Sexual myths and
misconceptions leading to anxiety are the most common sexual problems.
The common myths relating to various aspects of sex and sexuality
are handed down from one generation to another and many people imagine
more problems than they actually have.
PENIS SIZE & SHAPE:
What is the normal length of the erect penis to satisfy a woman?
A) Concern about penise size is as old as the human race. The width,
length and erection of the penis vary from one male to another,
as does the length of the nose, the depth and spacing of the eyes
and the width of the forehead. The average sexual length of the
vagina is about 15 cm. And only the outer third (5 cm) has the maximum
nerve endings. The inner two-thirds (10 cm) is virtually insensitive.
This leads to the conclusion that if a man wants to arouse his female
partner he should concentrate on the area of maximum nerve endings
i.e. the outer lips (labia majora) and the outer third i.e. the
outer 5 cm of the vagina. Therefore, for female sexual gratification,
the size of the erect penis could be anything from 5 cm plus. Penise
size is unimportant for female satisfaction and the size of the
penis seems important only to those women who harbor the myth that
a man with a large penis can satisfy his woman better than a man
with a smaller one!
Is the width of the penis important?
A) Not really. The vagina is highly elastic. It can expand from
the size of a little finger to that of a baby's head. The vagina
distends according to the width and size of the inserted penis.
Is there any relation between the size of the body and the size
of the sex organs?
Q) Can a smaller penis lead to conceptive inadequacy?
Is the penis usually inclined to the left?
A) Yes. This is true for a majority of men. This is so perhaps because
the left testis is lower than the right. Therefore, while wearing
under garments, most men adjust their penis on the left side as
enough space exists on the left side as compared to the right.
Does a slight curvature of the penis lead to any difficulty in penetration?
A) A slight curvature of the penis either to the left or to the
right is common and does not affect penetration at all. It is a
myth that an erect penis should always be at right angle.
Is semen vital? Does dissipation of semen devitalize a man and promotes
A) Semen is being secreted day in and day out by the genital apparatus
for erection and can not be stored indefinitely even if one wants
to do so. Barring conception, semen is not vital. Moreover, sperms
constitute less than one percent of the total seminal fluid and
the rest is the secretion of the accessory sexual glands, prostate
and seminal vesicles. The notion that one drop of semen is equal
to a hundred drops of blood which in turn requires a lot of nourishing
food is one of the most common sexual myths prevalent.
Does conservation of semen lead to longevity and athletic excellence?
A) If this had been based on physiological facts, then all bachelors
would have become athletes and lived longer!
Does the reduced consistency of semen indicate sexual inadequacy?
A) No. The consistency of semen may vary as it depends upon several
factors like the period of abstinence, the intensity of stimulation
etc. However, as a man grows older, the consistency of semen does
thin out, but this has nothing to do with the individual's sexuality.
What is the 'Dhat' syndrome?
A) Sometimes men pass a whitish fluid with urine or whilst straining
at stools. The belief that this fluid is semen/dhat is called the
'Dhat' syndrome. This is not a disease and it would not be inappropriate
to say that it exists only in the mind of the beholder. The
physiological sphincter at the neck of the urinary bladder always
remains closed and opens only when one is passing urine. Thus, it
ensures that normally urine and semen do not mix i.e. normally one
cannot pass semen and urine together. Sometimes, a physiological
alteration in the urinary solution may change the appearance of
urine, making it whitish which is mistaken to be semen by mistaken
to be semen by misinformed individuals. In reality, the whitish
discharge is largely the secretion of the urethral and prostate
glands. When a man squats in the toilet and exerts a little pressure,
the pressure is relayed from the rectum to the urethra and a few
drops of sticky white secretion accumulate, coalesce and trickle
down. The phenomenon is akin to there being ten drops of perspiration
and on being joined by the eleventh trickle down . In my opinion,
this misconception is prevalent in our country because of squatting
toilet habits, as people tend to look down and see the sticky substance
which they presume to be semen. In developed countries , most people
use western style commodes, so they look straight ahead. Hence,
what the eyes do not see, the mind does not perceive!
Why do people feel weak after sleep emissions?
A) Post emission weakness is largely psychological. Right from childhood
the idea has been drilled into our minds that the genitals are special
and anything coming out of it is equally special. This misconception
about the value of semen adds further anxiety in an individual
leading to neurathenic symptoms. In fact, the calories lost during
a sleep emission are equivalent to a glass of limejuice!
