encourage oxytocin production with caring behavior. In this way you protect and strengthen the bonding connections in your brain and tap the health benefits discussed above.
Sadly, the normal relationship pattern is for couples to get together, think they will love each other forever, and then end up fighting and splitting up, or simmering in resentment and stagnation. This roller coaster of passion-followed-by-separation is behind the decline in oxytocin. The result? The honeymoon ends.
Our experience, making love without orgasm, has been just the reverse of this typical pattern. Our relationship stays light-hearted and romantic and has grown closer with time. We believe this positive trend is the result of consciously avoiding the behaviors that create subconscious uneasiness between partners. In this way we maintain our initial levels of oxytocin. And, as we've become increasingly responsive to "the Big 'O'," that is, oxytocin, our connection grows stronger and healthier. It will work for you, too!
link:http://www.reuniting.info

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Sex & Spinal Cord Injury

"Sex is something you do, sexuality is something you are."
Although sexual adjustment of some kind is a fact of life for many persons with disabilities, frank discussion about sexuality and disability still remains a profoundly personal and sensitive topic. One reason is that sex (which has come to mean sexual intercourse) and sexuality (which embraces the whole self) are very often merged in people’s minds. Such confused thinking can easily produce the "you’re as good as your sexual performance" syndrome.
Another reason is that not enough health professionals have integrated sex education and counselling into their personal practice or rehabilitation setting. To be successful, rehabilitation must address people’s physical, emotional and social needs. Getting the facts about the sexual implications of your condition is an important part of this process. But so is integrating this knowledge into your relationships with partners, family, health attendants and co-workers. That’s where some people could use support from health professionals.
Just how well is the health profession doing with respect to sex education and counselling in rehabilitation programs? A recent study by Mitchell S. Tepper, M.P.H., of 458 members of the American National Spinal Cord Injury Association revealed an obvious gap between services needed and services offered in a rehabilitation program. To meet the needs of persons with spinal injury, the study suggested that a program include:

- discussion of sexuality initiated at an early stage;

- a combination of written materials, videos and individual counselling;

- four or more sessions dedicated to topics related to sexuality;

- consultation access to other persons with spinal cord injuries who have more sexual experience; and

- the individual’s physician being open and available for consultation.

While not all disabilities are the same, the issues remain the same for every person with a disability who has experienced altered sexual function, according to Dr. Michael Barrett, Ph.D., professor of zoology at the University of Toronto and chairperson of the Sex Information and Education Council of Canada (SIECCAN). These issues include sexual desire and response, partnership functions, bowel and bladder functions, fertility and contraception, mobility (positioning, caressing, etc.) and the effects that changes in these things can have on self-image and self-esteem.
Both sexes can have their sexual response altered by some disabling conditions such as spinal cord injury. A study by Meredith E. Drench, M.Ed., P.T., found that men place high value on performance. Any challenge to their sense of sexual adequacy, for example, changes in erection, ejaculation and fertility, can affect basic psychological needs and greatly impede overall adjustments and acceptance of their disability.
Women with cord injuries, on the other hand, adjusted better because they have traditionally placed more value on the intimate interpersonal relationship aspects of sexuality such as tenderness, care and concern. Their genital function loss is also considerably less and therefore these women’s sexual adjustment may be easier. Kettl et al., in "Female Sexuality After Spinal Cord Injury", report that women can often experience orgasm after spinal cord injury. Even women with complete spinal injuries may experience a buildup of sexual tension and release that, although different from before their injury, is physically and psychologically satisfying.
It is noteworthy that considerably more research exists on male sexuality after spinal cord injury than on female sexuality. According to Kettl, "the reasons for this are not entirely clear. Since only one in five spinal cord injuries occurs in a woman, this lack of information may reflect a lack of knowledge in a specialized area in a less affected population. However, medicine has ignored sexuality and especially female sexuality far too often and the lack of data concerning female sexuality may simply reflect this overall trend in medicine."
Contrary to well-established myths about persons with disabilities, men and women with spinal cord injury continue to have sexual feelings and can achieve sexual satisfaction depending on the level and extent of injury. For this reason, proper assessment of the injury by medical personnel is very important and a sexual history is helpful.
In the case of men, Drench reports that, generally, the higher the lesion, the greater the likelihood of erection, and the lower the lesion, the greater possibility of ejaculation.
Attaining an erection is not as problematic as having orgasm and ejaculation. Paraplegic women, along with experiencing orgasm, can conceive normally and carry babies to full term, often giving birth through vaginal deliveries. Since fertility is rarely affected, it is important to consider appropriate contraception options.
Men, however, experience low fertility following a spinal cord injury. This may be due to lack of erection or ejaculation or testicular atrophy with the absence of spermatogenesis. Since more than 90 per cent of men with spinal cord injuries experience serious decreased fertility, vibratory and electroejaculation techniques have been used to induce semen emission that can be used for insemination. Barbara Rines, R.N., a sexual health nurse at the G.F. Strong Rehabilitation Site in Vancouver, described this fertility enhancement procedure for men in the Winter 1992 issue of the Canadian Journal of Sexuality.
If you’re curious about what techniques can help you and your partner with sexual response and enjoyment, you may find some listed by Drench quite suitable to your needs. Sexual feelings can stimulate an erection for men with incomplete injury who have some body function and feeling below the level of the injury. Seeing what works is a good idea, for example by trying manual caressing of the penis, gently pulling at the pubic hair, anal stimulation, placing a finger in the rectum or slapping the thigh.
If erection is unpredictable or not possible, the recently developed Synergist erection system, or other such devices, is one possible alternative. This is an external device, simple, safe and effective to use and non-invasive, says Drench. Persons with spinal cord injury have rated it as very good to excellent in effectiveness and its contribution to satisfaction with their sex lives.
Maureen E. Neistadt, M.S., O.T.R./L. and Maureen Freda, O.T.R./L., in Choices, A Guide to Sex Counselling with Physically Disabled Adults, suggest a variety of possible adjustments that people with different disabling conditions can make. For example, they stress careful attention to urinary function and hygiene so that people can feel more relaxed in sexual situations. Here are some of their suggestions:
Bowel and Urinary Incontinence

