Sexual health is a state of physical, emotional, mental, and social well-being in relation to sexuality. It is not merely the absence of disease or dysfunction. Like brain health, it is complicated and poorly understood. Sexual health covers pregnancy, sexually transmitted infections, sexual behaviors, and attitudes toward sex. But it also covers sexual rights and sexual pleasure.¹

As scientists better understand the complex interaction between our brains, sexual organs, and hormones, the field of sexual health has broadened. Sexuality is influenced by biological, psychological, social, economic, political, cultural, legal, historical, religious, and spiritual factors.² The more you learn about your sexual health and the options available to improve it, the more empowered you may feel to make informed decisions about how you want to express your sexuality and protect your sexual health.

The World Health Organization defines sexual health as:

“…a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.” (WHO, 2006a)

The Importance Of Sexual Health

Sexual health, sexual pleasure, sexual justice, and sexual well-being are all important aspects of personal and societal public health. Education on sexual health should begin in early childhood in an age-appropriate manner. While sexual education is incorporated into school curricula, the curricula and the qualifications of the people teaching about sexual health vary. Each person should feel empowered to learn more about their sexual health and how to protect it. Only when sexual education is expanded beyond classrooms and integrated into daily life will sexual and reproductive health improve.³  

Aspects Of Sexual Health

To improve sexual health, it is important to go beyond the medical aspects of caring for the reproductive system. Sexual health also involves sexual rights and sexual pleasure.¹ Many factors influence sexual health, including cultural and societal norms, stigma, communication barriers, embarrassment, discrimination, lack of education, and poor-quality relationships.⁴

Body Image

Body image refers to a person’s feelings or perceptions about some aspect of their body. Body image and feelings of attractiveness can impact sexual health. It is normal and natural to experience physical changes such as weight gain or weight redistribution, sagging breasts, vaginal changes, changes in hair distribution, wrinkles, balding and gray hair. Feeling attractive is important for sexual satisfaction.⁵ Throughout puberty, middle-aged female menopause, and older age, bodily physical changes can affect the physical and psychological aspects of sexual health.⁶

Dr. Thomas Cash has researched the connection between body image and sexual health and developed a body image assessment: BESAQ. This 28-item self-report questionnaire can help determine how much your body image affects your sexual behaviors and sexual health.⁷

Consent 

Sexual rights involve applying existing human rights to sexuality and sexual health. Each person may fulfill and express their sexuality in the way they see fit.² Each person has the right to attain sexual health in a pleasurable, fulfilling, and safe way, without coercion, discrimination, or violence.⁸

The World Health Organization’s definition of sexual rights:

Rights critical to the realization of sexual health include:

• Rights critical to the realization of sexual health include:
• the rights to equality and non-discrimination
• the right to be free from torture or to cruel, inhumane, or degrading treatment or punishment
• the right to privacy
• the rights to the highest attainable standard of health (including sexual health) and social security
• the right to marry and to found a family and enter into marriage with the free and full consent of the intending spouses, and to equality in and at the dissolution of marriage
• the right to decide the number and spacing of one’s children
• the rights to information, as well as education
• the rights to freedom of opinion and expression, and
• the right to an effective remedy for violations of fundamental rights.

The responsible exercise of human rights requires that all persons respect the rights of others.

Applying existing human rights to sexuality and sexual health constitutes sexual rights. Sexual rights protect all people’s rights to fulfill and express their sexuality and enjoy sexual health, with due regard for the rights of others and within a framework of protection against discrimination.” (WHO, 2006a, updated 2010)

Sexual justice encompasses:⁹

• Sexual rights
• Sexual citizenship
• Sex-positive practice

Sexual consent is a voluntary, coherent, ongoing, and clear agreement to engage in sexual activity. Sexual activity without consent is considered rape or sexual assault. Consent is obtained before any sexual activity. It is essential to communicate with partners about sexual desires and boundaries.

It is important to teach consent to everyone, regardless of age or gender.

Gender Identity 

Gender identity is the gender a person identifies with internally and expresses themselves externally. Gender identity is not the same as biological sex. There are many different gender identities. Sexual health is a state of physical, emotional, mental, and social well-being in relation to sexuality. When a person feels discordance between their gender identity and societal and cultural expectations, or experience stigma, it will negatively impact their sexual health.

Education in schools and for healthcare providers is essential to improve the sexual health of the LGBTQ+ population. Everyone needs access to providers who use accurate terminology, provide reproductive care, and teach about preventing sexually transmitted infections in a culturally competent, sensitive, and inclusive manner.¹⁰

Intimacy

Sexual pleasure and intimacy are related to sexual health and sexual well-being. According to GAB (2018), “Sexual pleasure is the physical and psychological satisfaction and enjoyment derived from solitary or shared erotic experiences.” Aspects of sexual pleasure include: self-determination, consent, safety, privacy, confidence, and the ability to communicate and negotiate sexual relations.¹¹

Intimacy can occur with sex, but it does not equal sex. Physical touches and emotional connections build intimacy. Intimacy takes time to develop, and it typically begins with acts of intimacy outside of sex. Physical and psychological health are essential when building intimacy with a partner.

Build intimacy slowly as a team. Prioritize it in your relationship. Effective communication between partners and a shared sense of history can help reduce miscommunications that can destroy a relationship.

