Sex Tutorial
 

Sex positions
The missionary is the most commonly adopted
lovemaking position, because it is so comfortable, but
there are many different ways of enjoying each other's
bodies, and each of the positions illustrated on the
next pages may suggest another into which you can
move.
Greater intimacy is offered by some positions'
with all-over body contact and the opportunity to
embrace and kiss, others offer deeper penetration,
some are quite difficult to maintain, which creates a
certain sense of urgency and excitement.
Adventurous lovers will find variations of
their own, either by design or by chance: you may get
overtaken by lust half way up the stairs or while talking
in the kitchen. The important thing is to engage all your
instincts and feelings, while remaining acutely aware
of your partner's responses.
SEX POSITIONS
WITH PICTURES AND DESCRIPTIONS

Sex Tutorial - SEX POSITIONS

ASTRIDE
CRAWL
CROSS
CUISSADE
CUNNILINGUS
FELLATIO
FIRESIDE
FUTON
HEAD TO TOE
LAP
MISSIONARY
PRAGNANCY
SIDE BY SIDE
SPLIT LEVEL
SPOONS
SPREAD EAGLE
STANDING
STANDING CARRY
SWIMMING
URGENT
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Sex Tutorial
Astride
With the man lying on his back on the bed, the
woman can sit astride him and control the pace
of their lovemaking. Facing him, she may squat
on her haunches for a more powerful bouncing
movement, or, as here, kneel, supporting herself
with her hands. This way, she is free to lean
forward and kiss his mouth. From this position it
is easy for her to increase the intimacy by lying
with her whole body along his. A variation is for
her to face away from him, increasing the depth
of penetration.


Sex Tutorial
AIDS
ANAL SEX
CONDOMS
CONTRACEPTION
CUNNILINGUS
FELLATIO
FEMALE ORGASM
G-SPOT
HOMOSEXUALITY
KISSING
MASTURBATION
ORAL SEX
PREMATURE EJACULATION
SEX CHAT
SAFE SEX
SEX AIDS and APHRODISIACS
SEX POSITIONS
SEX IN PREGNANCY
SEXUALLY TRANSMITTED DISEASES (STD)

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Crawl
Deep penetration can be achieved with the
woman on all fours and her partner kneeling
behind her. This position gives both lovers the
opportunity to thrust against one another, and the
man may also caress his partner's breasts,
buttocks and clitoris. Rear entry positions like this
one are ideal when both partners are in the mood
for vigorous rather than tender lovemaking. A
variation is for both partners to stand with the
woman bending forward and supporting herself
against furniture.

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Cross
Here the woman lies on her back on the bed and
the man lies diagonally across her. She opens
her legs to allow him to enter and he rocks gently
from side to side. She can guide his movements
with the pressure of her hands. This position is
somewhat easier to maintain if the man lies
beneath on his back and the woman is in control.

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Cuissade
This position is known as 'cuissade', from the
French cuisse,meaning thigh. The woman lies on
her back, with the man at her side. She raises the
leg nearest to him and rests it on his body, and
he enters from under her thigh, with his nearest
leg crossing her body. They can hold one another
and kiss, and the position is a very intimate one,
possibly because of the 'secretive' form of entry.
The woman can exert a certain amount of
restraint with her thigh, which can make it more
exciting.

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Cunnilingus
In cunnilingus, the man stimulates his partner's
vulva and clitoris with his lips and tongue. For
most women, cunnilingus gives the most
delicious sensual pleasure and is the best way of
climaxing. It is also extremely arousing for her
partner.

Sex Tutorial
Cunnilingus - Oral
sex upon a vulva
What is cunnilingus?
Cunnilingus is the fine art of making love
to a vagina with your mouth and tongue. It
is a delicate skill, requiring patience,
practice, and dedication to get it right, but
any woman you learn to do it right for will
appreciate you all the more for it.
What applies to the penis applies to the
vulva-- every one is different, requiring a
different touch to make its owner happy.
But few tools can equal the tongue for the
amount of pleasure it can deliver to a
happy vagina.
This article assumes that you know what a
vulva looks like and can identify with some
precision the mons veneris, labia majora,
clitoral hood, clitoris, labia minora, urethra,
vagina, and perineum, to name them
(approximately) from top to bottom.

How fast should I go?
This isn't an attack. Don't go after the
clitoris like a fireman attacking a fire. Quite
often at first, the clitoris is far too sensitive
for direct stimulation. Lick around it,
stimulating the hood, teasing her inner
labia, tasting her. Take your time and
listen to her. Some women make noise,
and some do not. It will be a while before
you learn exactly what your lover prefers
as far as oral sex is concerned.
Some women may like additional
stimulation-- a finger or two into the
vagina, or perhaps even the anus. She
may want your hands to reach up and
play with her breasts, or she may want
your fingers to hold her labia apart so that
your tongue can get at her vulva more
directly.
I've heard cunnilingus
doesn't taste good.
If the taste or smell bothers you or is a
concern, ask her to wash first. Most
people who enjoy cunnilingus agree that a
clean vagina is a good, if acquired, taste.
As a woman nears her climax, she may
want more direct stimulation. In general,
fast, rhythmic stimulation is most effective
at causing climax-- but there shouldn't be
a rush to get there. Take your time and
learn to appreciate what you can do for
her.
What about
cunnilingus during
menstruation?

Some people are particularly turned off at
the suggestion of cunnilingus during
menstruation. If it is a concern to you,
then wait. A tampon may well hold the
blood back, as will a diaphragm, but some
men can't stand the taste anyway. If your
partner is healthy, however, there is no
particular danger in menstrual blood, and
some women find that orgasms during
their periods allievate cramps.

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Fellatio
In fellatio, the woman sucks, licks, kisses and
strokes her partner's penis. Exquisitely satisfying
for the man, fellatio can also give enormous
erotic pleasure to the woman as she senses his
responses and his total abandonment to her.

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Fellatio - Oral sex
upon a penis
What is Fellatio?
Fellatio, giving head, giving a blow-job. Many men
love this kind of stimulation, and many people,
both women and men, like giving it. Fellatio is the
act of applying your lips to a man's penis with the
purpose of giving him pleasure.
There are few tips to fellatio that can be given
other than practice. The lips and the tongue are
the major sources of stimulation, and it is with the
lips and tongue that you should apply the
attention to make him feel good. Both men and
women respond well to pressure and rhythm. A
steady, strong stroke will be enough to get the
reaction you're looking for.

What if it doesn't smell
or taste good?
If the smell isn't something you enjoy, then tell
him to go take a shower! While this is something
you're doing primarily for his pleasure, that
doesn't mean you have to suffer if he's lacking in
hygiene! And if you're worried about germs, your
mouth has millions more germs than a clean
penis.
What is "deep
throating?"
Deep throating is the act of taking the penis down
past your gag reflex. In reality, this particular
sexual adventure is very overrated. The best way
to give fellatio is still with the lips and tongue,
taking only as much as you can without gagging.
However, for those that want to know, the basic
lesson is still practice. Take the penis as far as
you can without choking, and then close your
eyes and concentrate, taking each quarter inch,
telling yourself that you won't choke, that you can
take it out at any time, and slowly swallow it down.
Then rise off of it just as slowly.
Are there any special
spots on the penis?
Every penis is different, and each has its sensitive
spots and its preferred ways of being handled.
Listen to your lover. The sounds he makes and
the feel of his body tensing are your best clues
that you're going this right.
Should I use my
hands?
Feel free to grasp with your hands whatever of the
penis you can't fit into your mouth. Many men like
as much stimulation as possible, and the feel of a
wet mouth and a saliva-slicked hand are enough
to send them to the brink of orgasm very quickly.

What is 69?
Some people feel that the best position to perform
oral sex is the 69 position, where each partner lies
with their head by the other's genitals. For fellatio,
this even makes sense-- most penises curve
upwards, towards the head, and in this position
that curve matches the curve of the throat.
However, it is difficult to both perform and
appreciate oral sex at the same time. Try the
position, or kneel by his body, but at least in the
beginning do one thing at a time.
My boyfriend wants me
to swallow. What do I
do?
Which brings us to a sensitive issue: swallowing
ejaculate. For many men, this is important to
them-- they like to feel that by swallowing their
semen, you complete this act of lovemaking and
accept a part of themselves into your body. But
many people don't like the taste of semen and
can't bring themselves. Talk about this
beforehand-- let him know if you can't handle it,
and that it's not personal.
Can I make my seminal
fluids taste better?
Macrobiotic nutritionists have actually done
research on this question, and the answer is in:
you are what you eat. Common sense dictates
that if you taste good, your lover will want to eat
you more often, so improving your body's taste
and smell should be important to you.
In general, nutritionsists say that alkaline-based
foods such as meets and fish produce a butter,
fish taste. Dairy products, which contain a high
bacterial putrefaction level create the foulest
tasting fluids by far. (Dissent: almost everyone I
know says that there is one worse than a
high-dairy content-- asparagus. You can't miss
the taste of asparagus-laced semen.) Acidic fruits,
such as sweets, fruits, and alcohol give bodily
fluids a pleasant, sugary flavor. Chemically
processed liquors will cause an extremely acidic
taste, however, so if you're going to drink alcohol,

What are the contents
of semen?
The question of semen content arises especially
among persons who regularly swallow semen, as
in fellatio, and who are concerned about calorie
intake and nutritional substances. The average
ejaculate contains aboutonia, ascorbic acid,
blood-group antigens, calcium, chlorine,
cholesterol, choline, citric acid, creatine,
deoxyribonucleic acid (DNA), fructose,
glutathione, hyaluronidase, inositol, lactic acid,
magnesium, nitrogen, phosphorus, potassium,
purine, pyrimidine, pyruvic acid, sodium, sorbitol,
spermidine, spermine, urea, uric acid, vitamin
b12, and zinc.
The caloric content of an average ejaculate is
estimated to be approximately 15 calories.
A last word.
There is only one true way to do fellatio, and
that's with enthusiasm. You have to love what
you're doing to him, either because you love him
or you love sucking cock. Loving both is best!
Faked orgasms have nothing on lackluster fellatio.

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Fireside
In this cozy position, which can follow
cunnilingus, the woman sits comfortably in an
armchair with her hands and legs around the
man, who enters kneeling in front of her. If she
leans back, he can support himself with his
hands on the back of the chair, which will allow
him more thrust.

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Futon
For this position you need to try out all your
furniture to find a piece of the correct height. The
woman lies on the edge of a table, futon or bed
covered with quilts and pillows, and spreads her
legs wide. The man can begin by kneeling to give
her cunnilingus, then he enters her, supporting
himself on his knees and holding her legs. This
affords him a great deal of control, and the angle
of penetration is steep.

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Head to toe
The man lies on his back with his legs spread and his
penis inside the woman, who also lies down on her
back, with her legs spread across his, her toes pointing
to his head, and her head away from him. The woman is
in control. The partners cannot see each other and
sensation is concentrated on the genitals. This position
can be adopted from one in which the lovers sit on the
bed facing one another, their legs interlaced.

Sex Tutorial
Lap
This is a position that may suggest itself while
cuddling on the sofa. The man sits with the
woman straddling his lap, facing him. She
controls the pace, they can kiss and he can
caress her breasts. She moves up and down on
him, supporting herself with her knees on the
sofa, and her arms around his neck. If they use a
dining chair, she can keep her feet on the floor
and hold on to the chair back for support if
necessary. If she faces away from him, they will
be able to achieve deeper penetration, and she
could support herself against furniture in front of
her.

Sex Tutorial
Missionary
The missionary position is the most popular
lovemaking position of all because it is
comfortable, affords a great deal of body contact
and good depth of penetration. The lovers can
kiss and hold each other at the same time. The
woman lies on her back with her legs spread and
her knees raised, and her partner lies on top
between her legs. From this position the woman
can move to clasp her legs behind her partner's
back or to close them tightly underneath him,
while he spreads his.

Sex Tutorial
Sex in
pregnancy
Unless your doctor tells
you otherwise, it is perfectly safe
for you to have sex throughout your pregnancy.
However, towards the expected birth date, your
size may make many positions uncomfortable for
you. Penetration may be easiest if you lie on your
side and your partner enters from behind. Oral
sex and mutual masturbation should cause no
problems. Some women fear that sexual activity
or orgasm may trigger off labor but sex cannot
induce labor unless the baby is due anyway,
when the prostaglandin present in the man's
semen may cause it to start.
The sex drive of some
women decreases during the first
trimester of pregnancy. This may be due to
tiredness and nausea, or to a hidden belief that it
is 'not right' for a mother to enjoy sex. The
problem will usually disappear of its own accord.
In some women, the sex drive actually increases
during the middle three months (the second
trimester) of pregnancy, and some claim that
their lovemaking is more satisfying than ever
before. This may be because the high level of
circulating hormones means that a woman can
be stimulated more easily and reach a pitch of
sexual excitement more quickly than when not
pregnant. A pregnant woman's sexual organs
breasts, nipples and genitals - are especially
highly developed, which probably increases
sexual awareness. Finally, there is of course
complete freedom from the worry of getting
pregnant, which allows a deeper level of 'letting
go'.
Some women and their
partners worry that sex may harm
the unborn child, but such fears are groundless.
The fetus is protected from infection by the plug
of mucus at the neck of the womb. In rare cases,
infection can occur, but this is usually due to lack
of normal hygiene precautions or having sex with
several different partners. The baby is also
protected against being squashed by the
amniotic fluid in which it floats in the womb. Avoid
over-athletic sex because it will be uncomfortable
for you, but don't worry about hurting the baby.
Sex should not cause a miscarriage in a normal,
healthy pregnancy.
You can resume sex after
childbirth as soon as it is comfortable to do so.
Women who have had an episiotomy (in which
the perineurn is cut to facilitate birth), will
probably feel sore for at least three weeks. When
you feel confident that your wound has healed,
begin to re-establish your sex life, taking it slowly
and gently and using a lubricating jelly if
necessary to prevent scar tissue causing
discomfort or pain. It is important to establish
sexual contact with your partner as soon as you
can, as you will both need to get close again. If
you still feel sore, remember there are other ways
of giving and receiving affection. Don't let your
partner feel that you are lavishing all your care
and attention on your baby and excluding him
from your love.