- You might remain on the same bowel and urination schedule that you started in the hospital. This way you would know at what times it would be safest for you to have sex.

- Discuss the possibility of an accident with your partner to avoid embarrassment.

- Keep towels handy in case of bowel accidents and protect your mattress.

- Avoid excessive intake of fluids before sex and attempt to void prior to sexual activity.

- In the case of urinary leakage, men may use a condom for small amounts of leakage. Before sex, thoroughly cleanse the penis. If your physician gives approval, you could credé prior to having sex. This involves pressing inward and downward on the lower abdomen to help empty the bladder and should be done several times in succession.

Catheters

- Ask your physician about the possibility of removing your catheter occasionally for sexual activity. If you can remove the catheter, be sure your bladder is empty beforehand.

- If you must leave the catheter in, try placing it in a convenient position. Then you could tape the tube securely to your stomach with paper tape. Women may find it more comfortable to use a rear entry position in this situation. Men can fold the tube back over the penis and either tape the tube with paper tape, or place a condom over the penis and tube after the penis is erect. Additional lubrication may be needed for more comfortable entry.

- Discuss your catheter with your partner to prevent surprise and embarrassment.

- If you’re worried about your catheter leaking, keep towels handy and protect your mattress.

- Place drainage bags securely in a convenient place. Ask your physician if you can temporarily clamp the catheter and remove the drainage bag during sex.

If you require intermittent catheterization, then you may wish to be catheterized before engaging in sexual activity. If you need a suprapubic catheter:

- You may want to use a long drainage tube to give yourself more freedom to manoeuvre. In this case the collecting bag can be placed securely out of the way.

- Try taping the draining tube down to your stomach to prevent excess pulling or pressure on your catheter.

- You may find certain sex positions make it easier to keep the drainage tube in.

Clearly dealing with the issues mentioned above requires effective communication. This includes everything from planning sexual activity, communicating likes and dislikes non-judgementally, sharing sexual fantasies and other ways of enhancing arousal to dealing honestly with anger, fears, frustration and sense of loss. This kind of communicating can be particularly important when there has been loss of sensation associated with the disability.
Loss of sensation can vary and there may result the inability to accurately feel pain, temperature changes, pressure or touch over one or several parts of the body. There may also be difficulty in telling how the arms or legs are positioned without looking at them. Be aware of what parts of your body have experienced sensation loss, and to what degree, and discuss this with your partner. Together you can explore unaffected parts and discover new erogenous zones -- often it is the skin right next to the area of sensation loss -- that can compensate for the loss of pleasure in the affected parts.
In addition to the facts and techniques men and women learn about their sexuality and disability, access to user-friendly literature is essential. Although there is an abundance of helpful literature for both professionals and the general public that deals with varied aspects of sex education, counselling, therapy, research, ethics, etc., Dr. Barrett says that much of the literature on sexuality and disability has been written for a professional audience. While some associations now distribute non-technical material on the sexual implications of specific disabilities, much remains to be done, he says: "To my knowledge there is no single ’clearing house’ in Canada through which people can obtain access to this growing body of literature."
Where to find the literature and videos and who has them will be addressed in the next issue of ABILITIES.

(Vida Jurisic is a freelance writer living in Toronto.)

