Am I pregnant?

Dear Anxious,
It’s not unusual for the possibility of pregnancy to stir up some anxiety. Taking a store-bought urine pregnancy test is a quick and accurate way to know your pregnancy status and to plan next steps. And while feeling queasy in the morning can certainly be a symptom of pregnancy, nausea and the "moving" feeling in your intestines could also be linked to having a stomach bug, food poisoning, a food sensitivity, or a number of other conditions that aren’t related to pregnancy at all. If you're a college student, your student health center may offer pregnancy tests. Costs may vary based on how your school funds its health services and your insurance, and as required by law, the services they provide you would be confidential unless you tell them otherwise. That being said, since it was only last week, it may be too soon to detect on a pregnancy test.
Some people may experience pregnancy-related nausea and vomiting (often called morning sickness) as early as two weeks after conception, but others may not. Keep in mind that early symptoms of pregnancy vary from person to person and pregnancy to pregnancy. Even if some signs point to "yes," you won't know until you take a pregnancy test and find out for sure. 
When used correctly, urine pregnancy tests are 99 percent accurate and can help quell your anxiety or allow you to proactively plan out next steps for carrying out or terminating a pregnancy. To ensure accuracy, make sure you read the instructions and follow them as closely as possible. You may also find peace of mind visiting a health care provider to confirm a positive home pregnancy test.
Urine pregnancy tests are most accurate after your period is late, even if the label says it can detect pregnancy prior to a missed period. There’s no harm in taking a pregnancy test at any time. However, be aware that if you haven’t missed your period yet, you’re more likely to get a false positive or negative result, which might cause you some unnecessary stress. If you don’t menstruate or aren’t on a regular cycle, waiting three weeks after sex may produce more accurate home test results.

Pregnancy tests work by detecting a hormone called human chorionic gonadotropin, or hCG. The production of hCG begins when a fertilized egg implants in the uterus (typically around ten days after the egg is fertilized by sperm). It takes time for hCG levels to build up, so taking a pregnancy test right away can lead to an inaccurate result.
You don’t have to go through this alone. If you prefer, you can choose to schedule a pregnancy test with a health care provider. If you have more questions, or you’re not sure how to find a provider, you can visit the Planned Parenthood website for more information about clinics that provide pregnancy testing and can help you navigate your options if you're pregnant. If you have more questions or as a student, pregnancy testing services aren’t available on campus, you could try to seek services off-campus to access pregnancy testing and assistance with navigating options if you’re pregnant. Associated costs would be dependent on the type of test, and due to the Health Insurance Portability and Accountability Act, all information shared with a health care provider is confidential unless you give permission for it to be shared with others.
Although it may be a bit early now, taking a home pregnancy test in a few weeks may provide some answers. Even if the result is a surprise, the sooner you find out, the sooner you can learn what options are available to you.
Alice!

Menstrual synchrony: Fact or fiction?

Dear Hopes She's Right,
You and your mother aren’t the only ones debating the facts surrounding menstrual synchrony (the tendency of women's menstrual cycles to converge). A heavy flow of controversy has existed since 1971, when a researcher studied the menstrual cycles of menstruating women living in the same residence hall. The findings suggested that there were factors, such as pheromones, that influenced the timing of a person’s period, causing it to shift and synchronize among women who live together. Researchers who have tried to replicate this study indicated that there may have been some methodological errors in the original study design. Furthermore, recent research on menstrual synchrony doesn't support the 1971 finding. What’s likely happening is that individuals with different menstrual cycle lengths live together long enough that there are times when their periods occur at the same time. 
While it’s unlikely that pheromones are shifting the timing of menstruation, there are some other factors that might have an impact:
Birth control pills: The birth control pill operates by altering the levels of progesterone and estrogen in the body, thereby influencing if, and when, menstruation occurs.

Extreme stress: Having high levels of stress, worry, or anxiety can lead early or late periods.
Chronic illness: If living with a chronic illness or taking certain medications, it may cause periods to be irregular.
Eating disorders: Anorexia, bulimia, binge eating, and other calorie-controlled patterns of eating can impact the timing of periods or whether it even comes.
List adapted from Cleveland Clinic.
Until more is known about good ol’ Aunt Flo, it’s difficult to definitively say whether menstrual cycles can sync up. In the meantime, you can check out the various studies on the topic, or you can start your own investigation among your close friends to see how you all align.
Here’s to getting on the same page, if not the same cycle!