Sex Tutorial
Positions for
pregnancy
Spoons
The woman lies
comfortably on her side
and the man enters her
from behind, fitting his
body closely to hers.
This position puts no
pressure on the
woman's abdomen and
is suitable for the most
advanced stages of
pregnancy. The man can cuddle up close and
caress her breasts, while kissing her shoulders
and the nape of her neck.
Leapfrog

The woman kneels on
the bed with legs spread
wide, and falls
comfortably forwards as
the man enters her from
behind. He can then
caress her back and
control the depth of
thrust. This position is
ideal when the woman
starts to feel uncomfortable with the man's weight
pressing down on her and she wants to protect
her belly from over-enthusiastic thrusting.
Astride
This is a good
position for the
middle months
of pregnancy,
when the
missionary
position has
become
uncomfortable,
but the woman
has quite a bit
of energy for
sex. She sits
astride the
man's lap and
supports herself with her arms. He can help her
as she moves up and down on top of him, taking
control when she gets tired.

Sex Tutorial
Oral sex
Oral sex begins with the first deep kiss, and
continues with kisses all over the body,
concentrating finally on the genitals. On the part
of the giver it requires a degree of emotional
involvement, because it must be done with
patience, tenderness, sensitivity and mounting
but controlled excitement if it is to be really good.
Lovers who give oral sex reluctantly and without
generosity or enjoyment make their partners feel
guilty and selfish, and too tense and worried to
relax and take pleasure themselves.
From the receiver, oral sex requires
trust, and the confidence that comes with being
made to feel desirable. In sex, as in other areas
of life, it is often more difficult to receive
generosity than to give it, but the person who
succumbs completely to pleasure delivers himself
or herself over to the lover, and this also gives a
sense of wonderment. It goes without saying that
sexual hygiene is of prime importance for anyone
who engages in oral sex.
Oral sex for women is called
cunnilingus. For many women, cunnilingus is
the most exciting of all the variations of sex, and
a gentle and skilful lover should be able to make
his partner come with his tongue more easily
than in any other way. A strong slippery tongue
can be used with precision on the clitoris without
danger of causing any pain, unlike a finger.
Begin by kissing your partner's face and
mouth, and then gradually work your way down
her body, kissing and stroking her breasts, belly
and inner thighs. Flick your tongue in light
feathery kisses along the fleshy folds of the outer
labia, smoothing away the pubic hair and then
parting the labia gently with your fingers. Move
very gradually inwards with your tongue. Vary
your movements according to your partner's
response. Try nuzzling, burrowing, thrusting with
your tongue into her vagina, sucking, long
delicate licks, short rapid flicking licks. She may
not like her clitoris to be stimulated directly at
first, so proceed tentatively until she is fully
aroused.
Once she can trust YOU and feel
confident that you like what you are doing, she
will be able fully to let go in orgasm. Being 'on the
spot', a man can get a special thrill from
experiencing so directly the blissful effect he has
on his partner, as well as from her vulnerability
and trust.
Oral sex for men is called fellatio. The
experience of having their penis sucked, licked
and kissed is one that most men find intensely
exciting. In some cases, there may be
psychological barriers to overcome. Some men
fear being bitten during oral sex. The woman
should open her mouth as wide as possible, and
close her lips, but not her teeth, over the penis.
Using all the muscles in the lips and tongue will
mean that the teeth should not come into contact
with the penis at all.
Some women are worried that they may
be choked during fellatio. The way to allay this
fear is to remain in control: you are the one who
should move while your partner lies still, so there
is no possibility of his thrusting deep into your
throat and making you gag. Some women find
the idea of swallowing semen repugnant. Of
course there is no need for you to do this if you
do not wish to, but many women do enjoy having
their partner ejaculate into their mouth.
Work your way down your partner's body,
beginning with kissing his face and mouth and
progressing to his genitals. Be very gentle, as
they are highly sensitive to pain. There are many
ways of stimulating the penis with your lips and
tongue. You can lick all along the shaft with a
delicate tongue, then use more pressure and
press your open lips as well as your tongue
against it as you rub them up and down towards
the head. You can lick and kiss the frenulum - the
sensitive place where the glans joins the shaft on
the underside, which will be facing towards you if
the man is lying on his back with an erection. You
can take the head of the penis in your mouth and
suck it, tickling it at the same time with your
tongue, and you can move your lips as far down
the shaft as is comfortable. Then move up and
down, sucking and pressing with your lips and
tongue.
The '69' position is so called because the
figures resemble a couple giving each other oral
sex. While many couples find this a good way of
arousing each other, others find it difficult to
concentrate on giving and receiving such intense
pleasure at the same time. If you are about to
come in this position, it is best to break off from
pleasuring your partner to avoid inadvertently
biting him or her. Use your fingers to indicate to
your partner what is happening and let yourself
go in orgasm.

Sex Tutorial
Masturbation
Masturbation is a natural and healthy
method of sexual release engaged in by most people
of both sexes. It is also a good way of learning one's
own sexual response. Women who can bring
themselves to orgasm by masturbating are more likely
to have orgasms with their partners, and men who
can masturbate for 15-20 minutes without ejaculating
are less likely to suffer from problems of premature
ejaculation during intercourse. Stimulating your
partner's genitals is also called masturbation, and is
an important part of lovemaking.
The external
female genitals
are called the vulva. Pubic hair
grows on the labia major, and
inside these outer vaginal lips
are the labia minor, which are
pinker and moister. If the sight of
your own genitals is not familiar
to you, examine them in a hand
mirror while you relax after a bath or shower. The
clitoris is situated where the labia minor join at the top.
It is a pink knob about the size of a dried pea, and is
highly sensitive. The clitoris is protected by a hood,
which retracts during sexual arousal. Below the clitoris
is the tiny opening of the urethra, through which urine
passes, and below that is the opening to the vagina.

When you start to
masturbate, make sure you have plenty
of time during which you won't be interrupted. Go
somewhere where it is quiet, completely private, and
warm. Some women like to lie on their back, some on
their front; some like their legs pressed tightly
together, others like them spread wide apart, or
propped up above the body. Use a lubricant and
stroke yourself gently, with your fingers or an object
such as a vibrator, varying your movements from time
to time to find out where and how you like to be
stimulated.
Many
women
find the clitoris
too sensitive for
direct
stimulation, so
you could begin
by rubbing the
whole vulva,
then gradually
move inside
with delicate
fingers. Allow
yourself to fantasize to increase arousal. Be patient,
but if the pleasure wears off without you having had
an orgasm then you should stop. Don't be
disappointed with yourself, as it may take several
sessions before you can relax enough to really let go.
When you feel a gathering tension in
the vaginal area and a build-up of warmth, orgasm is
on the way. Continue to stimulate yourself, as if you
stop, these sensations will fade and it may be difficult
to get them back again. The clitoris becomes
increasingly sensitive as you proceed, whether you
are stimulating it directly or not, and then orgasm
breaks out with waves of vaginal contractions. Most
women like some form of genital contact during
orgasm: either continued stimulation or pressing or
holding the vaginal area. Some like to insert a finger
into the vagina as they come.
Most men are

expert at giving
themselves pleasure, but
there's no harm in extra
practice. A good way of
finding out exactly how your
genitals respond to
stimulation is by soaping and
gentle massage in the bath,
allowing yourself to fantasize
as you do so. Some men
enjoy fondling their testicles,
and some enjoy penetrating the anus with a finger.
There are many different strokes you can use on the
penis. If you are uncircumcised, you can draw the
foreskin over the head of the penis and then pull it
back down the shaft to get an erection; if you are
circumcised, repeated squeezing round the shaft and
letting go is usually effective. Then you can let your
hand glide up and down the shaft in long slow
movements, gradually building up speed and
pressure. You may enjoy rubbing or tickling the glans
of the penis, though for some men this is too
sensitive. You may like gentle or firm pulling, stroking,
squeezing and stretching. Try holding off ejaculation
by varying the stroke when you become too excited,
before finally letting go in orgasm.
Masturbation need not be something
that you do only when you are alone. Many people
find the sight of their partner masturbating highly
erotic. It can also be very instructive to discover how
your partner reaches orgasm alone, as this will be the
best method for you to adopt when you are
masturbating him or her. Masturbating with your
partner will break down inhibitions and allow you to
get even closer.

Masturbating your partner
in the way he or she enjoys is an important part of
lovemaking, and many women like being masturbated
to orgasm before penetration. Both men and women
need to learn how to handle each other's genitals with
tenderness and sensitivity.

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Side by side
This position, with the lovers lying side by side
and facing one another, is easy to slip into after
mutual masturbation, and can be a prelude to
rolling over with either partner on top. Here, the
woman has her leg wrapped round her partner's
body to facilitate deeper penetration: she pulls
him towards her with her leg as he thrusts. The
partners can kiss and touch each other's genitals
while making love in this position.

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Split level
This is one of a number of 'split-level' positions
that gives the partners a different view of each
other and a different angle of penetration. Here,
the woman lies on her back, her legs round her
partner's waist, while he kneels. He is in total
control, and can also stimulate her clitoris with his
fingers. From this position he can let her legs
drop and lie on top of her in the missionary
position, or he can raise her legs, resting them
around his shoulders, then bend forward to kiss
her mouth at the same time gaining depth of
penetration.

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Spoons
The 'spoons' position is so named because of the
close fit of the two bodies. The partners lie on
their sides and the man enters from behind. This
position is cozy and relaxing, good for slow
drowsy lovemaking prior to failing asleep, or on
waking during the night. It is also a comfortable
position to adopt later in pregnancy when most
others put too much pressure on the woman's
belly.

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Spread-eagle
In this rear entry position, the woman lies face
down with the man on top of her. She spreads
her legs and he supports his weight on his arms.
If she raises her bottom off the bed slightly,
perhaps with the aid of a pillow under her hips,
then it will be possible to achieve deeper
penetration. The man can also lie with his full
weight on his partner, from which position it is
easy to roll into 'spoons'.

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Standing
Both parties stand, using the wall as support.
This position is often used when the desire to
make love strikes unexpectedly. Part of the
excitement lies in the fact that it is not easy to
move in this position.

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Standing carry
The man stands, holding his partner in his arms.
She wraps he legs round his waist and her arms
round his shoulders. She can move against him
by pulling herself up and down, and he can help
her with his arms. This position can be assumed
from sitting. It can, of course, be adopted in a
very confined space, but it is quite strenuous.
From this position you can return to sitting, or the
man can gently lower his partner on to a bed or
preferably a table, where thrusting can continue
without so much exertion.

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Swimming
The man lies on his back, spreading his legs, and his partner
lies on top of him, her legs along his, her feet on his. There
is a good opportunity for kissing and total body contact. She
controls the pace of lovemaking by dragging herself up and
down against him. Many women find this position very
exciting and are more likely to reach orgasm without direct
clitoral stimulation this way than any other.
She can vary the position by closing her legs tight while his
remain spread, or by getting him to close his, or both. She
can also move easily from this position to sit up facing him.

Sex Tutorial
Urgent
This position is ideal for when you are
unexpectedly overtaken by the urge to make
love. It does not require more than a loosening of
the clothes if you want. The woman leans over
the nearest available piece of furniture and the
man enters from behind. It is good for fast
exciting sex and gives both partners the
opportunity to thrust against one another.
 

Glossary of HIV/AIDS Terms
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
___ This glossary is provided for a better understanding of
HIV/AIDS terminology in current usage. Medical and scientific
terminology are based on the Surgeon General's Report of
AIDS, publications of the Centers for Disease Control and
Prevention, the former Global AIDS Programme of the World
Health Organization (now part of U.N.AIDS), AIDS Treatment
Data Network, and Harvard's Global Policy on AIDS Coalition.
The research literature was also consulted through the internet.
This glossary is up to date; some terms in this field have
changed (e.g. ARC; GRID) and are no longer used. For
purposes of discussion in this report, the term AIDS is
commonly used to include HIV infection and disease and
AIDS-related opportunistic infections and related-diseases.
HIV/AIDS is also used.
A
Abstinence-only: A strict morality-based philosophy that
preaches "no" to any sexual activity before marriage. Not having
sexual intercourse is the safest way to avoid the sexual
transmission of HIV/AIDS, although a majority of young adults
and teens do not believe abstinence-only is a realistic option.
However, the reality of HIV/AIDS is simple: avoid the exchange
of bodily fluids and blood especially.