Is sexual abstinence advantageous?
A) Prolonged sexual abstinence may be detrimental to mental and
physical health. There are people who are under the impression that
sexual abstinence is conductive to human health and happiness. Because
of this misguided belief, they make an attempt to conserve their
so-called 'energy' by sexual abstinence. The moment they are unable
to do this, they get a feeling of guilt and anxiety that they have
done something detrimental to their health. When this is repeated
several times, the roots of the problem get deeper and deeper. Consistent
suppression of the sex drive leads to emotional instability and
evokes an abundance of sexual imagery. This usually leads to inability
to concentrate, insomnia, irritability and extreme nervousness.
The extent of the disturbance depends on the individual's own mental
state and environment. At times, the consistent suppression and
continued inactivity of the sex organ lead to diminished ability
to function. One must remember it is the disuse that lead to atrophy
and not the use!
Mahatma Gandhi used to advocate this?
A) Yes, but Mahatma Gandhi was a politician and not a sexologist!
What is Brahmacharya?
A) Brahma in Sanskrit means Atma or soul and charya means search,
Brahmacharya is search of a soul.
Is semen analysis necessary for a patient having impotence?
A) Absolutely not. The absence or deficiency of sperm does not indicate
impotence. Sterility and virility are two entirely different things
and depend upon different types of cells present in the testes.
Absence or deficiency of sperm does not affect one's virility or
Would you advise circumcision for a newborn baby?
A) No. Certainly not. It is unfortunate that many baby boys are
circumcised without anesthesia and a healthy and normal part of
their body is cut off without their consent. Circumcised males are
twice as likely to contact non-gonococcus
arthritis as opposed to non-circumcised males. In fact,
an intact foreskin would act as a shield for any irritating lesions
on the glands following herpes or any other infections, by preventing
Do circumcised males have orgasmic control than non-circumcised
A) No. This is a myth.
What is virginity?
A) The word 'virgin' means one who has not had sexual intercourse,
which can be verified by an intact hymen. However, a girl whose
hymen is intact may have had intercourse; whereas a girl who has
never had intercourse may not have an intact hymen. The idea of
chastity and virginity needs to be clarified. There are virgin individuals
who are not chaste and chaste individuals who are not physiologically
Can a virgin becomes pregnant?
A) Yes. If the sperms are deposited near the vulva, they may pass
through the small hole of an intact hymen and may travel up through
the full length of the vagina and uterus and fertilize the ovum
resulting in pregnancy. BREAST:
Is breast size important?
A) No. Large breasts are not more sensitive to stimulation than
Are there any medicines or creams to enlarge breasts?
Can breast size be increased?
A) Certain exercises do help develop the Pectorals Major muscles
which could add a little bulk to the chest (but not the breasts
themselves) and this may apparently increase the breast size. Plastic
surgery may also prove beneficial.
Do hairs on the breasts suggest any pathology?
A) It is not uncommon for women to have a little hair around the
areola of the breast, which does not need any treatment. However,
if a woman desires, she may get them removed permanently by electrolysis
done by a qualified professional.
Is sex safe during pregnancy?
A) Usually, a healthy woman can safely indulge in sexual activity
during pregnancy. However, coitus should be avoided if there is
pain and/or bleeding at any stage. If a woman has had an abortion
in the first three months in the past, coitus during the first trimester
should be avoided. In the second trimester, coitus is contraindicated
if the woman has a history of 'habitual abortion' because the incompetent
cervical of the mouth of the uterus. In the last trimester
i.e. from the seventh month to labour, one may safely indulge in
sexual activity till the last day of delivery by altering the coital
position so as to ensure that direct weight does not fall on the
foetus. It must be remembered that if for any reason intercourse
is forbidden during pregnancy, the woman must avoid reaching orgasm
by any other means including masturbation. In fact, the contractions
of the uterus following masturbation intercourse. An obstetrician
may be consulted regarding indulgence in sexual activity during
pregnancy, as each case needs to be evaluated individually in so
far as any possible contraindication or modification needs to be
Are there any signs which indicate that a woman has reached orgasm?
A) When one reaches orgasm, one usually has gasping uncontrolled
movements, or has a sense of suspension. But these are non-verbal
communications to the partner that one has had an orgasm. In a majority
of women, orgasm is generally accompanied by vaginal contractions.
Later, after completion of the sex act, one appears calm and satisfied.