THERE IS A SEX LIFE AFTER DISABILITY

It’s Okay! is a frank new quarterly newsletter that talks about sexuality, sex and toiletting with honesty and an upbeat attitude. Launched by Linda Crabtree in St. Catharines, Ontario, it is consumer-written, published quarterly and aimed internationally.
"[It’s Okay!] addresses a topic that has been ignored too long," Linda comments. "People can write to me and get answers through a group of professionals I have available to me. It is a service as well as a newsletter."
The inaugural issue of It’s Okay! includes a profile of 26-year-old model Wendy Murphy, reviews of new publications about sex, and a column on personal hygiene. Linda hopes to "get the message out to people that there is a sex life after disability."

link:http://www.enablelink.org

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Ambiguous genitalia

Introduction
Boy or girl? It's one of the most common questions asked of brand-new parents in addition to the baby's weight and length. But what if the answer isn't so obvious? Such is the case for newborns with ambiguous genitalia, the medical term for a rare condition in which a newborn's external genitals don't appear to be clearly either male or female.
In ambiguous genitalia, the baby's genitalia may not be well-formed, or the baby may have general characteristics of both sexes.
Ambiguous genitalia can be very upsetting to parents and other family members, both because of the uncertainty involved and because of the social stigma attached to not knowing a child's sex right away. While ambiguous genitalia can present a difficult and complicated situation, medical advances can take much of the guesswork out of the process of assigning a sex to your child, and corrective surgery can help. Sometimes, despite the pressure to announce "girl" or "boy," it's best in the case of ambiguous genitalia to wait to make this important decision about your child's future.

Signs and symptoms
A newborn's genitalia are quite small, and the idea of looking "normal" spans a wide range. Your medical team will likely be the first to recognize the signs of ambiguous genitalia soon after your baby is born. These signs vary from the more obviously apparent to the outwardly invisible.
Characteristics in genetic females
For genetic females, the baby's genitals may take on the following characteristics:

• An enlargement of the clitoris, or what appears to be a small penis.


• A concealment of the vagina because the midline groove has closed over.

Characteristics in genetic males
For genetic males, the following characteristics may be present:

• A condition in which the narrow tube that carries urine and semen (urethra) doesn't fully extend to the tip of the penis (hypospadias).


• An abnormally small penis with the urethral opening nearer to the scrotum, indicating that the penis stopped growing early in its development.


• No recognizable male genitalia, in the most severe cases.

Causes
The genetic sex of a child is established at conception based on the 23rd pair of chromosomes it inherits. The mother's egg contains an X chromosome, and the father's sperm contains either an X or Y chromosome. A baby who inherits the X chromosome from the father is a genetic female (a pair of X chromosomes). A baby who inherits the Y chromosome from the father is a genetic male (one X and one Y chromosome).
In early fetal development, males and females are indistinguishable. Male and female sex organs develop from the same tissue in the fetus. For example, the same fetal tissue that forms a penis in a male also forms a clitoris in a female. The presence or absence of male hormones controls the development of the sex organs. Normally, male genitalia develop because of male hormones from the fetal testicles. In the female fetus — without the effects of male hormones — the genitalia develop as female.
A deficiency of male hormone in a genetic male fetus results in ambiguous genitalia. In a female fetus, the presence of male hormone during development results in ambiguous genitalia.
Although the deficiency or presence of male hormones is the main factor controlling genital development, the exact cause of ambiguous genitalia is often unknown. Many of the disorders seem to happen by chance.
Possible causes in genetic females
Causes of ambiguous genitalia in a genetic female may include:

• Congenital adrenal hyperplasia (CAH). Certain forms of this genetic condition cause the adrenal glands to make excess male hormones (androgens). Congenital adrenal hyperplasia is the most common cause of ambiguous genitalia in newborns.


• Ingestion by the mother of substances with male hormone activity, such as progesterone (taken in the early stages of pregnancy to stop bleeding).


• Tumors in the fetus or the mother that produce male hormones.

Possible causes in genetic males
Causes of ambiguous genitalia in a genetic male may include:

• Impaired testicle development due to genetic abnormalities or unknown causes.


• Leydig cell aplasia, a condition that impairs testosterone production.


• Congenital adrenal hyperplasia. Certain forms of this genetic condition can impair production of male hormones.


• Androgen insensitivity syndrome, a condition in which developing genital tissues are unable to respond to normal male hormone levels.


• 5 alpha reductase deficiency, an enzyme defect that impairs normal male hormone production.


• Ingestion by the mother of substances with female hormone activity, such as estrogens, or anti-androgens. This is unusual, but could occur if a woman taking birth control pills gets pregnant despite taking the pills — then, not knowing she's pregnant, continues taking the pills into pregnancy for several weeks. Also some "nutritional supplements" contain plant estrogens.