Abstinence-based: A slightly more open curriculum that
stresses abstinence as the safest way to avoid HIV but allows
for some discussion of sex and the ethics of sexual activity.
Acquired Immunodeficiency Syndrome (AIDS): A
progressive weakening of the immune system accompanied by
one or more indicator diseases (opportunistic infections) --
including Kaposi's sarcoma, invasive cervical cancer,
pneumocystis carinii pneumonia, and wasting syndrome. In
AIDS, common immune system deterioration is marked by a
depletion of T-helper (T 4/CD4) cells, which help stimulate
antibody production. AIDS is commonly thought to be caused by
a retrovirus, HIV.
AIDS: is now a commonly-used term for Acquired
Immunodeficiency Syndrome and also for HIV/AIDS; WHO uses
the term to "denote the entire health problem associate with HIV
infection."
American Foundation for AIDS Research (AmFAR): was
co-founded in 1985 by Dr. Mathilde Krim and by Dr. Michael
Gottlieb. It remains an influential advocate for HIV/AIDS
research and programs.
Anal sex: Sexual intercourse when the penis is inserted in the
anus. Often used as a birth control measure by young adults.
Antibiotic: A substance that kills or inhibits the growth of
organisms. Once considered a magic bullet, antibiotics are now
commonly used to combat disease and infection. Indications are
growing that many human viruses and bacteria are becoming
resistant to current antibiotics.
Antibody: Members of a class of proteins known as
immunoglobins. Antibodies may tag, destroy and neutralize
bacteria, viruses or other harmful toxins. Antibodies attack
infected cells, making them vulnerable to attack by other
elements of the immune system.
Antigen: A foreign protein that causes an immune response
(the production of antibodies to fight antigens). Common
examples of antigens are the bacteria and viruses that cause
human disease. The antibody is formed in response to a
particular antigen unique to that antigen, reacting with no other.
Antiretroviral: A substance that stops or suppresses the activity

of a retrovirus such as HIV. AZT was the first widely used
antiretroviral drug and now more combinations are reaching the
market. Antiretrovirals are not a cure but do help manage AIDS
as a chronic disease and perhaps helps strengthen a PWA's
health.
Asymptomatic: When there is no visible or noticeable changes
in the body; i.e., an HIV-positive person does not show any
signs of "AIDS symptoms." Thus, asymptomatic carriers are a
threat to their unsuspecting sexual partners.
At risk: Individual behavior that identifies a person who is
engaging in behaviors that are likely to transmit HIV, the AIDS
virus. "Groups" per se are not at risk -- rather the
commonly-practiced behaviors of their individual members make
them more susceptible to be infected.
Autoimmune disease: A disease which arises from and is
directed against an individual's own tissue (a problem with
transplants).
AZT: AZT, Retrovir and Zidovudine are the common names for
the chemical 3'-azidothymidine. It was the first drug on the
market for AIDS. It was thought that AZT might be the cure for
AIDS-related diseases but the hopes were dashed at the 1993
International AIDS Conference in Berlin. AZT is neither as good
as its manufacturer claims, nor is it as bad as AIDS activists
have alleged. In combination with other drugs (see "cocktail"), it
can be helpful in slowing the progress of HIV/AIDS. It definitely
helps to cut down on the transmission of perinatal AIDS.
B
B cells (B lymphocytes): One of the immune system's cell
types; B cells fight infection primarily by making antibodies.
During the time of infection, these cells are transformed into
factories that make thousands of antibodies against the foreign
antigen.
Behavior intervention/modification programs: Education
programs designed to change a specific behavior. Behavior
modification generally does this by targeting a very specific,
observable behavior and then reinforce a series of small

changes in behavior until the desired behavior is established.
Bisexual: Having sex with both men and women. Many teens
experiment with members of the same sex out of curiosity.
C
CD4 (T4): The protein imbedded on the surface of T-helper cells
to which HIV attaches itself and through which it first enters the
cells.
CD8 (T8): A protein embedded in the cell surface of
T-suppresser cells.
Centers for Disease Control and Prevention (CDC): Best
known as the CDC, this preeminent federal public health agency
is a branch of the Public Health Service that is directly involved
with the HIV/AIDS epidemic. It is based in Atlanta, Georgia.
Celibate: Choosing to abstain from any sexual activity. It is
often presented as holy scripture for many religious orders, and
less often for unmarried people; a prevention techniques for
HIV/AIDS.
Chronic: Continuous or ongoing -- As PWAs live longer,
HIV/AIDS is becoming a chronic disease.
Clades: "Families of a viral strain." Presently there are seven
known clades of HIV but more are expected to be found.
Clinical trial: A test to see how well a new drug works on
people (under tight government and clinical supervision.)
Combination therapy: The use of two or more drugs as
treatment. Also, the use of two or more types of treatment in
combination, alternatively or together.
Commercial sex workers (CSWs): Common
medical/epidemiological term for people (usually females, but
also males) who engage in prostitution (sex for money) as
employment.
Comprehensive sex ed health: Offers full and complete

information on the sexual transmission of HIV/AIDS; nothing is
deleted.
Condom: A prophylactic barrier a man wears on his penis for
sexual intercourse. While not 100 percent effective, its use is
recommended by most AIDS prevention professionals as an aid
to prevent HIV transmission.
Cytokines: Proteins produced by white blood cells that act as
chemical messengers between cells to mediate immune
response. CD8 (T-suppresser) cells release a cytokine that
appears to block HIV replication in infected cells, at least until
the advanced stage of HIV disease.
Cytotoxic: Term used to describe something which damages or
kills cells. Also used as the name of a type of T cell.
D
DNA (Deoxyribonucleic acid): A double strand of nucleotides
(chemical building blocks) that contain genetic information.
E
Elisa (also ELISA): One of the first blood assay tests developed
(by Abbott Labs in 1984) to test for HIV antibodies in the blood.
Epidemic: A contagious disease that spreads rapidly among
many individuals in an area such as a province or country (see
pandemic).
Experimental drug: A drug that has not been approved for use
as a treatment but is being tested.
F
Female condom: A new prophylactic (latex and plastic) barrier
that women put inside the vagina before sexual intercourse.

G
Gamma globulin (IgG): The portion of the plasma that contains
antibodies.
Gay: Term commonly used to describe men who have sex with
men exclusively (see homosexual, also lesbian).
Gp120: A piece of HIV that can cause damage to the immune
system and other parts of the body. Gp120 is the foundation for
several new vaccines.
H
Helper-suppresser ratio: The ratio of T-helper cells to
T-suppresser cells. In people with HIV this ratio becomes
increasingly inverted over time as T-helper cells become less.
Helper cells (T4, CD4): See T-helper cells.
Hemophilia: An inherited disease that prevents the normal
clotting of blood. Many of the first wave of HIV/AIDS infected
people were hemophiliacs who received contaminated blood
supplies.
Hepatitis B (HBV): A viral liver disease that can be acute,
chronic, and even life-threatening, particularly in people with
poor immune resistance.
Heterosexual: Men who have sex with women; women who
have sex with men (also referred to as "straight").
High risk behavior: Behaviors that are the most likely to lead to
infection: unprotected sex (anal, vaginal, sometimes oral); using
contaminated needles/sharing syringes; coming in ultimate
contact with bodily fluids (blood, semen, vaginal fluids, and
perhaps, although not usually, saliva).
HIV disease: A term used to describe a variety of symptoms
and signs found in people who are HIV positive. These may
include recurrent fevers, unexplained weight loss, swollen lymph

nodes, or fungus infection of the mouth and throat. Also
described as symptomatic HIV infection (previously known as
ARC). Most commonly used to describe AIDS.
HIV-negative: When test results show there are no HIV
antibodies in the blood (i.e., no HIV infection).
HIV-positive: When test results show there are HIV antibodies
in the blood (i.e., HIV infected); the stage before AIDS-related
diseases. Also referred to as being sero-positive.
Homosexual: Men who have sex with men (gay); women who
have sex with women (lesbian).
Human Immunodeficiency Virus (HIV): The retrovirus thought
to cause AIDS. Many different strains of HIV have been isolated.
Name and acronym selected by respected group of international
scientists in 1986 to describe HTLV-III; LAV; and ARV.
I
Immunity: A natural or acquired resistance to a specific
disease. Immunity may be partial or complete, long lasting or
temporary.
Incidence: The extent or frequency with which new HIV
infections and AIDS cases occur, in a defined population, within
a specified period of time.
Incubation period: Term used similar to "latency period;" when
an organism is in the body but not symptomatic.
Inhibitor: A drug, chemical or substance that inhibits or blocks
something from happening. Protease Inhibitors are a new drug
that is expected to help inhibit the progression of HIV.
Injecting Drug Users (IDUs): Current term now favored as
substitute for "intravenous" drug users (IV drug); includes
individuals who inject into the muscle or just below the skin, as
well as injecting into the veins and arteries.
Intercourse: Sexual activity that includes penetration by the
penis of the vagina and anus (also "coitus" and "fuck").

Interferon: A substance that is produced when the body detects
infection with a virus. Interferon is released to coat uninfected
cells to protect them.
Interleukin: A group of cytokines that help immune system cells
communicate and modulates immune response.
Intravenous (IV): Intravenous drugs are injected directly into
the veins and arteries ("injecting" drug user is now favored in
place of "i.v.").
K
Kaposi's sarcoma (KS): Blood vessels which grow rapidly and
cause pink to purple painless spots on the skin. KS can also
grow in other places such as the lungs. It can be accompanied
by fever, enlarged lymph nodes and stomach problems.
Knowledge, Attitude, Belief and Practice Survey (KABP):
Standard for questionnaire surveys; used extensively as a prime
HIV/AIDS educational research methodology.
L
Latency: The period when an organism in the body is inactive
and/or not producing any ill effects. HIV is never really latent,
although an infected person may not have symptoms or feel
bad.
Latex condom: Most condoms are made out of latex material
(safer than natural lambskin prophylactics), although rubber
quality varies greatly. Some are very good atinhibiting HIV
transmission (nearly 100 percent effective) while others, usually
ultra-thin or novelty brands are only 50 to 75 percent effective.
Lesbian: Term commonly used to describe women who have
sex with women.
Lymph Glands: Small immune system centers that are located
all over the body. Lymph glands protect the bloodstream from
infection by filtering out infection particles.

M
Macrophage: A large immune system cell that roams through
the blood looking for foreign matter. These cells also alert the
rest of the immune system that help is needed.
Maintenance therapy: Use of a treatment after the disease(s)
has been brought under control. For example, unless
maintenance therapy is used against PCP, the disease will
probably occur again.
Men having Sex with Men (MSM): A term used originally by
the CDC for describing gay and bisexual men.
Monogamous: Choosing to have one sexual partner for a
period of time, as in marriage or a steady relationship (promoted
as a sexually safer way of living in the 1990s).
Morality-Based: Term commonly used to describe
religious-based tenets. (There is disagreement with the term
"morality" as people who favor safer sex techniques believe that
their point of view is also morality-based. i.e., saving lives.)
N
Nonoxynol 9: An effective spermicide coating with condoms
that can kill many STDs and HIV.
O
Opportunistic Infection (OI): Infections that are caused by
agents that are frequently present in the body or environment,
and can cause an infection in an immune-compromised person
by an organism that does not usually cause disease in healthy
people. When an individual's immune system becomes weak,

these organisms may cause serious or even life-threatening
illnesses.
Oral sex: Refers to sex using the mouth and genitalia (also
"fellatio," "blow job," "sucking," also "cunnilingus.")
Outercourse: New "safer sex" term refers to foreplay ("petting")
and mutual masturbation between partners, as contrasted with
sexual intercourse.
P
Pandemic: Contagious disease prevalent over a wide
geographical area (the global AIDS incidence is a pandemic).
Pathogen: A substance or organism capable of causing
disease.
Pathogenesis: The origin and development of a disease.
PeerCorps®: Dr. Chittick's favored prevention technique
utilizing trained AIDS educators doing outreach with peers.
Perinatal Transmission: Refers to HIV transmission from the
mother to the baby during birth (estimated to occur in one-third
of cases, unless AZT is used).
Person with AIDS (PWA) or people living with HIV/AIDS
(PLWHA): PWA is the term commonly used to anyone living
with HIV/AIDS.
Pneumocystis carinii pneumonia (PCP): A lung infection that
causes the greatest number of deaths in people who are HIV
positive. It is both treatable and preventable.
Polymerase chain reaction (PCR): A very sensitive test for the
presence of HIV.
Prevalence: Commonly occurring infection of HIV or cases of
AIDS in a population; generally refers to all cases existing with
an infection/disease (i.e., HIV/AIDS) at a specified period of
time.
Promiscuous: Engaging in sexual intercourse with more than
one partner (this dictionary definition, including the use of

"indiscriminately," is not pejorative here, but refers to
multiple-sex partners over a relatively short period of time).
Prophylactic: A preventive medicine, device or measure; often
referring to condoms or a dental dam.
Protease/ Protease Inhibitors: A substance in the blood that
breaks down proteins. Drugs that inhibit protease may stop HIV
from breaking down the proteins it needs to grow. Protease
inhibitor trials involving PWAs are showing promise and the first
drugs are being introduced.
p24 antigen: A protein fragment of HIV. The p24 antigen test
measures this fragment. A positive result from p24 antigen
suggests that HIV is multiplying, although there is debate about
this.
R
Reality-Based: Term commonly used to describe explicit and
detailed "sex ed" curriculum with safer sex HIV/AIDS
components (often used as the opposite of abstinence-only).
Resistance: The ability of a disease to overcome a drug. For
example, after long-term use of AZT, HIV can develop strains of
virus in the body that are no longer suppressed by this particular
drug, and therefore are said to be resistant to AZT.
Retrovirus: A strand of RNA (ribonucleic acid) surrounded by a
protein shell. Retroviruses capable of infecting and causing
disease in humans are relatively rare (and were only discovered
in 1978). HIV is a retrovirus.
Reverse transcriptase: An enzyme that is crucial for HIV to
grow and multiply.
RNA (Ribonucleic acid): A strand of nucleotides (chemical
building blocks) that transmit genetic information. RNA performs
the same functioning in retroviruses that DNA does in viruses.
S

Secondary Virgins: Young people who have had sex once or
twice but then choose to be sexually abstinent, often after
learning about HIV/AIDS in sex ed classes.
Sero Dia Agglumination Tests: One of the early HIV tests to
measure HIV antibodies in the blood.
Seroconversion: After the initial introduction of HIV infection,
when HIV antibodies can be detected in the blood.
Seropositive: Refers to blood that shows traces of HIV
antibodies (i.e., HIV-infected persons, but without symptoms.
Seroprevalence: The number of a population or group
(identified by their behaviors) who are infected with HIV.
Sex Ed (Sexual Education): Education that deals with detailed
sexual education for teenagers (also referred to as
comprehensive health education).
Sexually transmitted disease (STDs): These diseases include
herpes, syphilis, gonorrhea, chlamydia, HIV/AIDS, and others.
STDs make HIV easier to spread from one person to another.
Currently, the term sexually transmitted infections (STIs) is also
being used to refer to STDs.
Sexually transmitted infections (STIs): A term now becoming
more used among medical professionals.
SIDA: French (and Spanish) acronym for Syndrome
Immuno-Déficitaire Acquis.
Spermicide: Used with some condoms (Nonoxynol 9 is a
common spermicide) and birth control creams to kill STDs, HIV
and sperm.
Surrogate markers: T4 cells are used as a surrogate marker in
people who are HIV-positive. The T4 cell count itself is not really
a direct measure of HIV, but a declining count is a sign that
disease is progressing. The T4 cell count is then said to be a
surrogate marker for HIV. Different surrogate markers are being
studied to see how well they measure the progress of HIV.
Symptom: A change in the body's appearance or functioning
(including mental and psychological changes) that indicates the
presence of a disease or illness.

