Sex may permeate our popular culture, but conversations about it are still associated with stigma and shame in Indian households. As a result, most individuals dealing with sexual health issues or trying to find information about sex often resort to unverified online sources or follow the unscientific advice of their friends.
To address the widespread misinformation about sex, News18.com is running this weekly sex column, titled ‘Let’s Talk Sex’, every Friday. We hope to initiate conversations about sex through this column and address sexual health issues with scientific insight and nuance.
The column is being written by Sexologist Prof (Dr) Saransh Jain. In today’s column, Dr Jain demystifies the crucial stages of a woman’s sexual health journey, from menarche to post-menopause, and advises ways to stay healthy through these transitory periods.
The journey of womanhood is incredible yet complex. In the process of metamorphosis, in which a little girl becomes a teenager who later grows into a woman, the female body undergoes innumerable changes. However beautiful and significant these changes might be, there are certain underlying causes that affect one’s physical and mental health during these transition periods.
Often, the lack of understanding and knowledge of these complications by a girl leads to serious health issues, and so, in this article, we intend to enlighten everyone about specific diseases, psychological problems and general concerns that are associated with the different stages in the development of the female body.
The major landmark of a girl’s puberty is menarche, which occurs on an average between ages 10-16. Analogous to but distinct from changes experienced by boys, a girl’s body undergoes gradual changes during puberty. Puberty is the process of physical changes by which a child’s body matures into an adult body capable of sexual reproduction to enable fertilisation. It stimulates effective changes in sexual development such as transformative growth of bones, muscle, skin, hair and sexual organs, with height and weight being the visible factors that change rapidly at the onset of puberty and later become slow in the adult body.
It is often not understood by the girl as to why such changes are happening, and therefore an honest and sincere conversation about female sexual health is imperative. Mostly it is the role of the mother to fill a daughter in about these things, but since sex is still a very uncomfortable subject in most Indian households, many just avoid having ‘the sex talk’. This avoidance doesn’t help the girl at all. Therefore, there should be more open and informative discussions about female reproductive and sexual health, not just in every home but also in every school.
The first thing that a girl this age should be taught is period hygiene, which if not followed strictly can lead to infections. Since the girl also undergoes a lot of physical change, it is also important to teach her to love her body. If she knows how to find beauty in her own unique shape and size, chances are she will grow up with a much better sense of self-worth. And lastly, instead of the ‘birds and bees’ talk, explain to her how adults have sex and why protection is essential during sex.
If she is informed about these things from an early age, she will have a much healthier sex life later, and will hopefully be able to avoid sexually transmitted diseases.
At the reproductive age, a woman should be able to openly discuss any health problems with her family and doctor. Ideally, from the early 20s, a young woman should periodically visit the gynaecologist to check on her sexual health.
The current generation’s pressing issue is infertility. Stress, wrong food habits (fast foods cooked in oils with
high levels of trans-fat) leading to obesity, too much or too little exercise, constant exposure to indoor pollutant, chemicals at workplace, industrial pollutant, cigarette smoke, radiations and pollution affects a person’s reproductive system.
Infertility being asymptomatic in nature, one can keep a tab on their menstrual cycle. A cycle too long (35 days) or too short (21 days), absent or irregular must be checked with a doctor, especially if one is between 30-40 years of age. There are many causes for infertility, such as damaged fallopian tubes, hormonal (overactive or underactive thyroid gland), uterine, cervical and ovulation disorders (premature ovarian failure and PCOS).
Many also struggle with UTIs and STIs during their early adulthood. So, before hooking up with someone, especially a stranger or someone whose dating/sexual history is not known to you, there are few questions every responsible adult woman should ask. The first question is ‘when was the last time he was tested?’. Also, check with him if he is willing to use protection. Even if you are on a pill, it is preferable to use protection.
Late Adulthood Pre-Menopause
Gaining weight, breasts growing sore and lumpy, loss of sex drive, changed skin texture, mood swings, and irregular periods are few signs of pre-menopause and are caused by hormone imbalances. Menstrual cycles may lengthen or shorten or even not release an egg (ovulate).
Menopause-like symptoms, such as hot flashes, sleep problems, and vaginal dryness, may also occur. Most of the women in pre-menopause have decreased bone density leading to brittle bones, vulnerable to fractures.
More often than not, women tend to disregard such symptoms as temporary or related to periods. Also, women pose a greater risk for developing diabetes, hypertension and thyroid problems in this decade. At this stage, it becomes imperative to visit a gynaecologist regularly and not forego any symptoms.
This stage is majorly characterized by complete cessation of the predictable menstrual cyclicity of the woman that progresses with ageing. There is a steady decline in the number of ovarian follicles, the amount of ovarian hormones, and fertility. The mean age of menopause occurring is 51 years and depends on the difference in geography, race/ethnicity, socio-economic status, menstrual and reproductive history, body mass index, and genetics.
Menopause is a highly debated subject when it comes to relating it with chronic diseases like cancers, osteoporosis, and heart conditions.
Decreased libido, genital inflammation, and painful sexual intercourse, usually leading to avoidance of sex altogether, can be seen in approximately 60% of patients. Muscle and joint pain worsens during menopause since there is a decrease in bone mineral density.
In the post-menopausal stage, the most common reason for women not giving much importance to their physical state is the psychological state. Due to the advancement of menopause, a woman tends towards depression and undergoes various psychological problems. These lead to severe issues such as insomnia or sleep apnea, where a person stops repeatedly breathing during the night, causing awakenings. This condition is linked to increases in the risk of heart attacks
Ageing results in deficiency of calcium and loosening of muscles for which a woman must focus on physical activity, which can be gained by regular exercises. Also, a balanced diet having vital minerals and vitamins is of utmost importance as body requirements keep changing to cope with the changes. A good amount of sleep of at least 6-8 hours is important to not disturb the biological rhythm. Maintenance of hygiene and having a proper diet that includes rich sources of vitamins, proteins, and essential minerals is a key to coping up with the body’s changes.
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