Risk factors
As is the case with many abnormalities, family history may play a role in the development of ambiguous genitalia. Possible risk factors associated with ambiguous genitalia include a family history of:

• Unexplained deaths in early infancy


• Infertility in close relatives


• Genital abnormalities


• Abnormal development during puberty

Because most causes of ambiguous genitalia are due to genetic abnormalities, the presence of similar abnormalities in family members is important. Having a family member with known congenital adrenal hyperplasia, infertility or abnormal pubertal development may indicate a genetic abnormality in the family. Also, a personal or family history of prior babies being born with genital abnormalities, or dying shortly after birth, may indicate an inherited abnormality that could result in future children being born with ambiguous genitalia.
When to seek medical advice
If both parents are carriers of congenital adrenal hyperplasia, there's the chance that their baby could develop ambiguous genitalia if he or she inherits the abnormal gene from both parents. Parents may not know they have congenital adrenal hyperplasia because as carriers they show no signs or symptoms of this condition.
If your family has a history of risk factors associated with ambiguous genitalia, seek medical advice before conceiving.
Screening and diagnosis
If your baby is born with ambiguous genitalia, you and your doctor will want to determine the underlying abnormality and extent of deformity. The first indication of ambiguous genitalia will be by a physical examination. Your doctor will likely recommend the following tests and procedures:

• Blood and urine tests to measure hormone levels


• Chromosome analysis to determine the genetic sex (XX or XY)


• Ultrasound to check for the presence of internal female sex organs


• A biopsy of your newborn's reproductive organs to determine if the organs will produce appropriate sex hormones for the sex assigned to the child


• A genitogram, a special X-ray to see if a vagina is present and its size

Using the information gathered from these tests, your doctor may suggest an appropriate sex for the baby.
Despite the social stigma attached to not knowing if your baby is a boy or a girl right away, some research shows that delaying gender assignment until the child is older may be of benefit. If the gender assignment is made too early, and the correct decision isn't made, the child may be confronted with difficult psychological and social issues later in life.
Complications
The outlook is good for many babies born with ambiguous genitalia in terms of their ability to conceive and be fertile later in life. However, for others born with ambiguous genitalia, the severity of the condition, complicated hormone levels and trouble adjusting to their assigned sex may make it difficult or impossible to conceive a child later in life.
Treatment
Management of ambiguous genitalia requires a team of doctors that may involve a number of specialties — pediatric endocrinology, neonatology, urology, plastic surgery, medical genetics and psychology. The timing of treatment depends on a child's specific situation. Your medical team can explain to you the options available for your child and likely suggest a course of action.
Treatment options may include:

• Reconstructive surgery. The goal of surgery is usually cosmetic, to make the boy's or girl's genitalia look natural. In some cases, the surgery can be more involved in hopes of restoring sexual function.
  Some surgeries are carried out soon after birth while others may be scheduled later in your child's development. Some research suggests that in severe cases of ambiguous genitalia, surgery is best delayed until your child can play a role in participating in the sex-assignment decision.
  For girls, sexual function of the organs is often not compromised despite any ambiguous appearance. Depending on the severity of the condition, surgery options range from uncovering a vagina hidden under the skin to removing excess masculine tissue around the clitoris. Surgeries are carried out carefully to avoid damaging nerve endings and blood flow in hopes of ensuring normal sexual function in the future. Little long-term research is available, but the initial success of surgeries, both in appearance and sexual functioning later in life, is promising.
  For boys, the surgery may be more complicated, but often successful. Surgery gives genetic males born with a shorter, incomplete penis the opportunity to have a normal penis. In many cases, no further surgery is required for this reconstructed organ, and it will have a normal look and erectile functionality. Female organs that remain under the skin — such as a uterus or vagina — rarely cause a physical problem, but are often surgically removed because a boy's knowledge of these structures later in life may be emotionally difficult.


• Hormone therapy. Depending on the severity of the condition, hormone therapy alone may be enough to correct the initial hormonal imbalance. For example, in a genetic female with a slightly enlarged clitoris caused by a minor to moderate case of congenital adrenal hyperplasia, proper levels of hormones may shrink the tissue close to a normal size.

Coping skills
Not knowing the sex of your baby immediately is a difficult issue to face. As parents, it's best to discipline your thoughts not to think of your baby as a girl or a boy until a medical evaluation is complete. Meanwhile you might consider giving the child a neutral name suitable for either a boy or a girl. You might also defer announcing the birth until the evaluations are complete in that the first question everyone asks regarding a new baby is whether it's a girl or a boy.
Because of the additional stress this may place on a family, ongoing counseling for the child as well as the family may become an important part of the process. Psychologists, counselors, mental health professionals and support groups may all help you to deal with this difficult and unexpected set of circumstances.

original link:http://www.mayoclinic.com

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Talking to school-age children about sex

Sex education doesn't need to be a single tell-all discussion. Follow your children's cues about what they need to know — and when.