Symptomatic: A change in normal bodily function; i.e.,
HIV-positive person shows symptomatic signs of AIDS.
Systemic: Affecting the whole body.
T
T4 cells: See T-helper cell.
T-helper cell (T4/CD4 cell): A type of white blood cell that
activates T-killer cells and helps stimulate antibody production.
Physicians regularly measure T-helper cell counts (CD4 counts)
in HIV-positive people to monitor immune system function. The
normal range for T-helper cells is 480-1800, but may vary in
individuals. HIV first enters cells by attaching itself to the CD4
receptor on the surface of T-helper cells.
T-killer cell (cytoxic T cells): A type of white blood cell that kills
foreign organisms when activated by T-helper cells.
T-suppresser cell: A type of white blood cell that helps control
the body's response to an infection.
Thymus: The organ of the body that trains T cells to be part of
the immune system.
Toxic reaction: A poisonous or unwanted reaction to a vitamin,
drug or other substance. A toxic reaction occurs when a helpful
medicine also causes damage to the blood or body. Toxicity is a
measurement of how much damage may be caused.
Transfusion: The process of giving blood, or parts of blood
from one person to another. Some people choose to have their
own blood drawn and stored, to be transfused back into them at
a later time.
Transmission: The passing of HIV through blood, semen,
vaginal secretions or breast milk from an infected individual to
another person. These four are the only body fluids known to
transmit HIV (although a small amount of HIV might be in saliva,
it is not thought to transmit HIV).

Tuberculosis (TB): An infection caused by "Mycobacterium"
tuberculosis. It is reported to be rising in urban areas and TB is
increasingly common among PWAs.
U
United Nations AIDS (U.N.AIDS): Created in 1995 to
coordinate all of the different UN providers of AIDS services,
U.N.AIDS began operations in 1996 under its first director, Peter
Piot.
Universal Precautions: Refers to safety measures (i.e.,
sterilization, latex gloves) used by personnel in hospitals and
clinics to ensure that infectious agents are not passed by
unclean or contaminated equipment or accidents.
V
Vaccine: A suspension of an infectious agent (e.g., virus) or
part of that agent. The suspension is administered (usually by
injection) in order to confer resistance or immunity to that
infectious agent. Other kinds of vaccines, therapeutic vaccines,
are in development and being studied. Therapeutic vaccines
may help fight HIV even after infection.
Viral Load: The amount of HIV in the blood; branch DNA is a
new testing measure that determines the progression of AIDS
(compared to the CD-4 count that measures the number of T
-helper cells in the blood).
Viremia: The presence of a virus in the blood stream.
Virucides: A physical or chemical agent that destroys or
inactivates viruses (researchers are looking for one especially
for women to avoid STDs/HIV.)
Virus: A strand of DNA surrounded by a protein shell. Viruses
are the smallest known infectious organisms and are unable to
live or multiply outside of a host cell. Viruses can cause
infectious disease (e.g., small pox, polio, influenza, herpes).

Infection with some viruses, such as CMV, may not produce
symptoms in people with an intact immune system, but may
prove dangerous or life-threatening for people with HIV/AIDS.
W
Wasting syndrome: A condition characterized by involuntary
weight loss of more than 10% of baseline body weight plus
either chronic diarrhea or chronic weakness and fever for more
than 30 days, when these conditions cannot be explained by
any illness other than HIV infection.
Wave: A metaphor used by researchers to explain the different
stages of HIV infection and cases of AIDS in the population.
Western blot: One of the major confirmatory tests for HIV
antibodies in the blood (see Elisa).
White blood cells (WBCs): White cells protect the body against
foreign substances such as disease-producing micro-organisms.
They are the heart of the immune system.
Window period: Refers to the time between infection with HIV
and when its antibodies can be detected in the blood (as short
as six weeks but usually longer, up to six months for test
purposes).
Z
Zidovudine (ZDV): A drug shown to be effective in reducing the
number of babies born with perinatal HIV.


Sex Tutorial
ANAL SEX
The Art of Anal Intercourse dates back to ancient
times suggests that the practice of anal sex
stimulation of the anorectal area, including penile
penetration has been around for many centuries.
In fact, some might find it surprising how common
a practice it is among heterosexual couples
today. In one survey of 100,000 female readers
of Redbook magazine, 43 percent of the women
said they'd tried it with their partners at least
once. Of that number, 40 percent said they found
it somewhat or very enjoyable. (That is, about a
quarter of the total number of women surveyed
said this.) Forty-nine percent said they didn't care
for it, and 10 percent said they had no strong
feelings one way or the other. While not a
controlled scientific study, this survey roughly
parallels the findings of many other sexual
surveys.
Something else that may come as a surprise to
many: While a fair number of heterosexuals
engage in the practice, not all homosexuals do.
In a review of the existing data on the subject, the
Kinsey Institute concluded that between 59 and
95 percent of male homosexuals had engaged in
anal sex at least once.
In the age of AIDS, anal sex has received a lot of
bad press and for good reason. Unprotected anal
intercourse is the single most risky behavior in
terms of exposure to the dreaded disease. It
bears mentioning, however, that if neither you nor
your partner is already infected with HIV (human
immunodeficiency virus), you cannot get AIDS
from anal sex. This may seem self-evident, but in
a nationwide sex survey conducted by the Kinsey
Institute, half of the American adults questioned
said they thought you could get AIDS through
anal intercourse, whether or not one partner was
infected. This is simply not true.
What is true is that having anal intercourse with
an infected partner, without using a condom, is
the kind of sex behavior most likely to transmit
AIDS. That's probably because the sensitive
lining of the rectum is likely to tear during
intercourse, allowing AIDS-infected blood or
semen to pass directly into a sex partner's
bloodstream. In fact, the evidence for this mode
of AIDS transmission is so clear-and AIDS itself
is so scary-that doctors now recommend against
having anal sex with anybody, under any
circumstances.
If you insist on trying it anyway, take two
precautions: The vagina is naturally elastic and
moistened by its own natural lubricants, but the
rectum is not. Therefore, before attempting anal
penetration, it's important to use a waterbased
lubricant like K-Y Jelly. Also, before entering the
vagina after anal intercourse, be sure to
thoroughly wash the penis. Otherwise, it's likely
to transfer bacteria from the rectum, which may
cause vaginal infections.

Sex Tutorial
How to use a condom
Condoms come ready-rolled and most end
in a teat, which catches the semen.
1- Expel the air from the teat at the tip of the
condom by squeezing it.
2 - Place the opening of the condom on
the head of the penis.
3 - Roll it down the shaft to fit
comfortably.
4- When fully unrolled, the condom
should extend almost to the base of the penis and fit
like a second skin, feeling silky and smooth.
After ejaculation, the condom should
be removed carefully to prevent spillage. First, the
man withdraws his penis from the woman's vagina,
holding the condom securely to his penis so as not to
leave it behind. Then he removes it and disposes of it.
Of course, care must always be taken that any semen
left on the penis does not get transferred - on the
fingers, for example - to the woman's vagina.
Putting on a condom can
be fun. Some women enjoy doing this for their
partners. You can use your lips and tongue to help
your fingers unroll the condom down the shaft of the
penis - but be careful not to snag the delicate material
with your nails or jewelry.


Sex Tutorial
Contraception
The ovulation testing
pack
is a completely new method of natural family
planning that allows you to enjoy making love
without using any contraceptives on most days of
your cycle. The pack includes a personal monitor
that checks your urine samples and analyses
them to indicate the days of the month on which
you are likely to get pregnant. You should use
contraceptives if you wish to make love on those
days. The pack is 93-95 per cent reliable and
very easy to use.
Natural family planning,
by contrast, requires meticulous record keeping
and iron self-discipline. It involves charting your
temperature day by day throughout the menstrual
cycle to discover the period of ovulation, during
which you must abstain from sex. Any
unpredictable irregularity in the cycle can carry
the risk of pregnancy.
The Pill is up to 99 per
cent reliable. It allows for
completely spontaneous lovemaking. The
freedom it gives is of enormous psychological
benefit in any relationship. The Pill also regulates
the menstrual cycle and reduces period pain and
heavy bleeding in many women. Mild side effects
occur in some women who take the Pill, but they
usually disappear after a few months. They may
include nausea, headaches, and depression,
weight gain and some bleeding between periods.
If side effects persist, the doctor or clinic will
usually recommend a change of contraception.
Before your doctor prescribes the Pill, he or she
will ask for your medical history, including
incidence of thrombosis in your family. The health
risks involved in taking the Pill are slight when
compared to the risks of pregnancy and
childbirth.
The combined Pill contains
synthetic forms of the sex hormones estrogen
and progesterone, which interfere with the
woman's regular 28day menstrual cycle. In a
woman who is not taking the Pill, production of
the sex hormones fluctuates during the cycle,
and it is this fluctuation that triggers ovulation.
When the Pill keeps the hormone level artificially
constant, the signal to ovulate is cancelled out.
The same happens during pregnancy, which is
why overlapping pregnancies do not occur.
Anyone who smokes heavily may be at risk of
thrombosis, smokers and those who are over 35
are often advised not to take the combined Pill.
The progestogen - only
Pill is not, as sometimes assumed, a low
dose Pill, but one containing a single hormone,
progestogen. It has the effect of thickening the
secretions in the cervix, which makes it difficult
for sperm to pass. It can be taken by breast
feeding mothers, unlike the combined Pill, which
suppresses lactation.
The condom is 85-98 per cent
effective as a method of contraception. Condoms
work by preventing the sperm from getting to its
destination, and they do not interfere with the
body's chemistry. The condom is also the key to
safe sex as it protects against all sexually
transmitted diseases. For more details about
condoms and how to use them, see page 128.
Caps and diaphragms act
as a contraceptive by forming a barrier across the
neck of the womb (cervix), which prevents the
sperm from reaching and fertilizing the egg. A
good fit is crucial. You need to be examined by
your doctor or family planning clinic so that the
right-sized cap or diaphragm can be chosen, and
you can be shown how to insert it. A cap or
diaphragm should always be used with a
spermicide. This combination has been found to
be a 95 per cent safe contraceptive. Smear a

little spermicide on to the diaphragm and around
the rim, to facilitate insertion. Squeeze the
diaphragm into a boat shape and insert it as you
would a sanitary tampon, opening the lips of the
vagina with one hand. When the rim rests behind
the pubic bone at the front and the dome covers
the cervix at the back, it is in place. Doctors
recommend that you should not leave the
diaphragm or cap in place for longer than 24
hours, but you should wait for at least six hours
after intercourse before removing it. Remember
that spermicide will be effective only for about
three hours, so you will need to put more into the
vagina if you have intercourse after the
diaphragm or cap has been in place for that
length of time. When you remove the diaphragm
or cap, wash it carefully in warm soapy water and
allow it to dry in a warm place, or pat gently with
a towel.
The female condom is as
effective as other barrier methods. It lines the
vagina and has an inner ring that sits over the
cervix and an outer ring that lies flat against the
labia. The female condom is made of colorless
odorless polyurethane. The woman pushes the
condom up inside her vagina before intercourse,
and afterwards removes it and disposes of it. Like
the male condom, the female condom is not
reusable. It comes ready lubricated for easy
insertion and no spermicide is necessary. Female
condoms are made in one size only and will fit all
women. During intercourse, it is a good idea for
the woman to guide the man's penis into the
condom to make sure it does not enter the vagina
outside the condom. As the female condom is
loose fitting, it will move during sex, but you will
still be protected, because the penis stays inside
the condom. To remove the condom after sex,
simply twist the outer ring to keep the semen
inside, and pull the condom out gently.
The I U D (intra-uterine device) or coil is a
small plastic and copper device that is inserted
into the womb to prevent conception. Only a
doctor trained in family planning can do this. The
IUD comes compressed in a thin tube, which is
slid through the cervical canal into the uterus and
then withdrawn, leaving the IUD to spring into
shape. Thin threads hang from the IUD about
3cm/ 1 inch into the vagina, and these can be felt
with the fingers to make sure that the device is
still in place. To remove an IUD, the doctor pulls
the strings with a specially designed instrument.

