What Determines Healthy Sexuality

• In an ongoing sexual relationship, both partners should be aware of the important role that sex plays in their lives.
• While it is important not to make sex an exaggerated area of focus, it is certainly important to recognize sexuality as a natural part of being human.
• There are also several formal definitions of what makes up healthy sexuality.
• One definition reviewed included having an appreciation for one's own body; learning about reproduction; understanding that human development includes sexual development, such as reproduction and genital sexual experiences); interacting with both genders respectfully and appropriately; understanding and respecting sexual orientation; appropriately expressing love and intimacy, and developing and maintaining meaningful relationships while avoiding exploitative or manipulative ones.
• Healthy sexuality has also been suggested to include communicating and accepting love, expressing emotion, giving and receiving pleasure, and having the ability to enjoy and control sexual and reproductive behavior without feelings of guilt, fear, or shame.
• It is important to be aware that there are differences in sexuality based on gender and also that sexuality changes throughout the lifespan and these changes must be understood.

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• There are several direct, biological risk factors including:
• Vascular disease may limit blood flow. As we know, for women and men to become physically aroused increased blood flow to the genitalia is necessary. Vascular disease may also allow blood that has entered the genitalia to slowly escape.
• diabetes impacts blood flow and can even cause nerve damage, which can lead to vaginal dryness in women and erectile difficulties in men.
• Hormonal levels (testosterone in men and women and estrogen in women) can impact sexual function.
• Researchers have identified heavy alcohol use as a risk factor for sexual dysfunction.
• Medication side effects can impact desire, arousal, or orgasm in both men and women.
• In terms of indirect biological risk factors, the natural aging process and certain lifestyle choices create indirect risk factors for sexual dysfunction.
• Psychosocial risk factors include:
• psychological disorders, such as depression, anxiety, substance use disorders, and eating disorders
• emotions (i.e., anxiety)
• maladaptive thoughts (being distracted during sex)
• negative attitudes towards sex (masturbation is dirty, premarital sex is wrong, sex within marriage is solely for the purpose of procreation)
• racial, ethnic, and religious background impact what we believe and expect with regard to sex. If these expectations and beliefs are negative they may serve as a risk factor
• the quality of one's relationship is a risk factor for developing, or worsening sexual dysfunction
• lack of education about normal sexual functioning is also a risk factor for developing sexual dysfunction

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• Men and women experience sexual desire at different levels. To recognize this, the DSM-5 now offers 2 disorders - Female Sexual Interest/Arousal Disorder and Male Hypoactive Sexual Desire Disorder. Each has its own criteria that must be met for a diagnosis to be made.
• Sexual addiction refers to a preoccupation with sexual thoughts or sexual behavior to the extent that this preoccupation continues even though it causes substantial harm.
• Erectile Disorder, or "ED" as it is commonly known, is defined as an inability to achieve and/or maintain a satisfactory erection necessary for the completion of sexual activity.
• Men with delayed ejaculation can have an erection, but have difficulties in ejaculation.
• Female Orgasmic Disorder involves marked delay in, marked infrequency of, or absence of orgasm, or marked reduced intensity of organismic sensations.
• Premature Ejaculation is a persistent or ongoing pattern of ejaculation happening during partnered sexual activity within approximately 1 minute following vaginal penetration and before the individual wishes it.
• Genito-Pelvic Pain/Penetration Disorder is a female sexual disorder that involves pain during penetration.
• Paraphilic Disorders require a paraphilia to be present - this involves intense and persistent sexual interest (recurrent fantasies, urges or behaviors of a sexual nature) that center around children, non-humans (animals, objects, materials), or harming others or one's self during sexual activity.
• Gender Dysphoria includes strong and persistent cross-gender identification.

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• Sexual health should not be taken for granted, and many sexual disorders are not easily prevented.
• There are many self-help steps that can be taken and these self-help actions are beneficial because they may: 1) maintain or improve one's sexual health 2) reduce the risk of developing a sexual disorder and 3) limit the negative impact of having a sexual disorder.
• Get Regular Medical Screening & Evaluation - It is important that you establish a comfort level with your doctors so that you can ask questions and receive appropriate screenings.
• Make Healthy Lifestyle Choices - Choosing not to smoke and limiting alcohol consumption can help improve sexual health and function. Eating a healthy diet and exercising regularly can improve circulation, which in turn can help to improve sexual health .Being aware of medical conditions and medications and their side-effects that can cause sexual dysfunction is also important.
• Maintain A Healthy Body Image - You might want to explore how you feel about your body. If you find that you have low body-esteem and that you are critical of your appearance, you may want to consider that this could be impacting other aspects of your sexuality.
• Increase Physical Comfort - Some simple things can make sexual activity more comfortable.
• Increase Intimacy & Passion in Your Relationships - Just like a car, a relationship requires maintenance to run smoothly. If you notice that passion has dwindled, keep in mind there are certain things you can do to spice things up.
• Educate Yourself: Become a "S-Expert" - There are many myths and misperceptions that can create or worsen sexual problems. Education can solve many problems that happen when people have false or unrealistic expectations of themselves, or their partner.

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