Sex education often begins as simple anatomy lessons during the toddler years. During the school-age years, you might wonder how much your children really need to know about sex. Never fear. Sex education doesn't need to be a single tell-all discussion. Instead, follow your children's cues about what they need to know — and when.
Expect detailed questions

Younger children are often satisfied with vague answers to questions about where babies come from or how babies are born. But school-age children tend to make stronger connections between sexuality and making babies. As their questions about sex become more complex — and perhaps more embarrassing — they may turn to friends or other sources for information.

When your school-age children ask questions about sex, you might want to first ask your children what they already know. Correct any misconceptions, and then offer enough details to answer the specific questions. Avoid long lectures.

Consider these examples:

• What's an erection? You might say: "A boy's penis is usually soft. But sometimes it gets hard and stands away from the body. This is called an erection." Describe how an erection can happen while a boy is sleeping or when his penis is touched. This might also be the time to describe a wet dream.


• What's a period? You might say: "A period means that a girl's body is mature enough to become pregnant." Explain how menstruation is an important part of the reproductive cycle. You might offer details on bleeding and feminine hygiene products.


• How do people have sex? If your children wonder about the mechanics of sex, be honest. You might say: "The man puts his penis inside the woman's vagina."


• Can two girls have sex? Or two boys? For some children, it might be enough to say: "Yes. There are many types of intimate relationships." If your children want to know more, you might take the opportunity to talk about respect for others or to share your personal thoughts about homosexuality.


• What's masturbation? You might say: "Masturbation is when a boy rubs his penis or a girl rubs her vagina." Remind your children that masturbation is a normal — but private — activity.

Even if you're uncomfortable, forge ahead. Remember, you're setting the stage for open, honest discussions in the years to come.
Preteen angst

Between ages 8 and 12, children may worry whether they're "normal." Penis size and breast size often figure heavily in these worries. Explain what happens during puberty for both boys and girls. Offer reassurance that children of the same age mature at wildly different rates. Puberty might begin years earlier — or later — for some children, but eventually everyone catches up. You might want to share experiences from your own development, particularly if you once had the same concerns that your children have now.
Everyday moments are key

You might have been using everyday opportunities to discuss sex all along. Keep it up! Teachable moments are everywhere. If there's a pregnancy in the family, talk about how a baby develops inside a woman's body. If you see a commercial for a feminine hygiene product, use it as a springboard to talk about periods. If a couple on a favorite TV show begins dating, talk about relationships and falling in love.

Take your role in sex education seriously. Encourage your children to take care of their bodies, respect themselves and seek information from trusted sources. Your thoughtful approach to sex education can help your children develop a lifetime of healthy sexuality.

original link :http://www.mayoclinic.com/

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Planning a good curriculum

In an academic situation, especially with younger learners, some subjects fail to impart information to the students simply because the students are not interested, and do not pay attention. This is unlikely to be the case with AIDS education; the simple fact that AIDS education involves the discussion of sex – a topic of fascination for young people who are discovering their own sexualities – is likely to ensure at least initial attention. This attention will wane, however, if the information is not imparted in a lesson interesting enough to maintain students’ concentration. It is not only important to have AIDS education, but to provide AIDS education in the right way.

In addition to providing information, a good, class-based lesson where a pupil is amongst his/her peers can help to shape attitudes, reduce prejudice, and alter behaviour.

The following are a few of the important points to consider when planning an AIDS education lesson or curriculum.

original link : http://www.avert.org/

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Attitudes to AIDS education in schools

The main obstacle to effective AIDS education for young people in schools is the adults who determine the curriculum. These adults – parents, curriculum planners, teachers or legislators – often consider the subject to be too ‘adult’ for young people – they have an idea of ‘protecting the innocence’ of young people. This often occurs for moral or religious reasons, and can cause very heated debate.

There is also obstruction to adequate AIDS education from adults who are concerned that teaching young people about sex, about sexually transmitted infections, HIV and pregnancy – that providing them with this information will somehow encourage young people to begin having sex when they otherwise might not have done.

“ I come from a family who believes that having sex out of marriage is not the moral thing to do. I also don't think sex ed. is something that young kids should be learning. Learning sex at a young age is like provoking more young people to have sex just for the fact they want to experience it for themselves instead of just getting information about it. ”

- Monica -

This attitude is still allowed to prevent adequate HIV and sex education from being taught in schools, in spite of the fact that it is a view that the majority do not share. A study in America, for example, shows that majority of Americans (55%) believes that giving teens information about how to obtain and use condoms will not encourage them to have sexual intercourse earlier than they would have otherwise (39% say it would encourage them)1 .

