SEXUALITY

It is a broad topic that includes various subheadings. Consult your physician for more detailed information you deem necessary.

1. Orgasm

It is an event related to the brain and body acting together. It is experienced differently in men and women. While a woman has multiple orgasms in a row, at least half an hour must pass between two orgasms for a man. Orgasm; It may start with sexual stimulation in the brain (including vision, hearing, touch, smell and fantasy). When brain and body signals do not act together, orgasm does not occur. Women can experience orgasm through thinking. Orgasm in women;
 

• Arousal phase
• Plato phase
• Organic phase
• Dissolution phase
It can be examined in 4 stages:

. In addition, orgasm disorders;
 

• Random orgasm
• Cortal anorgasm
• Premature orgasm

. Not having an orgasm is called anorgasmia. It can cause a person to lose self-esteem and confidence and cause depression. Orgasm may not be achieved in every relationship. It's normal. Lack of orgasm can cause sexual reluctance. Loss of interest in your partner may also prevent orgasm. Such people can experience orgasm with another partner or masturbation. It would be wrong to conclude that not having an orgasm will definitely cause unhappiness in the woman. However; Experiencing orgasm will help couples have a more enjoyable life. Orgasm disorders may be due to organic causes with a rate of less than 5%. Neurological disorders, neurological drug use, diabetes and alcoholism may have negative results. Moreover; Psychological factors, namely trauma, problematic childhood, problematic and traumatic sexual experiences in adolescence, and sexual identity conflicts may negatively affect the experience of orgasm.

Couples are advised to apply to the relevant centers and people so that anorgasmia does not negatively affect their lives, without making it a matter of pride.

2. Hymen

It is called Hymen in the medical dictionary. Its physiological purpose and function have not been explained to date. Despite this, it is thought to prevent microorganisms and foreign objects from entering the vagina during the embryonic period. The hymen has been discussed more in societies from a sociological perspective rather than physiology. It has sociological importance to varying degrees in every society. It is examined in the recognition of children exposed to sexual violence and abuse in developed societies. In developing societies (including our country), today it means pure, untouched, that is, virginity. It has a sociological function rather than a physiological and anatomical one.



When the hymen is examined anatomically, it is seen that it does not have a specific structure. Just at the entrance of the vagina, 1-1.5 cm from the lips. It is inside and is connected to the labia minora. It is considered one of the external genital formations. The front side facing outside is made of leather; The back side facing inward resembles mucosa. Rarely, it may not be congenital. The hymen, which is hard during childhood, stretches and changes due to the secretion of estrogen hormone in adolescence. The shape, thickness and flexibility of the hymen varies in each woman. The shape and structure of the hole in the middle of the vagina, which allows menstrual blood and vaginal secretions to flow out, is used to determine the types of hymen. Types ;
 

• Annular Hymen
• Crecentric Hymen
• Septal Hymen
• Cribriform Hymen
< It is examined in seven groups as
• Imperfore Hymen
• Microperforate Hymen
• Multiparous Hymen

. Character of the hymen hole and free edge, z It can also be classified according to the thickness and strength of the hymen.

Hymen is usually torn with the first sexual intercourse or the entry of a foreign object. A small amount of bleeding occurs. The tears heal within a few days and there is no bleeding again. Sometimes bleeding may occur during the next few intercourses. Sometimes, even if there is no relationship, the free edge of the hymen is not straight and has notches. 20% of women have these notches.

Usually, the rupture of the membrane occurs because the hole is smaller than the diameter of the penis. However; Since there are holes wide enough for the entrance of the penis, the hymen may not tear and bleed despite many intercourses. Such membranes are called membranes suitable for intercourse (duhule). Women have 26-41% of the membranes suitable for intercourse.

Although whether the first intercourse is painful or not depends on the slow and gentle behavior of the man, sometimes serious pain can occur. Generally, there is no discomfort. However, the man's behavior and approach are extremely important.

The amount of bleeding in the rupture of the hymen is generally small and stops spontaneously in a short time. Sometimes the vein behind the hymen is exposed and the bleeding does not stop. Sometimes, tears may occur at or inside the vaginal entrance and severe bleeding that does not stop may occur. In these cases, surgical intervention and stitches may be required. Stitches do not repair the hymen. Although the hymen may be ruptured, there may be no bleeding, or even though it cannot be ruptured, bleeding may occur due to tears or abrasions on the outer parts.

The hymen may deteriorate without intercourse or without a larger object entering the hole. Ex. Horseback riding, activities that require wide legs, or accidents and trauma may cause hymen deterioration. Once broken, the hymen does not repair itself. 7-8 days later It cannot be understood when it ruptured after it has passed. Since sperm can enter without the hymen intact, pregnancy, including ectopic pregnancy, may occur. In people with suitable membrane structure, speculum examination and abortion can be performed without damaging the hymen. Vaginal culture can be taken from virgins who may have a discharge problem.