Depending on type, IUDs are usually replaced
about every five years. The IUD is reckoned to be
96-99 per cent effective as a contraceptive,
although it is not clear exactly how it works. Many
women like it because it allows both partners to
be spontaneous in their lovemaking. However, it
does not suit everyone. Some women experience
discomfort and bleeding for a few hours or days
after the IUD is inserted, and one in four women
have to have it removed because of acute pain
and heavy bleeding. Sometimes an IUD may fall
out; this is more likely to happen during a period
than at any other time, and this is why it is
important to check regularly that the thin strings
are still inside the vagina.
Contraceptive injections may be
given with a drug that contains hormones of the
progestogen type. An injection is needed every
8-12 weeks and is a virtually 100 per cent reliable
contraceptive. However, it often has a disruptive
effect on a woman's menstrual cycle, making
periods more frequent or even disappear
altogether. Return of regular periods may be
delayed for up to a year after the last injection.
Contraceptive implants release a
hormone into the bloodstream. The implants are
small, stick-like and pliable, and are inserted
under the skin of the inner upper arm by your
doctor or clinic in a simple, almost pain free
procedure. They cannot be seen. The effects will
last for up to five years, and although the
implants can be removed at any time, the body
will not be free of the hormone for a short time
afterwards. Implants are more than 99 per cent
reliable, although they may make periods less
regular or disappear altogether. These side
effects may settle down after several months.
Emergency contraception is also
called the 'morning-after Pill'. This last-resort
method can be used if intercourse has taken
place without contraception or if the usual
method has failed, say in the event of a burst
condom. It may also be prescribed to a woman
after a sexual assault. It can be given up to 72
hours after intercourse and is 96-99 per cent
effective.I
The danger of AIDS, young people often
had sex with a new partner without a condom,
particularly if they had been drinking. It is
important to remember that AIDS is much more

dangerous to your health than pregnancy, and
unlike pregnancy, there is no way that the
disease can be terminated.
The message is clear: anyone who
engages in casual sex or is having sex with a
new partner should use a condom even if
contraceptive protection is provided by the Pill.
Women as well as men are recommended to
carry condoms with them.
Clean bodies are generally more
appealing than dirty ones, though the smell of a
lover's sweat can have aphrodisiac qualities.
Bathing is not always practicable or desirable, but
you should always wash the genitals and anus
before sex, to protect against infection, to
increase the enjoyment of your partner and to
give self confidence. Soap and water are all that
is needed. Deodorants and perfumes kill the
body's delightful natural scents, and they also
taste unpleasant. Vaginal deodorants can be
positively harmful, destroying the
micro-organisms in the vagina that protect
against disease. Always wash anything that is
inserted in the anus, as anal sex carries the
highest risk of infection.

Sex Tutorial
Female orgasm
Since the 1960’s, when Kinsey
began to bring sex out of the closet, there has
been such a great deal of open discussion
centred around the female orgasm that many
women feel under intense pressure to 'perform'. If
you feel your partner is comparing you to
previous lovers, or to an orgasmic ideal in his
head, it detracts from the intimate pleasure of sex
and turns it into a competition.
Many women are
bothered by the idea that there may be
two types of orgasm - vaginal and clitoral. They
wonder whether the orgasms they are
experiencing are 'the real thing'. But are there
really two types of orgasm? It was Freud who first
suggested that there were. He said that the
orgasm experienced through clitoral stimulation
was the precursor of a deeper, more satisfying
orgasm experienced in the vagina during
penetration by the penis. According to him, the
vaginal orgasm was a 'true, mature' sexual
response, while the clitoral orgasm was its
immature inferior. The value judgements Freud
and his followers placed on the two types of
orgasm have caused a lot of unhappiness among
some women who never experience orgasm
during penetration. They feel that they are
missing out, and are therefore inadequate: less
than 'real women'.
Researchers into sexual
response have been much concerned
with the categorization of the female orgasm
since Freud's time. Kinsey's view was that there
was only one type of orgasm, that it was
triggered by clitoral stimulation and involved
contractions of all parts of the female body,

including the vagina. He could not distinguish a
second type of orgasm that centered solely on
the vagina, and he utterly refuted Freud's
distinction between 'mature' and 'immature'
orgasms.
Subsequent clinical
evidence has proved conclusively that
Kinsey was right, and now sexologists are
generally agreed that an orgasm is an orgasm.
Researcher Helen Kaplan has come to this
conclusion: 'Regardless of how friction is applied
to the clitoris, i.e. by the tongue, by the woman's
finger or her partner's, by a vibrator, or by coitus,
female orgasm is probably always evoked by
clitoral stimulation. However, it is always
expressed by circurnvaginal muscle discharge.'
Although all orgasms
are equal, women do report different
sensations according to whether they are being
penetrated or masturbated. And the surprise is
that masturbatory orgasms, which are
experienced by all women who can teach
themselves to come through masturbation, alone
or with a partner, are the more pleasurably acute.
All women who orgasm in this way know the
acute tension of the clitoris. The voluptuous
rushing sensation that breaks into multiple
contractions of the surrounding tissue. A small
minority of women (around 20 per cent,
according to sex researcher Shere Hite), who
also orgasm with a penis inside the vagina,
describe that as a quite different experience.
Although Freud claimed that orgasms during
intercourse were superior, the majority of women
in a survey carried out by Shere Hite said they
were less intense. Whereas masturbatory
orgasm is experienced as a high, sweet, rippling
sensation, the peak of sensitivity, orgasm with
penetration is like the boom of a distant
explosion, powerful, but somewhat muffled.
Orgasms triggered by the
partner's fingers or tongue, and by masturbation,
are probably more intense because stimulation is
more localized and more sensitively guided.
Masters and Johnson reported stronger
contraction spasms and higher rates of heartbeat
during orgasm without intercourse, and especially

during masturbation, and many women confirmed
that they had their best orgasms when alone.
Orgasm during penetration is undoubtedly quite
rare for many women because a thrusting penis
can stimulate the clitoris only 'in passing', if at all,
depending on the position of the couple. The
orgasm experienced may be more diffuse
because the penis alters the focus of attention
from the clitoris to the whole of the lower part of
the woman's body, and because the vagina is full
‘muffling' the sensation.
A simultaneous orgasm,
when both partners come together during
penetration, may feel like a surprisingly big
underground explosion, but it probably offers the
least in terms of sensual awareness. The reason
for this is that if both parties are focused on their
own experience or 'black-out' and become
oblivious of each other, the sensation of the
partner's orgasm is largely lost. For a woman,
simultaneous orgasm is often followed by a
feeling of disorientation, and a disappointment
that lovemaking has come to an end.
Orgasm during
intercourse is often less acute.
However, many of the women who are able to
experience it prefer it for emotional reasons,
because it involves complete body-to-body
contact, holding the partner and giving oneself to
him at the same time. Feeling whole and loved
and emotionally satisfied are important aspects of
a good sexual relationship, but these feelings can
be experienced whether orgasm takes place
during intercourse or not. What is important is
that women should experience regular
masturbatory orgasms. Orgasm relieves tension,
recharges the body and revitalizes the mind. It
leaves the woman feeling sparkling and whole.
When shared with a partner, it represents the
peak of sexual fulfillment and can be a powerful
expression of love, helping to unite the couple.
Multiple and sequential
orgasms, like vaginal and clitoral
orgasms, are concepts which have caused a lot
of confusion and left many women worried that
their sexual response might be somewhat
inadequate. Because orgasms come in waves,
some women are not even sure whether their
orgasms are multiple or single. Multiple orgasms
are those that are experienced in a chain, one
directly after another; sequential orgasms are
those with a gap of a few minutes between each
one. It seems that true multiple orgasm is
extremely rare, although many women are
capable of sequential orgasm.
On the topic of multiple
orgasm, Masters and Johnson wrote: "If
a female who is capable of having regular
orgasms is properly stimulated within a short
period after her first climax, she will in most
instances be capable of having a second, third,
fourth, and even a fifth and sixth orgasm before
she is fully satiated. As contrasted with the male's
usual inability to have more than one orgasm in a
short period, many females, especially when
clitorally stimulated, can regularly have five or six
full orgasms within a matter of minutes."
Being capable of six
orgasms in a row is not the
same as needing or even wanting that many.
According to Shere Hite, about 90 per cent of
women who orgasm feel completely satisfied with
a single climax. And in many women the clitoris
remains hypersensitive, and further stimulation is
uncomfortable and can even prove painful.

Sex Tutorial
Does the G-spot really exist?
The G-spot is named after its discoverer, Ernst
Grafenberg. While many women still doubt its
existence, others claim that stimulating a place
about 5cm/2 inches inside the vagina towards the
front of the body gives them intense pleasure.
The G-spot is said to be the female equivalent of
the male prostate gland, which is situated about
5cm/2 inches up the rectum towards the front of
the body. Stimulation of both these places can
lead to orgasm in some cases. Some women
have even found that they ejaculate a fluid if they
have an orgasm by stimulation of the G-spot, and
researchers in Canada and the United States
claim that the composition of the fluid is
remarkably similar to the secretion of the prostate
gland.
How do you find the G-spot?
If you doubt the existence of the G-spot, you can
try to find it yourself. The easiest way to reach it
is with your own or your partner's finger, but there
are also positions for intercourse in which the
penis stimulates the sensitive area. Rear-entry is
best, particularly with the man on top and a pillow
beneath your hips, so that the penis presses
against the front wall of the vagina.

Sex Tutorial
Homosexuality
Human sexuality is a complex
phenomenon, and not so neatly categorized by
the labels 'heterosexual' and 'homosexual' as
society could wish. Between the strong and
exclusive attraction of man to woman, and that of
man to man, or woman to woman, lies a whole
spectrum of sexual and emotional affinities: the
ardor, or warmth, or coolness of any human
relationship depends on the individuals within it,
and not on any of the arbitrary specifications
which might be imposed by society.
Some men want sex with
other men as a permanent part of their lives;
some are curious about male bodies, and may
experiment at some time in their lives; some feel
equally attracted to men and to women; some
men enjoy looking at other men's bodies without
desiring sexual contact; some prefer the
company of other men for leisure; some work in
an all male environment. Women also feel and do
all these things with other women. These infinite
permutations and the confusion that results from
them cannot be accommodated by society, which
needs order in which to function. Order means
ignoring varying shades of grey and
distinguishing only between black and white; it
means putting labels on things. And since society
is never stronger than when it is united against a
common evil, labeling things also means defining
society's outcasts.
Various attempts have been
made this century to 'explain' homosexuality, and
even to 'cure' it. But the question is not really why
some people are homosexual, but why our
society is heterosexual. People born into a
homosexual society generally conform to the
norm, just as do people born into a heterosexual
society. Most of us have a broad enough sexual
response to allow us to be conditioned
comfortably to either mode of behavior. The
people who feel less comfortable with the status
quo, and those who feel positive discomfort with
it are in no way unnatural; rather, it is the
restrictions that society places on them that
should be considered against nature.
One man in three has had
some form of homosexual experience resulting in
orgasm, according to the Kinsey Report,
published in 1948. Kinsey was not saying that
one man in three was homosexual; but he was
tearing off the label that branded sexuality
between men as 'abnormal'. Kinsey pointed out
that humans were not alone among animals in
engaging in same-sex activity: the assumption
that animals had sex only when reproduction
could be guaranteed was a man-made one,
designed to bolster the view that homosexuality
was 'against nature'. Of course, half a century
has elapsed since the publication of the Kinsey
Report and sexual mores have changed.
However, Kinsey's findings still represent
extremely valuable research into this area of
sexual behavior and the underlying trends are
still relevant today.
Homosexual encounters between
men usually begin in foreplay and end in orgasm,
but the pattern of lovemaking is much less rigid
than the pattern of lovemaking between men and
women tends to be, and both partners almost
always reach orgasm. Many homosexual men
consider sex with other men to be liberating
because there are no rules: it does not involve
pressure to perform or pressure to satisfy the
other person, and mutual satisfaction is effortless
because men understand each other's bodies so
well.
Men report that another advantage of sex
without obligations is that they feel they can
come straight to the point; a sexual relationship
often precedes a social friendship, and not the
other way around. Many men describe their
sexual relations with male partners as generally
more honest and straightforward, both physically
and emotionally, than their relationships with
women.
Most homosexual men derive a great
deal of physical and emotional satisfaction from

being penetrated. Hygiene should always be the
first priority in any act of anal penetration, as
disease is especially. easily transmitted in this
way. Always wear a condom. A condom on a
finger inserted into the anus can aid lubrication
as well as protect against scratches - from
fingernails and rough skin -that could lead to
infection. You should always wash thoroughly
before and after anal sex, and if you use a
vibrator for penetration, make sure that this is
washed thoroughly too, in hot soapy water with a
splash of antiseptic added.
Some women rebel against the
narrowness of the status quo and become
lesbians for political reasons, feeling dissatisfied
with a male dominated society, others do so
because they find men unsatisfactory as lovers or
as partners on an emotional level, and others
because they are intensely emotionally involved
with a member of their own sex and wish to
express their feelings through their sexuality.