The signs of having had an orgasm are quite fleeting. The best way
of knowing is to ask the partner. Orgasm is like a sneeze , if a
woman has had one, she knows about it, otherwise any attempt to
explain it is akin to showing a rainbow to a blind man!
Is there a difference between 'clitoral orgasm' and 'vaginal orgasm'?
A) No, there is no difference. An orgasm may be more or less satisfying
depending upon several factors, but whatever be the means of stimulation,
ultimately ' all roads lead to Rome'.
& FREQUENCY OF THE SEX ACT:
What is the 'normal standard time' for an intercourse?
A) There is no normal standard time for an intercourse. It depends
upon the partners. The act needs to be mutually satisfying. The
notion that a prolonged intercourse gives more pleasure is a myth.
What is important is not how long, but how satisfying and how blissful!
How often should a couple have sexual intercourse?
A) Sexual intercourse is a means to an end, the end being pleasure.
Therefore, a couple can have intercourse as often as it pleases
them. Sex is a pleasure to be shared between partners and there
is no need to keep a tally. How often to indulge in sex depends
upon the individual couple. The best thing to do is to forget the
number game and indulge in sex as often as is mutually pleasurable
and satisfying. Moreover, the quality of sex is important and not
Is frequent intercourse harmful?
A) Present medical knowledge acknowledges the fact that as long
as intercourse is indulged in amongst accepting partners and is
not associated with any physical trauma or irritation, the act itself
is not harmful irrespective to its frequency. SEXUAL POSITIONS:
Are there different positions for sexual intercourse?
A) Yes. The human anatomy allows freedom for innumerable conjugal
positions, which may be used depending on the practicability, and
one's individual anatomy and preference.
Are they useful?
A) Yes. Different positions offer different advantages in different
situations with respect to accommodation, penetration and enhancement
of pleasure. They also add a feature of novelty. In addition, a
position like the female superior is often helpful in delaying the
male's by side, rear entry and female superior positions are more
comfortable in pregnancy. Penetration can be easy and deeper if
the woman's thighs are wide open with a pillow beneath her buttocks.
Positions in which her legs are closed after penetration enhance
penile as well as clitoral stimulation. ORAL AND ANAL SEX:
Is oral sex normal?
A) Yes. Oral sex can be an excellent variation.
Why do some people prefers anal sex?
A) Due to the similarity in the neurological innervations of the vagina and the anal canal, the central neurological perception
is likely to be similar in both, vaginal and anal sex. Further,
the latter position allows freer access for manual stimulation of
the breasts and the clitoris. Some experience a better grip whereas
others enjoy the novelty. Thus, anal sex may be preferred for any
one of the multitudes of reasons.
What is an alternative orientation?
A) Any sexual inclination apart from the popular heterosexual indulgence
can be termed as an alternative orientation. It is not necessarily
an aberrant or deviant expression of one's sexuality but no one
knows why some people develop such alternative preferences.
What is homosexuality?
A) Sexual attraction towards, and/or indulgence in sexual activity
with partners of the same biological sex as oneself is called homosexuality.
Do you recommend homosexuality?
A) Neither do I recommend nor do I condemn! Nevertheless, if a homosexual
is satisfying his relationship in a positive way, he is better off
than not satisfying at all or being a destructive heterosexual one.
SEX & AGEING:
What are the common sexual misconceptions prevalent among middle
age men and women?
A) Men harbor the misconception that misconception that increasing
age and excessive use may lead to weakening of the genitals and
end in 'seminal bankruptcy'. Because of this misguided belief, they
observe sexual abstinence. One should remember that it is disuse
which leads to atrophy and not the use. As a man grows older, he
walks slow, he talks slow but he expects that his erection should
not be slow! One needs to remember that this a normal phenomenon.
Some are under the impression that 'one failure in making it means
an end to sex life'. As a result, many men move from effective sexual
functioning to various degrees of importance. I always emphasize
that occasional failures are common and a failure does not mean
an end. Women harbor the misconception that menopause marks the
end of sex life. Menopause merely marks the end of a woman's reproductive
career and not the conjugal career, which can continue up to the
end of one's biological life. In fact, the maturity of the partner's
end the relationship, along with guaranteed natural contraception
many enhance the sex life. The misconception that 'sex after sixty
is not possible' needs to be changed. Men and women can continue
to remain sexually active till the last day of their lives provided
they are in sound mental and physical health.