The same study tells us that only 7% of Americans believe that young people should not receive sex education in schools. Many adults recognise that informing young people about the dangers of HIV is the best way to prevent them from becoming infected in later life. Many schools in many countries do provide adequate AIDS education – but many, sill, do not. Young people are rarely asked for their opinions by those adults who decide what they will study – but when they are asked, they almost always demand more comprehensive sex and HIV education.

“ I am a student, living in Johannesburg, South Africa. I believe that sex ed that is handled appropriately, and that is age-appropriate, will really empower kids to make healthier, informed and positive choices. ”

- Maire -

In some places, legislation may dictate the type and quality of AIDS education that schools are allowed to offer – some countries have no policies on AIDS education, allowing schools to include it or not, as they decide. Other countries may have policies that specifically preclude AIDS education, or certain types of AIDS education. Legislation allowing or inhibiting certain types of AIDS education often comes from the moral views of the voting majority – or reflects the religious attitudes of the government in power. The most commonly used types of AIDS education are discussed in our page on AIDS education and young people.

It is within the context of these attitudes and beliefs that teachers and educators must work to provide the most effective information and education they are able to.

original link : http://www.mayoclinic.com/

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Talking to toddlers and preschoolers about sex

Sex education can begin anytime. Here's how to set the stage — and how to answer your children's questions.

Sex education is a topic many parents would prefer to avoid. And if you have young children, you might think you're off the hook — at least for a while. But that's not necessarily true. Sex education can begin anytime. Let your children set the pace with their questions.
Early exploration

As children learn to walk and talk, they also begin to learn about their bodies. Open the door to sex education by teaching your children the proper names for their sex organs, perhaps during bath time. If your children point to a body part, simply tell them what it is. This is also a good time to talk about which parts of the body are private.

When your children ask questions about their bodies — or yours — don't giggle, laugh or get embarrassed. Take their questions at face value. Offer direct, age-appropriate responses. If your children want to know more, they'll ask.

Expect self-stimulation

Many toddlers express their natural sexual curiosity through self-stimulation. Boys may pull at their penises, and girls may rub their external genitalia. Teach your children that masturbation is a normal — but private — activity. If your child starts masturbating in public, try to distract him or her. If that fails, take your child aside for a reminder about the importance of privacy.

Sometimes, frequent masturbation can indicate a problem in a child's life. Perhaps he or she feels anxious or isn't receiving enough attention at home. It can even be a sign of sexual abuse. Teach your children that no one is allowed to touch the private parts of their bodies without permission. If you're concerned about your child's behavior, consult his or her doctor.
Curiosity about others

By age 3 or 4, children often realize that boys and girls have different genitals. As natural curiosity kicks in, you may find your children playing "doctor" or examining each other's sex organs. This exploration is far removed from adult sexual activity, and it's harmless when only young children are involved. As a family matter, however, you may want to set limits on such exploration.
Everyday moments are key

Take advantage of everyday opportunities to discuss sex. If there's a pregnancy in the family, for example, tell your children that babies grow in a special place inside the mother. If your children want more details on how the baby got there or how the baby will be born, offer them.

Consider these examples:

How do babies get inside a mommy's tummy? You might say: "A mom and a dad make a baby by holding each other in a special way."

How are babies born? For some kids, it might be enough to say: "Doctors and nurses help babies who are ready to be born." If your children want more details, you might say: "Usually a mom pushes the baby out of her vagina."

Why doesn't everyone have a penis? Try a simple explanation, such as: "Boys and girls bodies are made differently."

Why do you have hair down there? Simplicity often works here, too. You might say: "Our bodies change as we get older." If your children want more details, add: "Boys grow hair near their penises, and girls grow hair near their vaginas."

As your children mature and ask more detailed questions, you can provide more detailed responses. Answer specific questions using correct terminology. Even if you're uncomfortable, forge ahead. Remember, you're setting the stage for open, honest discussions in the years to come.

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Whats is AIDS?

People have been warned about HIV and AIDS for over twenty years now. AIDS has already killed millions of people, millions more continue to become infected with HIV, and there's no cure - so AIDS will be around for a while yet. However, some of us still don't know exactly what HIV and AIDS actually are. This page sorts the myths from the facts about AIDS.

What is HIV?
HIV is a virus. Viruses infect the cells of living organisms and replicate (make new copies of themselves) within those cells. A virus can also damage human cells, which is one of the things that can make an infected creature become ill.
People can become infected with HIV from other people who already have it, and when they are infected they can then go on to infect other people. Basically, this is how HIV is spread.