Sex Tutorial
Kissing
There is an infinite
variety of kisses that lovers can
exchange, from playful or tender lip kissing to
deeply arousing open-mouth kissing with tongue
play. Kissing someone you are mad about is one
of life's great pleasures - or should be.
Surprisingly large numbers of people have no
idea how to kiss, and a poor kisser can be a
terrible disappointment, just as someone who is a
skilled practitioner of the art of kissing can have
you tearing off your clothes.
The lovers' kiss or French kiss,
involving the whole mouth and tongue, is said to
have its origins the way mothers used to feed
their babies in prehistoric cultures. This practice
can be observed in peasant communities in some
parts of Europe even today. The mother chews
the food for her baby before transferring it directly
from mouth to mouth She pushes her tongue,
and the food, inside the infant's mouth, and it
reacts with searching movements of its tongue
inside her mouth. Considerations of hygiene and
today's associations of mouth-to-mouth contact
with sexual arousal make this type of feeding
unacceptable in our society, but the action lives
on in adult erotic behavior.
A deep kiss is very often the first
mutual acknowledgement that sexual attraction
exists between a couple, and it is the first
element of sexuality to disappear from a
relationship that is on the wane. According to
Relate (the British Marriage Guidance Bureau),
couples whose marriages are in trouble are more
likely to have intercourse than to kiss. That mouth
and tongue contact retains a special intimacy
while intercourse can seem businesslike and
remote is also illustrated by the fact that
prostitutes never kiss their clients.
The first thing to do when
kissing a new lover is to find out with your lips
and tongue where his or her teeth are, so you
can avoid banging into them with your own teeth.
Clashing teeth is as impersonal as clashing
spectacle frames. The next thing to remember is
that kissing should be wildly exciting: don't get
stuck in a rut endlessly repeating the same
movement, or your partner will lose concentration
and grow bored. Vary the pace, and vary the
initiative, sometimes taking it, sometimes being
receptive to your partner.
Here are a few tips for more
enjoyable kissing:
* If your new partner does
not smoke and you do, now would be a very
good time to give up the habit. Non-smokers do
not like the taste or smell of tobacco.
*Until you have got to
know someone well and they
have assured you they don't mind it, don't eat
strong tasting food, such as garlic or curry,
unless your lover is eating it too.
* Oral hygiene is important. Make
sure your mouth looks and tastes good. Get your
dentist to de-scale your teeth regularly and eat a
healthy diet so that your breath is fresh.
*Don't kiss or have oral sex if you
have a mouth or throat infection. Kissing can
transfer an estimated 250 different bacteria and
viruses carried in saliva, though as yet there is no
evidence to suggest that AIDS can be caught in
this way.
*Being kissed
passionately by a man with a
stubble chin is not anywhere near as erotic as
being kissed passionately by a man who has
recently shaved.
*If you have a beard,
consider the fact that it makes a barrier between
your skin and your lover's. There is no doubt that
more erotic contact is possible between a
clean-shaven man and his partner.
*Women who wear
make-up should be prepared to have it
licked off or, at the very least, smudged. Consider
how you feel about this before applying your
make-up, but whatever you do, don't let yourself
be inhibited by a perfectly painted face. Many
men would prefer to kiss a face bare of make-up
anyway.
* To maximize sensation
when kissing, make full use of all the muscles in
your mouth and tongue. it is much better kissing
someone whose mouth responds to yours and
who knows how to use pressure, than someone
whose mouth is flabby and slack.
*Remember that nothing, but
nothing, is worse than a slobbery kiss.

Sex Tutorial
Premature
Ejaculation
Anxiety is often the
cause of premature ejaculation. In an
extramarital relationship a man may ejaculate as
soon as he penetrates his partner's vagina,
despite the fact that he does not have this
problem with his wife. This is a sign of guilt. A
man may also ejaculate before he wishes to if he
feels frightened that his technique is not good
enough, and ejaculating quickly will prevent him
from having to reveal his lack of experience.
Believing that sex is bad
because of what you were told as a child is
another possible cause of premature ejaculation.
If as a boy, you were punished for masturbating,
you may have taught yourself to come quickly to
lessen the chance of being found out and to
minimize the guilt you felt at your own pleasure.
Fear of getting too close
to another person may also be a contributing
factor. Intimacy always brings with it the risk of
loss, and the unbearable pain attendant on that
loss. Subconsciously, a man who gets sex over
with quickly may be trying to protect himself from
close emotional involvement.
Several techniques can
help men last longer, and these should be
used in conjunction with examining the cause of
the problem. Understanding what is wrong often
brings its own release.

The stop-start technique
for delaying ejaculation
The aim of these
exercises is to learn to keep yourself
below the point at which ejaculation seems
inevitable for as long as possible. Men who do
not have a partner can practice the first three
steps. In them selves, they will help you gain a
greater measure of control. For the final four
steps you will need the co-operation of a partner.
* Step one Masturbate with a dry
hand. Avoid fantasizing, and concentrate instead
on the sensation in your penis. Allow the
pleasure to build up but stop immediately you feel
you are about to lose control. Relax for a while,
still keeping your mind free of fantasies, until the
danger of ejaculation has passed, then begin
again. Following the same pattern, aim to
continue stopping and starting for 15 minutes
without orgasm. You may not be able to manage
it at first, but keep trying. As you get more
practiced, you will probably find you have to stop
less often. When you have completed three
15-minute sessions on three consecutive
occasions (not necessarily one immediately after
the other!), proceed to step two.
* Step two involves masturbating with a
lubricating jelly to heighten sensation, and make
delay more difficult. Follow the technique in step
one until you have completed three separate
consecutive sessions as above.
* Step three You will now have gained a
good measure of control. The next step involves
masturbating with a dry hand for 15 minutes
before ejaculation. Keep focusing on your penis
rather than fantasizing. When you feel yourself
getting dangerously excited, don't stop, but
instead, change rhythm or alter your strokes in
such a way that the pressure to ejaculate fades.
Experiment to see which strokes excite you most,
and which allow you most control. Work on this
step until you have completed three consecutive
sessions as before.

* Step four Now involve your partner. Lie
on your back and get her to masturbate you with
a dry hand, as in step one. Concentrate on the
sensations in your penis and ask her to stop
every time you get too aroused before the 15
minutes is up. The aim is to last for three
consecutive 15-minute sessions.
* Step five Repeat step four, but ask your
partner to use a lubricant while she masturbates
you. You will find ejaculation much more difficult
to control, and you may have to ask her to stop
more often. Once you have mastered three
consecutive 15-minute sessions, you are ready to
try the stop-start technique with intercourse.
* Step Six The best position for delaying
ejaculation is with the woman on top. Once you
are inside her, ask her to move gently. Put your
hands on her hips so that you can let her know
with your hands when you want her to stop, and
when you are ready for her to start again. Again,
aim to last for 15 minutes, but if you can't, don't
worry; you can start again once you recover your
erection, and the second time you will probably
have more control. During intercourse,
concentrate entirely on yourself. Give your
partner your full concentration and bring her to
orgasm either before or afterwards, with oral or
manual stimulation.
* Step seven Move on to other positions.
It is more difficult to delay -ejaculation with the
man on top, so save this until last.
The squeeze technique for
delaying ejaculation
The 'squeeze' action is designed to
cause your erection to subside, and it can be
applied every time you get too close to
ejaculation. Your partner performs the squeeze
by gripping your penis firmly, and pressing with
her thumb on the frenulum. This is the place on
the underside of the penis where the head joins
the shaft. At the same time, she presses on the
opposite side of the penis with her forefinger, and
with her other fingers curled round the shaft. It
is important that she presses fairly hard on the
penis and doesn't move her hand while doing so.

Too light a touch could cause you to ejaculate
straight away.
* Step one Get your partner to masturbate you
with a dry hand. Any time you get too close to
ejaculation, signal to her to stop and squeeze
your penis. As with the stop-start technique, aim
to last for three consecutive 15minute sessions
before moving on to step two.
* Step two get your partner to masturbate you
slowly and gently as before, but this time ask her
to use a lubricant. Follow the procedure for step
one.
* Step three now you are ready for intercourse,
but not for thrusting. Instead, lie on your back and
ask your partner to sit on top of you, with your
penis inside her. Neither of you should move. As
soon as you feel the urge to come, your partner
should rise off you (this movement is dangerous
as it applies stimulation), and immediately hold
your penis in the squeeze grip. Repeat the
exercise a couple of times before you allow
yourself to ejaculate.
* Step four When you feel more confident about
your self-control, ask your partner to move gently
while she sits on top of you in the same position.
When you feel the urge to ejaculate, she should
move off you and squeeze as before, until you
can last 15 minutes without ejaculating.
* Step five you are now ready to try other
positions, but remember that with the man on top,
you will have least control. As with the stop-start
technique, during intercourse you should focus all
attention on yourself. Your partner will not feel
neglected if you bring her to orgasm orally or


Sex Tutorial
THINKING ABOUT BIRTH CONTROL
Thinking about birth control is part of
thinking about having intercourse. Some
people choose to engage only in sexual
behaviors other than intercourse -- some
because they prefer other forms of
intimacy; some because they're not ready
for intercourse; and some because they
don't want to risk pregnancy.
Choosing a method of birth control isn't
always easy. In addition to thinking about
the effectiveness, benefits, and possible
side-effects of the methods you're
considering, you need to think about what
you feel comfortable using. It's important
to ask yourself what methods realistically
fit with your personality and lifestyle.
Talking about birth control with a partner
can be hard. It may help to try to sort out
your own feelings before you bring up the
subject with your partner. Try to find a
time and a way to talk about it that feels
comfortable to you.
What Do Effectiveness Rates Mean?
A range of effectiveness is listed for each
method of birth control in this handout.
The lower rating listed is the "typical
effectiveness," which takes into account
incorrect or inconsistent use. The higher
number is the "theoretical effectiveness"
rate, which describes the method's
effectiveness when used correctly every
time a couple has intercourse.
Effectiveness statistics are difficult to
evaluate because they vary widely
depending on the design of the research
study. The method with the highest
effectiveness rating may or may not be
the "best" method for you. The best
method is the one which you are informed
about, comfortable with, and will use
consistently.
Birth Control and Sexually Transmitted
Diseases (STDs)
You may be primarily concerned with
preventing pregnancy when you choose a
method of birth control, but if you or your
partner has ever had sexual contact with
anyone else, you may be at risk for
contracting an STD. Using condoms and
spermicide provides the greatest
protection against STDs. Other methods
of birth control (noted in this handout) may
also provide some protection. Many
women and men use condoms and
spermicide along with other methods of
birth control to protect themselves and
their partners from STDs.
What If Your Method Fails?
Correct and consistent use of your birth
control method makes it less likely to fail;
however, no method is perfect. If your
method fails, or you have unprotected
intercourse, the risk of pregnancy may be
reduced by immediately inserting two
applications of spermicide into the vagina.
Also, call the Gynecology Clinic or
Dial-A-Nurse about the availability of the
morning-after pill.
METHOD Birth Control Pill
EFFECTIVENESS 97-99.9% HOW TO
OBTAIN Requires recent gynecological
exam and attendance at Birth Control
Education Class. Call Gynecology for
appointment and class schedule. STD
PROTECTION No OTHER
CONSIDERATIONS Provides continuous

protection. Must be taken at the same
time every day. Regulates menstrual
cycle, decreases cramps and flow. May
cause breakthrough bleeding, breast
tenderness, nausea, weight gain/loss
during the first few months. Some women
are not good candidates because of
medical history.
METHOD Norplant (Hormonal Implants)
EFFECTIVENESS 99.9% HOW TO
OBTAIN Not available at McKinley -- call
Gynecology for information. Newly
available in 1991. Initial cost $400-$600.
STD PROTECTION No OTHER
CONSIDERATIONS Requires minor
outpatient surgical procedure for insertion
and removal. Provides continuous
protection for five years (may be removed
sooner, if desired). May cause weight
gain. Frequently causes irregular bleeding
during the first year of use.
METHOD Depo-Provera (DMPA
(Hormonal Injections EFFECTIVENESS
99.9% HOW TO OBTAIN Not available at
McKinley, call Gynecology for information.
Approved for contraception use in 1992.
Cost is $25 - $45 per injection. STD
PROTECTION No OTHER
CONSIDERATIONS A shot every 12
weeks provides continuous protection.
Does not contain estrogen. May cause
irregular bleeding and spotting, heavier or
lighter periods. May cause breast
tenderness, nausea, during first few
months. May cause weight gain.
METHOD IUD (Intrauterine Device)
EFFECTIVENESS 97-99.2% HOW TO
OBTAIN Requires 2 appointments for
gynecological exam and insertion. STD
PROTECTION No OTHER
CONSIDERATIONS Provides continuous
protection. May cause heavier menstrual
bleeding and more severe cramps. Some
women are not suitable candidates.