Can a very active sex life in the early years affect one's sexual
A) A very active sexual life in youth does not precipitate an early
termination of the sex drive or capacity. On the contrary, persons
having a strong sexual interest and capacity in the early years
are more likely to retain the same in the later years. This has
been confirmed by a longitudinal study on sexual behavior and old
What are the most common conditions which could decrease sex drive
A) The common reasons for a reduced sex drive in later years are:
Monotony and loss of interest Changes in physical appearance Misconceptions
about one's waning sexuality Lack of communication Depression
Q) Does female sexual desire increase or decrease at menopause?
A) Some women report an increase while others report a decrease
in sexual desire at menopause. Increase in sexual desire may be
because of relative freedom from pregnancy and hence one may respond
and perform with greater enthusiasm. Some women harbor the misconception
that menopause marks the end of their sexual career and this fear
increases their sexual drives as an affirmation of their femininity.
During menopause (or even a few years earlier), a reduction in the
secretion of the ovarian hormones may cause atrophy of the vaginal
epithelium which leads to reduction in lubrication and hence pain
at the time of sexual intercourse. This causes a decline in sexual
desire and a woman tends to avoid sexual overtures.
What are the most common sexual dysfunction among diabetics?
A) Sexual dysfunction is common amongst diabetics. The causes could
be vascular, neurological or psychological. In diabetic impotence,
the history is suggestive of presence of desire but decline in erectile
ability at all times. Usually the onset of the problem is gradual.
In some, the presenting symptom could be premature ejaculation and
rarely retrograde ejaculation. Diabetic women sometimes complain
of reduction in lubrication and difficulty in reaching orgasm. Monilial
infection may further reduce lubrication and associated itching
makes intercourse uncomfortable. Monilial infection often leads
to Balanitis. A misconception that "all diabetics become impotent"
may itself lead to psychogenic sexual dysfunction.
How safe is a sexual activity in-patient with heart disease?
A) One must consult a cardiologist, because what is good for one
person may not necessarily be good for another. Hellerstein and
Friedman have studied cardio-pulmonary responses in middle-aged
middle-class convalescent males engaging in sexual activity with
their wives in the privacy in their bedrooms. From their studies,
it was concluded that if a cardiac patient could walk on a treadmill
at 3 miles per hour asymptomatically and without undue elevation
of blood pressure or electrocardiograph changes, he could safely
participate in sexual activity.
What limits should one observe?
A) There is nothing like a limit in sex; either you indulge or you
do not. The incidence of heart attacks during sexual activity, as
per statistics, is 1 in 200. This could have happened even otherwise
like while passing urine or going to toilet. However, the best person
to advise you would be a cardiologist because the patient's regimen
needs to be tailored according to individual needs.
The following precautions may be useful:
Avoid clandestine sexual activity as it tends to increase the heart
rate even more than usual. Avoid elaborate meals and alcohol prior
to the sex act as lot of energy and blood flow is being utilized
for digestion. It is preferable to have sexual intercourse in the
morning when one is not fatigued. It is advisable to do regular
physical exercise need be an unaccustomed exertion. One may keep
a nitroglycerine tablet handy or use nitroglycerine ointment if
anticipating chest pain.
Has blood pressure anything to do with sex?
A) There is a marked increase in blood pressure during sexual intercourse.
Theoretically speaking, very high blood pressure does pose a danger
of cerebral hemorrhage and myocardial infarction. A study recently
conducted clearly showed that cerebral hemorrhage among patients
with high blood pressure occurred as frequently during sleep defecation
as during sexual intercourse. However it is desirable to control
high blood pressure. Patients need to be informed very clearly that
the danger of catastrophic events in negligible with the short term
changes that occur during intercourse and other physical activities.
It is equally if not more, important, to inform the patients about
the likely side effects of anti-hypertensive drugs on sexual response.
How does arthritis affect sexual relationships?
A) In arthritis, pain and deformity usually leads to disturbance
in the sex act, especially where there is an involvement of hip,
knees or the back. Factors like frustration, anger, dependency and
low self image due to deformity, lead to depression. Steroid side
effects e.g. obesity and moon like face complement this.
is sexual desire excessive?
A) The term 'excess' needs to be defined. In our culture, increased
male sexual activity is considered as a sign of masculinity, while
the similar behavior in a woman is considered a stigma or an illness
--- nymphomania. Increase desire can be seen in mania where there
is acceleration of activity in all spheres.