HIV stands for the 'Human Immunodeficiency Virus'. Someone who is diagnosed as infected with HIV is said to be 'HIV+' or 'HIV positive'.

HIV (Human Immunodeficiency Virus)

Why is HIV dangerous?

The immune system is a group of cells and organs that protect your body by fighting disease. The human immune system usually finds and kills viruses fairly quickly.

So if the body's immune system attacks and kills viruses, what's the problem?

Different viruses attack different parts of the body - some may attack the skin, others the lungs, and so on. The common cold is caused by a virus. What makes HIV so dangerous is that it attacks the immune system itself - the very thing that would normally get rid of a virus. It particularly attacks a special type of immune system cell known as a CD4 lymphocyte.

HIV has a number of tricks that help it to evade the body's defences, including very rapid mutation. This means that once HIV has taken hold, the immune system can never fully get rid of it.

There isn't any way to tell just by looking if someone's been infected by HIV. In fact a person infected with HIV may look and feel perfectly well for many years and may not know that they are infected. But as the person's immune system weakens they become increasingly vulnerable to illnesses, many of which they would previously have fought off easily.

The only reliable way to tell whether someone has HIV is for them to take a blood test, which can detect infection from a few weeks after the virus first entered the body.

What is AIDS?

A damaged immune system is not only more vulnerable to HIV, but also to the attacks of other infections. It won't always have the strength to fight off things that wouldn't have bothered it before.

As time goes by, a person who has been infected with HIV is likely to become ill more and more often until, usually several years after infection, they become ill with one of a number of particularly severe illnesses. It is at this point that they are said to have AIDS - when they first become seriously ill, or when the number of immune system cells left in their body drops below a particular point. Different countries have slightly different ways of defining the point at which a person is said to have AIDS rather than HIV.

AIDS (Acquired Immune Deficiency Syndrome) is an extremely serious condition, and at this stage the body has very little defence against any sort of infection.

How long does HIV take to become AIDS?

Without drug treatment, HIV infection usually progresses to AIDS in an average of ten years. This average, though, is based on a person having a reasonable diet. Someone who is malnourished may well progress to AIDS and death more rapidly.

Antiretroviral medication can prolong the time between HIV infection and the onset of AIDS. Modern combination therapy is highly effective and, theoretically, someone with HIV can live for a long time before it becomes AIDS. These medicines, however, are not widely available in many poor countries around the world, and millions of people who cannot access medication continue to die.

How is HIV passed on?

HIV is found in the blood and the sexual fluids of an infected person, and in the breast milk of an infected woman. HIV transmission occurs when a sufficient quantity of these fluids get into someone else's bloodstream. There are various ways a person can become infected with HIV.
Ways in which you can be infected with HIV :

Unprotected sexual intercourse with an infected person Sexual intercourse without a condom is risky, because the virus, which is present in an infected person's sexual fluids, can pass directly into the body of their partner. This is true for unprotected vaginal and anal sex. Oral sex carries a lower risk, but again HIV transmission can occur here if a condom is not used - for example, if one partner has bleeding gums or an open cut, however small, in their mouth.

Contact with an infected person's blood If sufficient blood from an infected person enters someone else's body then it can pass on the virus.

From mother to child HIV can be transmitted from an infected woman to her baby during pregnancy, delivery and breastfeeding. There are special drugs that can greatly reduce the chances of this happening, but they are unavailable in much of the developing world.

Use of infected blood products Many people in the past have been infected with HIV by the use of blood transfusions and blood products which were contaminated with the virus - in hospitals, for example. In much of the world this is no longer a significant risk, as blood donations are routinely tested.

Injecting drugs People who use injected drugs are also vulnerable to HIV infection. In many parts of the world, often because it is illegal to possess them, injecting equipment or works are shared. A tiny amount of blood can transmit HIV, and can be injected directly into the bloodstream with the drugs.

It is not possible to become infected with HIV through :

sharing crockery and cutlery

insect / animal bites

touching, hugging or shaking hands

eating food prepared by someone with HIV

toilet seats

HIV facts and myths


Around the world, there are a number of different myths about HIV and AIDS. Here are some of the more common ones :

'You would have to drink a bucket of infected saliva to become infected yourself' . . . Yuck! This is a typical myth. HIV is found in saliva, but in quantities too small to infect someone. If you drink a bucket of saliva from an HIV positive person, you won't become infected. There has been only one recorded case of HIV transmission via kissing, out of all the many millions of kisses. In this case, both partners had extremely badly bleeding gums.

'Sex with a virgin can cure HIV' . . . This myth is common in some parts of Africa, and it is totally untrue. The myth has resulted in many rapes of young girls and children by HIV+ men, who often infect their victims. Rape won't cure anything and is a serious crime all around the world.