METHOD Diaphragm & Cervical Cap
EFFECTIVENESS 82-94% HOW TO
OBTAIN Requires recent gynecological
exam and may require multiple
appointments for fitting STD
PROTECTION Some OTHER
CONSIDERATIONS Most effective if
inserted before any genital contact. Does
not affect menstrual cycle. Some women
cannot be fitted. Minimal side effects.
Some consider it messy or difficult to use.
METHOD Condom EFFECTIVENESS
88-98% HOW TO OBTAIN Can be
obtained at Health Resource Centers
(locations on back of handout) and at drug
stores STD PROTECTION Yes, most
effective OTHER CONSIDERATIONS
Most effective if put on before any genital
contact. Recommended to be used with
additional spermicide. May reduce
sensation.
METHOD Spermicides (Jelly, foam,
cream) EFFECTIVENESS 79-97%
HOW TO OBTAIN Spermicidal jelly is
available at Health Resource Centers
(locations on back of handout). Other
spermicides can be obtained at drug
stores. STD PROTECTION Some OTHER
CONSIDERATIONS Most effective if
inserted before any genital contact. Some
consider messy to use. Recommended to
be used with a condom. Provides
additional lubrication. May cause irritation
(switching brands may help)
METHOD Sponge EFFECTIVENESS
82-94% HOW TO OBTAIN Not available
at McKinley -- can be obtained at drug
stores. Cost is $1 - $2 each. STD
PROTECTION Some OTHER
CONSIDERATIONS Most effective if
inserted before any genital contact.
Effective 24 hours. Recommended to be
used with a condom. Some consider it
messy or difficult to use. May cause
itching, irritation. May not fit all women
well.
METHOD Fertility Awareness
EFFECTIVENESS 80-98% HOW TO
OBTAIN Individual instruction about this
method is available at Planned
Parenthood -- call 359-8022 to schedule
an appointment. STD PROTECTION No
OTHER CONSIDERATIONS Requires
some instruction, high motivation, and
diligent record-keeping of fertility
indicators. Increases awareness of
changes in menstrual cycle. Requires use
of back-up method or abstinence from
intercourse during fertile part of cycle. Can
be an all natural method. Stress, illness,
or vaginal infection can affect fertility
indicators
A NOTE ABOUT WITHDRAWAL,
RHYTHM, AND DOUCHING Withdrawal
is a method couples sometimes use. It
can fail due to the presence of sperm in
pre-ejaculatory fluid, or the couple
misjudging when the man should
withdraw. This method requires a high
level of trust and cooperation, and couples
may find it unsatisfying to use.
Withdrawing before ejaculation is better
than using no method at all. Couples who
use the rhythm ("safe time") method
abstain from intercourse (or use another
form of birth control) during the fertile time
in the woman's menstrual cycle. This
method can fail because it is possible for
a woman to ovulate at any time during her
cycle, including while she is menstruating.
The Fertility Awareness Method
(described briefly in this handout)
combines charting of a woman's
menstrual cycle with other fertility
indicators to provide more complete
information about when ovulation occurs.
Douching after intercourse is not an
effective form of birth control, because
some sperm may reach a woman's uterus
almost immediately after ejaculation. In
addition, douching may push sperm
toward the uterus and increase the
likelihood of pregnancy.
Reference: Hatcher, et. al. (1990).
Contraceptive Technology, 1990-1992,
15th Revised Edition, New York: Irvington
Publishers, Inc.
Copyrighted by the University of Illinois
Board of Trustees, 1994
THE DIAPHRAGM
What Is a Diaphragm? --------------------
The diaphragm is a soft, thin rubber cup
that is placed in the vagina before
intercourse. It is a "barrier" method of
contraception, and one of its advantages
is minimal side effects. The diaphragm
covers the cervix and prevents sperm
from entering the uterus. When properly
used with spermicidal jelly or cream each
time you have intercourse, the diaphragm
can be 97% effective. Since women differ
in the size and shape of the vagina,
diaphragms are made in several sizes and
types. The correct size and type can only
be determined by a doctor or nurse during
a pelvic exam.
When Do I Insert the Diaphragm?
------------------------------ The diaphragm
must be inserted before intercourse. If
intercourse does not occur within 2 hours,
a second application of the spermicide is
necessary. The diaphragm should not be
removed to do this. Insert the additional
jelly or cream with an applicator. An
application of spermicide is required each
time you have intercourse. Be careful not
to dislodge the diaphragm with the
applicator. You need:
Diaphragm -- available by prescription at
McKinley Health Center pharmacy; comes
in its own plastic case.
Spermicidal Jelly or Cream -- available by
prescription at McKinley pharmacy;
available from both Health Resource
Centers; available at other pharmacies for
purchase over-the-counter.
Plastic Applicator -- for inserting additional
spermicide. Available at McKinley and
generally comes inside the spermicide
package.
How Do I Insert It? ------------------- Wash
your hands before handling the
diaphragm. Before insertion, put about 1
tablespoon of spermicidal jelly or cream
into the dome of the diaphragm and
spread some around the rim. If desired,
apply a small amount to the outside of the
diaphragm to aid insertion. The diaphragm
may be inserted while you are standing,
squatting or reclining. (It can also be
inserted by your partner.)
First, using the thumb and first 2 fingers,
press the rim together so that the
diaphragm folds in the middle. With the
other hand, spread the vaginal lips. Now,
insert the diaphragm into the vaginal canal
and gently push the diaphragm along the
vaginal floor as far as it will go, to make
sure it passes the cervix. The diaphragm
will open up once inside; now, tuck the
front rim up behind your pubic bone.
Check to make sure the cervix is covered!
Run your finger over the surface of the
diaphragm -- you should feel the cervix
behind the diaphragm. If the diaphragm is
uncomfortable, remove it and reinsert. Be
sure and check the cervix again.
When and How Do I Remove It?
---------------------------- The diaphragm must
be left in place 6 - 8 hours after
intercourse. To remove the diaphragm,
hook your finger under the front rim and
gently pull down and out. If you have
difficulty with removal, bear down, while
squatting, and pull on the diaphragm.
Care of Your Diaphragm:
------------------------ After removing the
diaphragm, wash it with a mild soap and
water. Rinse it with clean water. Dry
carefully. Do not use perfumed soaps
containing cold cream or detergents to
wash the diaphragm. The elements in
these soaps may have a harmful effect on
the latex rubber diaphragm.
Dust the diaphragm lightly with cornstarch
and replace it in the container. Do not
allow the diaphragm to air dry. Do not use
any type of body powder, baby powder,
flour or face powder, as they may contain
elements that could affect the latex rubber
diaphragm. Do not use cold cream,
Vaseline or other oily substances as a
diaphragm lubricant, as these may also be
harmful to the diaphragm.
Additional Information: -----------------------
1. If you gain or lose 10 lbs. or more, or
become pregnant, the diaphragm should
be refitted.
2. If you think you may have sex, you can
insert your diaphragm before you go out.
Be sure you insert additional jelly with the
applicator before intercourse (if more than
2 hours).
3. In the past, women were counseled to
only use certain positions during
intercourse. There is no evidence to
support this. There should be no fear of
dislodging the diaphragm if it is fitted and
inserted correctly.
THE PILL
Over 10 million women in the United
States currently use an oral contraceptive,
the pill, to prevent pregnancy. There are a
number of different brands available,
manufactured by several different
companies.
The questions and answers outlined
below provide important information to
assist you in using the pill in the safest,
most effective manner. Be sure to read
these directions before you start taking
your pills, and any time you are not sure
what to do. Please address any questions
you have to your medical provider.
How does the pill work? -----------------------
* It prevents ovulation * It alters the
cervical mucus, making it less penetrable
to sperm It alters the endometrial lining,
inhibiting implantation of a fertilized egg, if
ovulation has occurred.
How effective is the pill?
-------------------------- The pill is 99%
effective when taken correctly. If you stop
taking the pill, you may become pregnant
very soon. Many pregnancies occur when
women stop taking their pills and have
intercourse without using another method
of contraception.
Who should or should not take the pill?
--------------------------------------- Each
person is evaluated on an individual basis.
Determining factors include: past medical
history, family history, and findings of a
physical exam.
What are the benefits? ----------------------- *
decreases blood loss and incidence of
iron-deficiency anemia * decreases
severity of menstrual cramps * regulates
menstrual periods * decreases risk of
fibrocystic breasts and ovarian cysts *
often improves acne
What are the risks? ------------------- The
risks of using the pill are low compared to
the risks of pregnancy and childbirth.
Nearly all risks are associated with the
cardiovascular system. Smoking
significantly increases these risks. If you
experience any of the following
symptoms, you should seek medical care
right away and tell the physician you are
on the pill:
A - Abdominal pain (severe) C - Chest
pain, shortness of breath, coughing up
blood H - Headache (severe), numbness
or weakness in arms and legs E - Eye
problems (vision loss, blurring, or flashing
lights) S - Severe leg pain in calf or thigh
What about cancer and the pill?
-------------------------------- Since 1960,
when birth control pills first became
available, important information about pills
and cancer has been learned: pills reduce
the risk for ovarian cancer; pills reduce the
risk for endometrial cancer; most studies
suggest that pills neither reduce nor
increase risk for breast cancer.
Further research is needed, as there may
be a small number of women who are at
increased risk for breast cancer. Women
are recommended to do breast
self-examination every month, and report
any changes or problems to their health
care provider.
How do I get a pill prescription?
---------------------------------- First-time pill
users must attend a birth control
education session at McKinley. All pill
users must have a pap test done within
the year by a McKinley clinician or by a
health care provider or clinician. First-time
pill users are dispensed three (3) pill
packets. Before you finish taking the third
packet, return to Pharmacy for refills. If
you have any problems, call Gynecology
Clinic.
How do I take the pill? ------------------------
Important facts to remember are:
1. (Before you start taking your pills), look
at your pack to see if it has 21 or 28 pills.
The 21-pill pack has 21 "active" pills to be
taken one-a-day for 3 weeks, followed by
1 week without pills. The 28-pill pack has
21 "active" pills to be taken one-a-day for
3 weeks, followed by 1 week of "reminder"
pills to be taken one-a-day for 7 days.
2. The right way to take the pill is to take
one pill every day at the same time.
Establish a regular routine. If you miss
pills, you can get pregnant. This includes
starting the pack late. The more pills you
miss, the more likely you are to get
pregnant. Take a pill every day, until you
have completed the pill pack.
3. Some women have spotting or light
bleeding, breast tenderness, and/or
nausea during the first 1-3 packs of pills. If
you experience any of these, do not stop
taking the pill. For nausea, try taking your
pill after meals. All of these symptoms will
usually go away. If they don't, check with
your health care provider before getting a
refill from the pharmacy.
4. If you take a pill more than six hours
late, it is considered a missed pill. Varying
the time you take your pills may cause
spotting or bleeding and increase the risk
of pregnancy.
5. If you have vomiting or diarrhea, for any
reason, or if you take other prescription
medicines, including antibiotics, your pills
may not work as well. Use a back-up
method (such as condoms, foam, or
sponge) if you have intercourse, and
check with your health care provider. (See
handout titled Oral Contraceptives and
Drug Interactions).
6. Your period will probably be shorter and
lighter. If you miss a period, and you've
taken your pills correctly, you are probably
not pregnant. Stay on schedule with your
pills and get a pregnancy test to be sure.
7. At the end of your pill pack: If you are
on a 21-pill pack, you should wait 7 days
to start your next pack. You will probably
get your period during that week. Don't
wait longer than 7 days to begin your next
pack. If you are on a 28-pill pack, you will
start a new pack the day after you finish
your current pack. Do not wait any days.
WHEN TO START THE FIRST PACK OF
PILLS
You have a choice of which day to start
taking your first pack of pills. Decide with
your health care provider which is the best
day for you. Pick a time of day which will
be easy to remember.
Day 1 start: ------------ 1. Take the first
"active" pill of the first pack during the first
24 hours of your menstrual period.
2. You will not need to use a back-up
method of birth control, since you are
starting the pill at the beginning of your
period.
Sunday start: -------------- 1. Take the first
"active" pill of the first pack on the Sunday
after your period starts, even if you are
still bleeding, If your period begins on
Sunday, start the pack that same day.
2. Use another method of birth control as
a back-up method if you have intercourse
any time from the Sunday you start your
first pack until the next Sunday (7 days).
Condoms (used with foam or the sponge)
are good back-up methods of birth control.
WHAT TO DO IF YOU MISS PILLS
If you miss 1 "active" pill: 1. Take it as
soon as you remember. Take the next pill
at your regular time. (This may mean you
take 2 pills in 1 day.) 2. You do not need
to use a back-up method if you have
intercourse.
If you miss 2 "active" pills in a row in week
1 or week 2 of your pack: 1. Take 2 pills
on the day you remember and 2 pills the
next day. 2. Then take 1 pill a day until
you finish the pack. Remember, bleeding
may occur. 3. If you have intercourse, you
must use another birth control method
(such as condoms, used with foam or
sponge) as a back-up for the next 7 days
after you miss the pills.
If you miss 2 "active" pills in a row in week
3 of your pack: 1. If you are a Day 1
Starter -- Throw out the rest of the pill
pack and start a new pack that same day.
If you are a Sunday Starter -- Keep taking
1 pill every day until Sunday. On Sunday,
throw out the rest of the pack and start a
new pack of pills that same day. 2. You
may not have your period this month, and
spotting may occur. However, if you miss
your period 2 months in a row, call your
health care provider, because you might
be pregnant. 3. If you have intercourse,
you must use another birth control method
(such as condoms, used with foam or
sponge) as a back-up for the 7 days after
you miss the pills.
If you miss 3 or more "active" pills any
time during your pack: 1. If you are a Day
1 Starter -- Throw out the rest of the pill
pack and start a new pack that same day.
If you are a Sunday Starter -- Keep taking
1 pill every day until Sunday. On Sunday,
throw out the rest of the pack and start a
new pack of pills that same day. 2. You
may not have your period this month, and
spotting may occur. However, if you miss
your period 2 months in a row, call your
health care provider, because you might
be pregnant. 3. If you have intercourse,
you must use another birth control method
(such as condoms, used with foam or
sponge) as a back-up for the 7 days after
you miss the pills.
If you forget any of your 7 reminder pills in
week 4 of your 28-day pill pack:
1. Throw away the pills you missed. Keep
taking 1 pill each day until the pack is
empty. you do not need to use a back- up
method if you have intercourse.
If you are still not sure what to do about
the pills you have missed:
Use a back-up method any time you have
intercourse. Keep taking one "active" pill
each day, and contact your health care
provider.
Is there anything else I need to know?
---------------------------------------- The birth
control pill does not protect against
sexually transmitted diseases. Condoms
and spermicide do.
If you are concerned about any difference
in your treatment plan and the information
in this handout, you are advised to contact
your health care provider.
Reference: ---------- Hatcher, R., Guest, F.,
Stewart, F., Stewart, G., Trussell, J.,
Bowen, S., & Cates, W. (1989).
Contraceptive technology, 14th Revised
Edition. New York: Irvington.
HOW TO USE A CONDOM
1. Put the condom on before any genital
contact. If uncircumcised, pull back the
foreskin.
2. Cover the head of the penis with the
condom and gently press the air out of the
tip. Unroll it, so that the entire erect penis
is covered. A drop of lubricant may also
be placed in the tip of the condom before
unrolling it onto the penis.
3. If needed, you may generously apply a
water-based lubricant to the outside of the
condom before penetration. Do not use
oil-based lubricants.
4. To prevent slippage, hold the condom
at the base of the penis whenever
withdrawing.
5. If ejaculation occurs, withdraw the penis
before it gets soft. Hold onto the condom
to prevent slippage. Throw the condom
away.
HOW TO USE SPERMICIDAL JELLY
1. For vaginal intercourse: insert
spermicide before any genital contact and
repeat application if more than 15 minutes
passes before intercourse.
Fill the applicator completely by attaching
to the tube and squeezing. Insert the
applicator deep into the vagina and push
the plunger completely into the applicator.
Use an additional application of jelly if
intercourse is repeated. Do not douche for
eight hours after intercourse.
2. For anal intercourse: if spermicidal
lubricant is used, it should be applied to
the outside of the condom prior to
penetration.
Even if you use a lubricated condom, the
use of additional lubrication can increase
pleasurable sensations and help prevent
tearing of the condom. Lubricants or
spermicides containing nonoxynol-9 can
provide extra protection because this
chemical kills many STD (sexually
transmitted disease) germs.
STDs can be passed during vaginal, oral
and anal sex. If you are using a condom
for oral sex, you may prefer to use a
non-lubricated or flavored condom. A
condom can be cut to form a latex square
for use as a barrier during cunnilingus or
during oral-anal contact.
If a condom breaks, immediate withdrawal
is recommended. A new condom can then
be used. To reduce the risk of pregnancy,
a woman can immediately insert two
applications of spermicide into the vagina.
THINGS TO REMEMBER
Latex condoms are recommended for best
STD protection.
Proper usage can increase a condom's
protection. Avoid sharp objects,
fingernails, and air bubbles. Be sure there
is plenty of lubrication.
Store condoms in a cool place.
Plan ahead and be prepared.
Learn the facts about how HIV and other
STDs are spread.
Learn about how to talk with your partner
about safer sex.
Alcohol and other drugs lower inhibitions,
seriously affect judgment, and lead to
unsafe sex.