It can be understood by examination whether the hymen is broken or not. However, it may be difficult to decide on the hymen, which has a natural notch structure. The gynecologist may deem colposcopic examination appropriate. It cannot be understood from bleeding whether the hymen is broken or not. The hymen can be repaired, although it is not guaranteed to be 100% free of bleeding. Only a gynecologist or forensic medicine can understand the repaired hymen. The number of connections is not important for repair. It can even be repaired for a woman in labor. However; It is impossible to completely repair or restore it. Although a new hymen is created with pieces taken from the vaginal wall, the wound can easily become infected. It is known that hymen repair greatly reduces first night murders.

3. Pregnancy and Sexuality

Sexuality, which is of great importance in life, is often negatively affected during pregnancy. In cases where everything is normal, sexuality may be restricted in the last four weeks. Intercourse is not recommended in the last four weeks due to the possibility that some substances in the man's ejaculatory fluid may initiate uterine contractions. Intercourse is strictly prohibited in pregnant women with bleeding, a history of miscarriage, or a risk of premature birth. Intercourse may be restricted for the first two months in pregnant women with a history of recurrent miscarriage and premature birth. In the presence of genital infection, whether in men or women, intercourse should be prohibited until the infection treatment is completed. In case of placente previa, which is classified as high-risk pregnancies, bleeding may also occur. It is undesirable to have sexual intercourse due to the risk of sexual intercourse. Apart from these, sexual intercourse has no positive or negative effect on a normal pregnancy. However, especially in mothers with their first pregnancy, there may be a coldness towards sexuality while they are adapting to the pregnancy process. Since pregnancy is a process that radically affects a woman's life, sexuality and sexual life are often negatively affected. In addition to physical changes, women also experience psychological changes. It is necessary to understand and not force a pregnant woman who avoids intercourse due to psychological fears.

4. Vaginismus

It is a condition that falls within the field of psychiatry. It is the involuntary contraction of the muscles surrounding the entrance to the vagina and not allowing penetration. It does not allow situations such as tampons and examination. It can be seen in women of all age groups. Women with this problem do not have problems with sexual desire and orgasm. They can experience orgasm outside of sexual intercourse as they wish. There are two types: primary and secondary. In primary vaginismus, also called phobia, the person has never had sexual intercourse in his life. The second is vaginismus, which occurs later despite having previously had problem-free sexual intercourse. Indifference to the partner and factors that cause dyspareunia may affect secondary vaginismus.

The most important cause of primary vaginismus is fear. Although sexual intercourse is desired, subconscious fears prevent it. The trials enter a vicious circle. It may cause erectile disorders in men. Treatment should generally be done by applying psychotherapy to couples. However; It is necessary to make sure that possible gynecological reasons do not cause this situation. In addition, psychological support from the partner of the woman in this situation will also help the treatment. This situation is related to femininity. Explaining to the patient that it is not relevant will reassure the patient.

5. Recommendations for Those Who Want to Become Pregnant

Briefly, if the conditions described below are taken into consideration, the probability of becoming pregnant will increase.

• Protection should be discontinued 3 months before the planned time of conception.
• Intercourse should be had every other day at the most appropriate time to get pregnant.
• It is most appropriate for the man not to ejaculate for 48 hours before the first intercourse in the most suitable period for pregnancy and between intercourses.
• Intercourse should be had early in the morning.
• Lubricants should not be used.
• Vaginal douche should never be performed.
• Positions suitable for pregnancy that ensure the natural position of the vagina should be preferred.
• Alternative sex methods should be avoided.
• Intercourse should not be had under water.
• 6. Painful Sexual Intercourse


It is the woman's temporary or permanent pain during sexual intercourse. Reasons may be psychological or physical in origin.

Physical causes;
 

• Infection in genital organs
• Scar tissue due to reasons such as previous surgery or radiotherapy
• Episiotomy scar
• Myoma or other uterine tumors
• Endometriosis
• Thicker than normal Hymen
• Urethrado (the part of the bladder that opens to the vagina) damage
• Insufficient lubrication
• Vaginal dryness due to hormone deficiency, such as after menopause
• Orgasm
• Semen allergy
• Fungal infections
• Vaginal infections
• Allergic reactions
• Skin diseases
• Genital herpes
• Trauma and irritations
• Pelvic infections
• Uterine and urinary sores Sagging of the esophagus
• Intra-abdominal adhesions
• Intestinal diseases

 

Psychological reasons;< br />  

• Fear of pregnancy
• Fear of physical harm to the baby during pregnancy
• As a result of insufficient foreplay
• Sexual experience and insufficient information
• Previous sexual injury or psychological trauma
• P

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