Sexual Health

Sexual health is more than the absence of disease. WHO defines it as physical, emotional, mental and social well-being related to sexuality. In practice, it covers pleasure, safety, consent, contraception, fertility, sexual function, and freedom from coercion and violence.

Foundations

• Consent — free, willing, and ongoing. Consent can be withdrawn at any time. Sex without consent is assault.
• Safety — condoms protect against most STIs and pregnancy.
• Communication — with partners, and with a Health Expert when something is off.
• Self-knowledge — understand your own body and what feels right.

Common concerns — all medical, all treatable

• Low desire, painful sex, erectile difficulties, premature ejaculation, orgasm problems — all common and often treatable. Cause may be physical (hormones, heart, diabetes, nerve, thyroid, pelvic floor), medication, or psychological.
• Vaginal dryness — especially around menopause; safe, effective treatments exist.
• Fertility concerns.
• Gender and sexual identity concerns.

When to see a Health Expert

• Any sexual concern affecting quality of life.
• Pain during sex.
• Sudden change in sexual function.
• Symptoms of an STI.
• After an unwanted or risky sexual exposure — post-exposure HIV and pregnancy prevention are time-sensitive (PEP in 72 hours; emergency contraception in 72-120 hours).
• After sexual violence — get to hospital; one-stop centres (Sakhi centres) support survivors.
• Sexologist clinics advertised online are often unregulated; start with a gynaecologist, urologist, or family doctor.

Emergency and support numbers

• 112 — general emergency.
• 181 — Women's Helpline (24-hour).
• 1098 — Childline, for any concerns involving a child.
• ICTC centres — free confidential HIV testing.

Cultural silence around sex in India creates avoidable harm. Medical problems around sex are no different from medical problems anywhere else. Ask; you are not the first person to ask.