'It only happens to gay men / black people / young people, etc' . . . This myth is false. Most people who become infected with HIV didn't think it would happen to them, and were wrong.

'HIV can pass through latex' . . . Some people have been spreading rumours that the virus is so small that it can pass through 'holes' in latex used to make condoms. This is untrue. The fact is that latex blocks HIV, as well as sperm - preventing pregnancy, too.

What does 'safe sex' mean?

Safe sex refers to sexual activities which do not involve any blood or sexual fluid from one person getting into another person's body. If two people are having safe sex then, even if one person is infected, there is no possibility of the other person becoming infected. Examples of safe sex are cuddling, mutual masturbation, 'dry' (or 'clothed') sex . . .

In many parts of the world, particularly the USA, people are taught that the best form of safe sex is no sex - also called 'sexual abstinence'. Abstinence isn't a form of sex at all - it involves avoiding all sexual activity. Usually, young people are taught that they should abstain sexually until they marry, and then remain faithful to their partner. This is a good way for someone to avoid HIV infection, as long as their husband or wife is also completely faithful and doesn't infect them.

What is 'safer sex'?

Safer sex is used to refer to a range of sexual activities that hold little risk of HIV infection.

Safer sex is often taken to mean using a condom for sexual intercourse. Using a condom makes it very hard for the virus to pass between people when they are having sexual intercourse. A condom, when used properly, acts as a physical barrier that prevents infected fluid getting into the other person's body.

Is kissing risky?

Kissing someone on the cheek, also known as social kissing, does not pose any risk of HIV transmission.

Deep or open mouthed kissing is considered a very low risk activity for transmission of HIV. This is because HIV is present in saliva but only in very minute quantities, insufficient to lead to HIV infection alone.

There has only been one documented instance of HIV infection as a result of kissing out of all the millions of cases recorded. This was as a result of infected blood getting into the mouth of the other person during open mouthed kissing, and in this instance both partners had seriously bleeding gums.

Can anything 'create' HIV?

No. Unprotected sex, for example, is only risky if one partner is infected with the virus. If your partner is not carrying HIV, then no type of sex or sexual activity between you is going to cause you to become infected - you can't 'create' HIV by having unprotected anal sex, for example.

You also can't become infected through masturbation. In fact nothing you do on your own is going to give you HIV - it can only be transmitted from another person who already has the virus.

Is there a cure for AIDS?


Worryingly, surveys show that many people think that there's a 'cure' for AIDS - which makes them feel safer, and perhaps take risks that they otherwise shouldn't. These people are wrong, though - there is still no cure for AIDS.

There is antiretroviral medication which slows the progression from HIV to AIDS, and which can keep some people healthy for many years. In some cases, the antiretroviral medication seems to stop working after a number of years, but in other cases people can recover from AIDS and live with HIV for a very long time. But they have to take powerful medication every day of their lives, sometimes with very unpleasant side effects.

There is still no way to cure AIDS, and at the moment the only way to remain safe is not to become infected.

original link : http://www.avert.org/

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AIDS arround the world

When AIDS first emerged, no-one could have predicted how the epidemic would spread across the world and how many millions of lives it would change. There was no real idea what caused it and consequently no real idea how to protect against it.
Now we know from bitter experience that AIDS is caused by the virus HIV, and that it can devastate families, communities and whole continents. We have seen the epidemic knock decades off countries' national development, widen the gulf between rich and poor nations and push already-stigmatized groups closer to the margins of society. We are living in an 'international' society, and HIV has become the first truly 'international' epidemic, easily crossing oceans and borders.

Just as clearly, experience shows that the right approaches, applied quickly enough with courage and resolve, can and do result in lower national HIV infection rates and less suffering for those affected by the epidemic.
Globally, we have learned that if a country acts early enough, a national HIV crisis can be averted.

The child of an HIV positive mother, Tanzania

It has also been noted that a country with a very high HIV prevalence rate will often see this rate eventually stabilise, and even decline. In some cases this indicates, among other things, that people are beginning to change risky behaviour patterns, because they have seen and known people who have been killed by AIDS. Fear is the worst and last way of changing people's behaviour and by the time this happens it is usually too late to save a huge number of that country's population.
Already, more than twenty-five million people around the world have died of AIDS-related diseases. In 2007, around 2.1 million men, women and children lost their lives. More than have died so far - 33.2 million - are now living with HIV, and most of these are likely to die over the next decade or so. The most recent UNAIDS/WHO estimates show that, in 2007 alone, 2.5 million people were newly infected with HIV.
It is disappointing that the global numbers of people infected with HIV continue to rise, despite the fact that effective prevention strategies already exist.

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