Private practices

Sexual practices are highly varied in our society but some pose risks of infections.

EVERY person is different. People themselves also differ at different phases of their lives. In the same vein, there is much variation in sexual practices.

The practices described in this article are for information only. There may be religious, cultural, social or other reasons for acceptance or non-acceptance of any of the practices.

Foreplay

Petting is an American word that means “to stroke or caress”. It has the same meaning as foreplay, that is, something done prior to commencement of sexual intercourse. It refers to the stimulation of another person’s genital organs or breasts. This prepares the body for sexual intercourse.

Petting is useful for those who need to express their emotions and get sexual relief and who do not want to have sexual intercourse or whose circumstances do not permit it.

There is a small risk of acquiring sexually transmitted infections (STI) if the petting involves oral sex but it is substantially less than that of the full course. The infections include herpes, gonorrhoea and even HIV.

In general, petting is very safe and if done skilfully, is vital for female sexual satisfaction.

DIY

Masturbation refers to sexual arousal and often orgasm resulting from manual stimulation of the genital organs. The term is commonly used to indicate self stimulation. However, the actual definition includes pleasuring by and of another person.

Masturbation was frowned on until the latter part of the 20th century and was widely considered as a sin. To some extent, this was influenced by doctors who did not approve of it with claims that it had terrible health consequences, which was all not evidence based.

Societies gradually became more tolerant of masturbation but negative connotations still persist although most experts today have a positive view of it. Some people, especially in Asia, believe that it drains the body of energy and may shorten one’s life span but there is no published evidence to support such a belief.

This practice is the one that most people learn first, quite instinctively. A baby boy learns that touching the penis makes him feel good even before he learns to talk. It is not surprising that most baby boys touch their penis a lot.

By the time of adolescence, the boy discovers that masturbation can lead to ejaculation and orgasm. Males masturbate mostly in their adolescent years with the frequency getting less as they get older.

Adolescent girls do not masturbate as boys do. Some girls discover at a young age that they get pleasant feelings from their genital organs.

Masturbation is one of the safest sexual practices. The only occasion when masturbation is unsafe is when potentially harmful objects like vacuum cleaners are used.

Oral

Oral sex refers to the use of the mouth, tongue, teeth and throat in stimulation of the genital organs.

Oral sex performed on a female is called cunnilingus and that on a male is called fellatio. The oral stimulation of the anus is called analingus.

Published data on the prevalence of oral sex is limited. However, a survey of more than 12,000 Americans in 2005 revealed that more than half of teenagers had practised oral sex.

Sexually transmitted infections (STI) can be transmitted through oral sex. They include human papilloma virus (HPV), herpes, hepatitis, chlamydia, gonorrhoea, and HIV. Although the risks are less than that of vaginal or anal sex, there are risks nevertheless. This is particularly so when the recipient of oral sex has wounds or open sores on their genital organs or the giving partner has wounds or sores on or in their mouth and/or oral cavity.

Activities that traumatise the mouth and/or oral cavity such as brushing or flossing teeth soon after giving oral sex increases the risk of contracting STI and other common infections in the genital organs.

By itself, oral sex cannot lead to pregnancy as there is no communication between the gastrointestinal and reproductive tracts. However, there is a potential risk if there is indirect contact between the male’s semen and the female genital organs. The use of condoms and/or dental dams will reduce the risk of infection considerably.

Penetration

Vaginal sex refers to the insertion of the erect penis into the vagina. It is the method practised by most heterosexual couples.

Some couples insert devices into the vagina as part of their sexual activities. This is not considered vaginal sex. Such practice is not to be encouraged as the devices can perforate the genital organs, damaging it and other internal organs.

During my career, I have had to remove such devices from the abdominal cavity and intestines. All the patients affected were not only physically traumatised but also psychologically.

Pregnancy and sexually transmitted infections (STI) are the common risks. There are many contraceptive choices to prevent unwanted pregnancy such as the pill, intra-uterine contraceptive device, injections and condoms.

The use of condoms will reduce the risk of STI. It is also used in addition to other contraceptive methods for this reason. The best method of preventing STI is to have a faithful sexual partner.

Rear entry

Anal sex refers to sexual activity involving the anus. The activities include inserting the penis into the partner’s anus, inserting a finger into the anus (postillionage), inserting the hand into the rectum (fisting), contact between the mouth and the anus (rimming) and inserting devices into the anus.

The anal area in males and females has a very extensive supply of nerves, which is probably the reason why some couples obtain pleasure from anal sex. The common perception that anal sex is practised solely by homosexual men is not accurate. It is estimated that about a third of gays do not practise anal sex and that about 10% of heterosexual couples regularly practise anal sex. According to the Durex 2005 Sex Survey, 19% of Malaysian respondents had experienced anal sex as compared to 35% globally.

There are many people who view the various types of anal sex, especially anal intercourse, with disgust. The objections may be religious, cultural or personal. While some people find anal sex repulsive, there are others who find it stimulating and part of their routine sexual activity.

The risks of contracting sexually transmitted infection and other infections of the lower genital tract are increased in anal sex. The infections include human papilloma virus (HPV), herpes, hepatitis, chlamydia, gonorrhoea, HIV and Escherichia coli. The risks are much more than oral sex.

In fact, anal sex is the commonest mode of transmission of HIV in many countries. HPV and HIV infections transmitted during anal intercourse predispose the affected individual to other infections, and in the case of HPV, the development of cancer of the anus as well.

The best way of avoiding the risks of anal sex is to avoid it altogether. There are other sexual practices that are just as pleasurable. However, some couples may still practice anal sex regardless. It is advisable to use condoms, especially toughened ones designed for anal intercourse, and water soluble lubricants which may provide some protection. Other safety measures include: ensuring that the anal area is clean and the bowels have emptied; and the recipient must be able to relax the anal sphincter.