Sexual health for Valentines

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Dear Reader,

Although it may have started with the Romans as a pagan winter festival, Valentine’s Day since has morphed into a multibillion-dollar holiday celebrating a historically obscure saint and all matters loving. It’s the perfect time to consider how we can keep those we adore, and ourselves, in optimal sexual health.

Challenges to reproductive health

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Experts define sexual health as a state of physical, emotional, mental and social well-being in relation to sexuality. It is not just the absence of disease, dysfunction, or infirmity. It requires a positive and respectful approach to sexuality and sexual relationships, and the possibility of pleasurable and safe sexual experiences, free of coercion, discrimination, and violence.

Though sex has been a central part of human life since the dawn of time,  Americans are challenged about sexual health partly because it’s hard to talk candidly about it.

In a perfect world, we all would be born into loving, two-parent households. We’d grow up healthy and chaste until we found mates, married, and started families. In the 21st century, it doesn’t always, or even often, work that way. Research indicates that young people who delay sexual activity do lessen their chances of contracting venereal diseases. There are indicators that young people aren’t becoming sexually active as fast as they did even a few years ago; pregnancies among teens are declining.

STD epidemic

But America also is in the midst of a silent, destructive epidemic of sexually transmitted diseases (STDs) — and infections are increasing and worsening.

We need to take steps, especially with the young, to curb STDs and help our youth avoid unwanted pregnancy and develop healthy sexual lives. If parents, teachers, and other appropriate grown-ups can’t talk with kids about it, sex education needs to be taught in schools, and we need to do better at it. Abstinence education sounds good; yet our young people get bombarded with too much mass media for that approach to be as effective as we need it to be.

In talking more openly about sex, we need to recognize thatmores and practices aren’t fixed in stone, especially among generations and individuals. As strong as our views on sexuality may be, few of us would want them to harm our young; their orientation, for example, shouldn’t cause them to be bullied, ostracized, and make up half the homeless living on Washington‘s streets.

What we can do

We can discuss with the young the harms of unintended and unwanted pregnancy, and educate them about contraception and condoms. We should vaccinate boys and girls against human papilloma virus (HPV), a cause of cervical, genitourinary, and throat cancers.

STD infections are spiking; the 1.4 million incidences ofchlamydia in 2014 were the highest number of annual cases ever reported to the Centers for Disease Control and Prevention. We all need to protect ourselves from  viruses and bugs. These can be treated, especially if detected early. They can lead to dire consequence if untreated, including infertility, blindness, disfigurement, strokes, and other serious afflictions, as well as death.

Poverty, discrimination, ignorance, and sexual stigmatization abet the spread of STDs like syphilis, gonorrhea, and HIV-AIDS (see sidebar). New technologies that foster promiscuity (akahookup apps that have become a billion-dollar business) don’t encourage safe, responsible sex. We need to understand that persistent infections like herpes, even when controlled, can be a struggle to live with.

This puts even more emphasis on candor and communication with our doctors. Awareness and screening are key todetecting, treating, and defeating STDs, as well as ensuring that we’re healthy enough to enjoy a healthy sex life (see sidebar). Yes, there’s an app or two to help the amorous find sites, online services, or kits for STD testing. Many of us need to talk frankly with our caregivers, and to help our doctors be less bashful about talking to us about sex. Research shows MDs also may want to let us know that, for our benefit, they’re using opt-out screening for STDs, especially for HIV-AIDS.

Great sex

Want a healthy sex life? Be open with your partner. You need time and trust for your relationship to grow and flourish. Great sex won’t happen if you’re both always so rushed that, among other things, you can’t be honest with each other about your sexuality, needs, and desires; by the way, seeminglymonogamous Americans cheat — with disastrous effect, especially on their sexual well-being. 

If you’ve gotten this far and wondered why this cupid hasn’t quivered arrows for you about libidinous best practices — holy, kama sutra — c’mon: I have to keep this newsletter safe for work. Besides, what are web search engines for? Meantime, I can wish that you find lots of good, clean, safe, fun loving for Valentine’s Day and far beyond!


Challenges to reproductive health

Healthy enough for sex

HIV-AIDS: a scourge persists



Percent of married Americans who said in national poll that love should be the top reason for marriage, ahead of factors like children, finances, and companionship.


Percent of American women who said in a 2015 national poll that divorce is morally acceptable;  67% of men respondents said this was so.


Percent of unmarried Americans who said in national poll that they wanted to marry. Though the age for first marriage has risen to 29 for men and 27 for women, by age 45, 9 in 10 Americans have married.

No. 1

1,000 women’s ranking of sex in major research study on which activities in life made them most happy.


Recent research finding as to best frequency for married couples’ having sex for optimal happiness.

Healthy enough for sex

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Your good health is integral to healthy sex — and vice versa.

Women learn early that their reproductive health relies on taking good care of a sometimes delicate and complex body system. The same focus and attention on sexual health also can benefit them by helping, for example, with early detection and care for breast, colon, endometrial, lung, cervical, skin, and ovarian cancers.

Women who don’t feel well enough for sex, especially because they’re always tired, may want to get a cardiovascular checkup; heart disease is the No. 1 killer of women, and its warning signals for women differ from those in men. Unlike men who might experience stabbing chest pain, radiating into the arm, women with heart disease may feel chest and frequent, unexplained weariness.

Both men and women worry about resuming sex after heart disease.

For men, sexual dysfunction can be a powerful warning of cardiovascular conditions that should be checked out. Although drugs have become a $3.4 billion therapy for male sexual dysfunction,these should be used only under doctor supervision; herbal and online alternatives have flourished — some are dangerous.

Speaking of medications, many can interfere with sexual function.

Men and women also can’t ignore the role that mental health plays in sexuality. Depression has become so significant that an important health group recently urged physicians to routinely screen for it. Depression has been linked to sexual dysfunction. Although they may seem alluring, hookups — casual sexual encounters, especially as facilitated by apps — don’t leave participants happier and may contribute to depression and low self-esteem.

HIV-AIDS: a scourge persists

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In 1995, almost 320,000 Americans died of HIV-AIDS or its related causes. By 2012, the most recent year for data, that annual toll had dropped to just under 14,000. Medical-scientific advances have helped to reduce this disease’s ferocity.

But federal officials emphasize that 1.8 million Americans now live with HIV-AIDS — 1 in 8 of them are unaware they have the disease. New infections have leveled out nationally at roughly 50,000 annually. Washington, D.C., once an epicenter of the HIV-AIDS epidemic in the U.S., has made strides, with steady decreases in infections. Still, more than 16,000 district residents live with the disease; with 2.5% of its population affected, the district exceeds World Health Organization criteria for a generalized epidemic. African-Americans are disproportionately affected as are those older than 40. The chief means of transmission continues to be men having sex with men and heterosexual contact.

Over time, HIV-AIDS deaths and infections have declined as: safer sex practices have become more common; testing has become easier, faster,and more wide-spread; and therapies have improved. Anti-viral regimens for many have transformed HIV-AIDS into a chronic rather than a fatal condition for many, and allowed those with the disease to live longer; disease care still can be costly and difficult.

Although a vaccination against the disease has remained elusive, some experts see prophylactic drugs further reducing HIV-AIDS’ harm. Studies suggest that taking antiviral medications before sex can block HIV-AIDS infection. Pre-exposure or PrEP regimens, while embraced by some proponents, have proved controversial. Some fear they need further proof of their effectiveness, that they undercut the long, difficult efforts to encourage safe sex and condom use, and that they can stigmatize users as promiscuous.


Patrick Malone
Patrick Malone & Associates