Reproductive Health 

Reproduction is an essential part of sexual health, as is avoiding unplanned pregnancies. Taking care of your reproductive health long before you want to have offspring is important. Untreated sexually transmitted infections can cause damage to the fallopian tubes and epididymis, which can cause scarring and infertility.¹²

Characteristics Of A Sexually Healthy Person

A sexually healthy person embodies the following characteristics:⁹

• Expresses sexual respect for themselves and others
• Displays overall satisfaction with physical sexuality, sexual identities, and sexual preferences
• Retains control over sexual thoughts and desires
• Able to communicate easily with sexual partner(s)
• Avoids feelings of shame and blame
• Feels safe in expressing themselves sexually
• Educated about sexual health, sexual rights, and sexual pleasure
• Treats and prevents any sexually transmitted infections

Consequences Of Poor Sexual Health 

Sexual health is essential throughout the lifespan. Many people face barriers to achieving sexual health and receiving education based on geographic location, age, societal restrictions, sex, or sexual orientation. Cultural and social factors commonly prevent older adults from seeking and receiving advice and treatment for sexual health. Social and cultural norms frequently see older adults as asexual.⁴ Education and healthcare provider training on sexual health is one essential step towards providing resources for all people. If you feel that you are unable to discuss your sexual health with your current healthcare provider, look for someone you can connect with. Sexual, psychological, and general physical health are equally important.

Sexual health and physical health are intertwined. For example, erectile dysfunction (the inability to get and maintain an erection suitable for penetrative sex) is frequently an early indicator of cardiovascular disease. In addition to poor cardiovascular health, sexual dysfunction can be associated with diabetes mellitus and neurological disorders.¹³ Learn the causes, symptoms, and treatment for erectile dysfunction and other sexual medical conditions. Poor sexual health can have physical and psychological impacts. Conversely, physical and mental illnesses can have a negative impact on sexual activity and sexual satisfaction. A satisfying sex life can significantly impact quality of life.¹⁴

Improving Your Sexual Health 

The first step to improving your sexual health is assessing where you currently are in terms of the various aspects of sexual health:

• Separating intimacy and sex
• Identifying ways to improve your sexual satisfaction
• Identifying barriers to sexual health and working on overcoming them
• Educating yourself on sexual health and physiology
• Developing a social network
• Reducing risk factors for sexually transmitted infections
• Practicing safer sex
• Understanding your sexual rights
• Communicating your needs

Invigor Medical is an online telemedicine clinic that helps men and women feel great and improve their physical and sexual health. Products such as Passion, PT-141, and tadalafil-oxytocin can increase passion and libido, fostering connectedness and intimacy and treating sexual health conditions, such as ED.

DISCLAIMER

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

1. Gruskin S, Yadav V, Castellanos-Usigli A, Khizanishvili G, Kismödi E. Sexual health, sexual rights and sexual pleasure: meaningfully engaging the perfect triangle. Sex Reprod Health Matters. Dec 2019;27(1):1593787. doi:10.1080/26410397.2019.1593787

2.  World Health Organization. Sexual and Reproductive Health and Research (SRH). Accessed December 13, 2022. https://www.who.int/teams/sexual-and-reproductive-health-and-research/key-areas-of-work/sexual-health/defining-sexual-health

3. Hall KS, McDermott Sales J, Komro KA, Santelli J. The State of Sex Education in the United States. J Adolesc Health. Jun 2016;58(6):595-7. doi:10.1016/j.jadohealth.2016.03.032

4.  Ezhova I, Savidge L, Bonnett C, Cassidy J, Okwuokei A, Dickinson T. Barriers to older adults seeking sexual health advice and treatment: A scoping review. Int J Nurs Stud. Jul 2020;107:103566. doi:10.1016/j.ijnurstu.2020.103566

5. Thomas HN, Hamm M, Borrero S, Hess R, Thurston RC. Body Image, Attractiveness, and Sexual Satisfaction Among Midlife Women: A Qualitative Study. J Womens Health (Larchmt). Jan 2019;28(1):100-106. doi:10.1089/jwh.2018.7107

6. Wilson CM, McGuire DB, Rodgers BL. Body Image Related to Sexual Health: Development of the Concept. J Midwifery Womens Health. Jul 2021;66(4):503-511. doi:10.1111/jmwh.13226

7. Gillen MM, Markey CH. A review of research linking body image and sexual well-being. Body Image. Dec 2019;31:294-301. doi:10.1016/j.bodyim.2018.12.004

8.  Heidari S. Sexual rights and bodily integrity as human rights. Reprod Health Matters. Nov 2015;23(46):1-6. doi:10.1016/j.rhm.2015.12.001

9. Mitchell KR, Lewis R, O’Sullivan LF, Fortenberry JD. What is sexual wellbeing and why does it matter for public health? Lancet Public Health. Aug 2021;6(8):e608-e613. doi:10.1016/s2468-2667(21)00099-2

10. Taylor NM, King CK. Sexual Health and the LGBTQ+ Community. Prim Care. Jun 2021;48(2):271-282. doi:10.1016/j.pop.2021.02.009

11. GAB Sexual Health and Wellbeing. Sexual pleasure: An assessment tool. Accessed December 12, 2022. https://www.gab-shw.org/resources/sexual-pleasure-an-assessment-tool/

12. Ochsendorf FR. Sexually transmitted infections: impact on male fertility. Andrologia. Apr 2008;40(2):72-5. doi:10.1111/j.1439-0272.2007.00825.x

13. Kliesch S. The Connection Between General and Sexual Health. Dtsch Arztebl Int. Sep 25 2020;117(39):643-644. doi:10.3238/arztebl.2020.0643

14. Schäfer GA, Englert HS, Ahlers CJ, Roll S, Willich SN, Beier KM. Erektionsstörung und lebensqualität–erste ergebnisse der berliner männer-studie. Sexuologie. 2004;10(2-3):50-60.

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