Sex Tutorial
Sex aids and
aphrodisiacs
A variety of sex aids or
toys are sold over-the-counter in sex shops
or by mail order through magazines. These
include Chinese balls (a woman can wear them
in her vagina where they vibrate slightly as she
moves about during the day) and condoms with
various protrusions on them, which are designed
to stimulate the clitoris during intercourse. Other
condoms are brightly colored and flavored with
fruit.
The vibrator is by far the most
popular sex toy. Shaped like a penis and
battery-ope rated, it can be used in love play or
for female masturbation. Some vibrators have an
ejaculation mechanism. Many sex therapists
advise the use of a vibrator for women learning to
give themselves orgasms.
To help maintain
erection, the simple ring designed to fit
at the base of the penis is probably the only
useful device. A piece of ribbon will do equally
well. Tied fairly tightly around the penis, it acts as
a one-way valve. Blood enters the penis but is
prevented from leaving it, and thus the erection is
maintained for a little longer. A variety of creams
and sprays that claim to prolong erections or to
trigger orgasms are also available.
Named after Aphrodite,
the Greek goddess of love, aphrodisiacs are
drugs claimed to excite lust. They may also be
taken to stave off exhaustion or heighten
pleasure during sex. The popularity of these
drugs throughout history is a testimony to the
fickleness of human sexual chemistry.
In some civilizations, highly
nutritious foods were regarded as the most
reliable stimulants, and may indeed have had a
beneficial effect on people whose diet was
usually poor. The Greeks went for eggs, honey,
snails, and shellfish such as mussels and crabs.
One Arab recipe from The Perfumed Garden
recommends a glass of very thick honey, twenty
almonds and a hundred pine nuts to be taken for
three nights on retiring. Other recipes were to be
applied externally. In order to increase the
dimensions of small members and make them
splendid', the author of The Perfumed Garden
advised rubbing the penis with the melted down
fat from the hump of a camel, bruised leeches,
asses' members, and even hot pitch. These 'rubs'
were probably less effective than the treatment of
rubbing itself.
The Chinese were more scientific in
their approach. They measured and blended the
powdered roots of plants, then gave them colorful
names like 'the bald chicken drug'. This drug got
its name when a septuagenarian civil servant
who took it regularly, fathered three sons and
paid so much attention to his wife that she could
no longer either sit or lie down. He was forced to
throw the remains of the drug out into the yard,
where it was gobbled up by the cockerel. The
cock jumped on a hen straight away, and
continued mating with it for several days without
interruption, all the while pecking at its head to
keep its balance, until the chicken was
completely bald, whereupon the cockerel fell off.
The proud inventor of the drug claimed that if it
were taken three times a day for sixty days, a
man would be able to satisfy 40 women.
Horns have long been thought to, have
aphrodisiac properties because of their obvious
phallic shape. Continuing belief in the potency of
rhinoceros horn has brought the single-horned
African rhinoceros to the brink of extinction. In
fact horn consists of fibrous tissue, similar in
construction to hair and nails. Like them, rhino
horn contains the protein keratin, and the
minerals sulfur, calcium and phosphorus. The
addition of these elements to a poor diet might
improve vigor, but a cheese sandwich would do
just as well.
Another famous
aphrodisiac is Spanish fly, the
common name of the beetle cantharides. The
beetle is dried and the active principal,
cantharidin, is extracted. If swallowed,
cantharidin causes an intense burning sensation
in the throat, followed by diarrhea. Then the
urinogenital tract becomes so inflamed that
urination becomes impossible. The penis ends up
engorged and throbbing, but this is due to
excruciating pain rather than to sexual urgency.
Taking Spanish fly can sometimes be fatal.

Sex Tutorial
Sexually
transmitted
diseases
The SYMPTOMS of sexually transmitted
diseases (STD) are often impossible to detect
initially, but if your partner is infected, or you have
a sexual relationship with someone who is
promiscuous, then a check-up is essential. If
symptoms do manifest themselves, they are
likely to take the form of a discharge from the
vagina, penis or anus, or itching or soreness
around the genitals or anus, or a lump or rash on
the genitals, anus or mouth.
• Always use a condom.
If you suspect you may have a
sexually transmitted disease, you should see
your doctor or clinic straight away. You can find
the telephone number of your nearest clinic by
looking up 'special clinic', 'venereal disease' or
'VD' in the telephone directory, or by phoning
your local hospital. You will be tested as quickly
as possible, and if the test is positive, you will be
advised to contact your recent sexual partners,
as they too may need treatment. Avoid sex until
you are clear of the disease.
• Always use a condom.
AIDS stands for Acquired Immune
Deficiency Syndrome, and the disease is caused
by the human immuno-deficiency virus, known as
HIV Once it is inside the body, this virus invades
the white blood cells, which normally fight off
disease, then it multiplies and destroys them. It
also breeds inside the brain. Three to four years
normally elapse between infection with HIV and
any subsequent development of the symptoms
associated with AIDS.
• Always use a condom.
As AIDS develops the body's
natural defences become depleted, and the AIDS
patient is increasingly likely to contract diseases
that a healthy body would normally ward off, and
so rare forms of cancer and pneumonia develop.
Sometimes AIDS patients are attacked by
several infections at once, such as candida,
herpes and TB. At the same time, the brain may
succumb to increasingly severe dementia.
Somewhere between one in ten and one in three
of those infected with HIV are likely to develop
AIDS. As yet there is no cure for AIDS. AIDS
usually progresses through various infections and
stages of increasing debility to the eventual death
of the sufferer.
• Always use a condom.
How to avoid
AIDS
• Always use a condom.
• Avoid anal sex.
• Always use a condom.
• Don't share toothbrushes,
razors or any other instrument
that might transfer blood from
cuts or abrasions.
• Always use a condom.
The virus is present in
body fluids, primarily semen and
blood. It may also be present in saliva, though
research indicates that saliva seems to
present little risk. Having anal intercourse with an
infected partner is the most likely way of catching
AIDS, and 80 per cent of British cases so far
have been male homosexuals.
The second most common way of
contracting the disease is through infected blood.
Almost a quarter of Britain's haemophiliac
population now carry HIV because they have
been injected with the clotting agent collected
from infected blood. (Haemophiliacs are born
without the blood-clotting factor, and can suffer
severe bruising from a minor injury, and bleed to
death from a cut unless they receive the clotting
factor from donated blood.) HIV in the blood may
also be transmitted on infected needles, and drug
addicts are the third most highly at risk group of
the population.
To become HIV positive you do not
have to be homosexual or promiscuous, a drug
addict or a haernophiliac. Heterosexuals are also
at risk. Even a heterosexual in a steady
relationship stands the risk of contracting the
disease if their partner has been infected in a
previous relationship. Therefore when
embarking on any new relationship, it is safest to
wear a condom.
Gonorrhoea is caused by the bacterium
gonococcus, which cannot survive outside the
body and is transmitted only by sexual
intercourse, and never (as is sometimes
imagined) on toilet seats or towels. In men the
urethra, along which urine passes from the
bladder, is infected, and there is sometimes pain
on urinating and a thick discharge from the penis
within a week after infection. In homosexual men
the rectum may be infected, with the possibility of
irritation and discharge from the anus. In women,
gonorrhoea infects the cervix, urethra and
rectum, and, as with men, there may be
discharge and pain on urinating. If infection
spreads to the uterus there is a 10 per cent
chance that the fallopian tubes may be blocked,
causing sterility. Often, however, there are no
symptoms in either men or women.
The treatment for gonorrhoea is
usually a single dose of antibiotics such as
penicillin, with a check-up afterwards to make
sure the infection has cleared. If gonorrhoea is
not diagnosed and treated, serious complications
can develop. Men may suffer epicliclymitis - pain
and swelling in the testicles; women may suffer
peritonitis - inflammation of the membranes of the
abdomen. Both sexes could develop gonococcal
septicaernia, an infection of the bloodstream with
skin rashes and arthritis. In serious cases,
sterility can result in both sexes. Pregnant
women with gonorrhoea may pass it on to their
babies, who can be born with gonococcal
opthalmia, an acute inflammation of the eyes.
Complications are, however, relatively rare
nowadays.
Non-specific urethritis or NSU can be
identified by lumps, soreness or itching around
the genitals, anus or mouth. There may also be a
discharge from the vagina or penis. The
treatment is usually a two-week course of
antibiotics for anyone who has had contact with
an infected person. During treatment, patients
are asked to give up alcohol, as this can bring
about a recurrence of the symptoms.
Complications can occur, and these are similar to
those for gonorrhoea, but fortunately early
diagnosis and treatment can prevent these. It is
possible for a man to be periodically reinfected
with NSU without changing his sex partner, and
no explanation has so far been put forward for
this. However, both partners will need treatment
each time NSU manifests itself.
Syphilis is quite rare in Britain today. It
affects women less than men, and its main
victims are male homosexuals. Symptoms
appear between 10 days and 12 weeks after
infection. In the primary stage of the disease a
small hard sore or chancre appears on the penis,
vagina or rectum. It is painless and usually
disappears very quickly. A few weeks later, in the
secondary stage, the patient is feverish, with
swollen glands and itching skin. The disease is
curable with antibiotics, but if for some reason it
should not be treated, serious complications will
develop many years later. Until the advent of
antibiotics, tertiary syphilis used to be quite
common, with patients eventually suffering from
dementia and dying a slow, agonizing death.
Chlamycliais one of the most common
STDs and is caused by a bacterial parasite called
chlamydia trachomatis. The disease is diagnosed
by a swab test, and treatment is with antibiotics.
Symptoms in men include a whitish yellow
discharge from the penis, frequent 'burning'
urination, and redness at the tip of the penis.
Women may notice a discharge, a frequent need
to urinate, and mild discomfort which they may
mistake for vaginitis or menstrual cramps.
However, many women experience no symptoms
until they develop complications such as pelvic
inflammatory disease, a serious condition which
can result in infertility. Babies born to infected
mothers may suffer from eye infection, which is
sometimes serious, or pneumonia.
Genital herpes is a viral infection
transmitted through sexual intercourse. It is very
similar to the other sort of herpes, which causes
cold sores, and can also be caught by having oral
sex with someone who has active cold sores.
The symptoms are itching, pain in the groin,
discomfort on urinating and fever, followed by the
appearance of painful red blisters on the vulva or
penis, which burst to form ulcers. After about 10
days the symptoms disappear and the patient
appears to be cured. But the infection is only
lying dormant and may recur at any time,
particularly when the patient is under stress.
There is as yet no treatment for this disease.
While the disease is dormant, it is safe to have
sex without infecting one's partner, but it is
impossible to predict the next attack, so the risk
of infection remains. If the infection is active at
the end of a pregnancy, a Caesarean section
may be performed to prevent the baby becoming
infected in the birth canal.
Genital warts are unpleasant but painless
and can be treated quite easily. They are small
lumps that appear on the penis, vulva, or anus
and are mildly contagious. The treatment
involves either painting the warts with a
preparation called poclophyllin, or freezing them
off with liquid nitrogen. An association has been
identified between genital warts and cervical
cancer, so it is important to get rid of them as
soon as possible, and to have regular cervical
smears.
Thrush is a fungal infection that develops in
certain conditions in the vagina. It is sometimes
linked to taking the Pill, and if it recurs frequently,
a different method of contraception may be
advisable. A man may carry thrush, though he
usually manifests no symptoms. Thrush causes
vaginal soreness and itching, and a thick white
discharge. The doctor will probably prescribe
anti-fungal cream, to be used by both partners,
and vaginal pessaries, though oral treatments are
available too. Some women find that natural
yoghurt in the vagina is effective. Avoid hot
baths, and wearing tights, tight jeans and nylon
knickers.
Trichomoniasis is one of the most
common and least serious of all sexually
transmitted diseases and may be passed on by
bad hygiene practice in the use of towels as well
as by sexual contact. It can exist in a
symptomfree form and some people act as
passive carriers for the disease. However, it can
also cause discharge and pain in urinating in both
sexes. Several drugs are available for treatment
and their success rate is high.
• Always use a condom.