Safer sex between women

Dear Reader,
It’s great that you’re asking these questions because it's a common misperception that sex between female-identifying partners is without risk. While women who have sex with women (WSW) are typically at lower risk for sexually transmitted infections (STIs), including HIV, they’re still at risk for some infections. As such, practicing safer sex is still a good idea to keep both you and your potential partner(s) safe. Read on for more about infections for which WSW may be at risk, how they’re transmitted, and prevention strategies to utilize while still keeping it fun in the bedroom.
Though there are a number of STIs that are less common among WSW, sexual contact between female partners does still provide opportunities for exposure. Infections may still be passed in a number of ways, including through skin-to-skin contact, vaginal fluids or menstrual blood, and shared use of sex toys. STIs that are less likely to be transmitted between female sex partners include gonorrhea, hepatitis B, syphilis, and HIV. It’s been noted, though, that WSW who have been diagnosed with any of these less common STIs often have previously had sex with male-identifying partners at some point in their lives.
The STIs that WSW are at a higher risk for include:
•Bacterial vaginosis
•Chlamydia
•Genital herpes
•Human papillomavirus (HPV)
•Trichomoniasis 
•Pubic lice

List adapted from the U.S. Department of Health & Human Services Office on Women’s Health.
With this in mind, it’s wise to consider how you and your partners might protect each other and reduce the risk of infection. Safer sex between women involves many of the same strategies as for any set of partners, and the ideas below could be part of your sex life while keeping it safe and fun:
•During oral sex, cover the entire vaginal or anal area with a dam (a square of thin material, often latex or polyurethane), a cut-open condom, or latex or nitrile glove. Use creative means of keeping the material or wrap in place, such as a garter belt, to leave your hands free to roam. During vulva-to-vulva contact, a similar barrier may be placed over the vaginal area.
•If you or your partner plan on getting handy (i.e., manual penetration or fingering), a pit stop in the restroom to wash your hands is a wise decision. For the penetrating partner, making sure to cover cuts or sores on the hands may also help to reduce the risk of infection; this may be done by using gloves, condoms, or finger cots. It’s also recommended that you swap out for new materials when moving from the anus to the vagina or between partners.
•Is a little playtime with sex toys in order? Then it’s good to make sure that the toys you’re using have been washed before and after use, particularly if you plan on sharing. You might also choose to use a condom to cover the toy when in use (and use a new one if you swap with a partner).
This isn’t an exhaustive list of all the creative activities you may get into between the sheets. The bottom line here is that you might use some of the tools and strategies to limit contact with your partner’s skin, mucous membrane(s) (such as your mouth or vagina), or bodily fluid(s) that may put either of you at risk for infection during sex. Lastly, one more critical tool in your safer sex toolbox is having a frank conversation with your partner about STIs, safer sex methods, what activities are of interest, and whether or how often to get tested. You can check out the related Q&As for more information and tips on talking about safer sex. And now that you're informed, it’s not a bad idea to stock up on some supplies of your choice and enjoy!
Alice!

Can you get pregnant the first time?

Dear Reader,
The short answer is yes; someone can absolutely get pregnant the first time they have vaginal sex. And many people have. When one partner’s semen (cum) comes into contact with another partner’s vagina, pregnancy is theoretically possible — regardless of whether it’s anyone’s first time or their thousandth. Fertility, however, can be fickle. Some people who desperately wish to conceive have to try for months or years before success. Other people unexpectedly conceive the first time they have sex. Ready for some more baby-making biology? Read on!
In a typical menstrual cycle, hormones stimulate the ovaries to release an egg, a process known as ovulation. Ovulation most often happens around day 14 of the typical 28-day cycle. It’s good to note that many people’s cycles fall between 26 to 32 days but the exact timing of ovulation can vary from person to person. After ovulation, the egg journeys down the fallopian tube where it has about 24 hours to meet up with a sperm cell. If fertilized by sperm, the egg moves to the uterus, where it attaches to the uterine lining. At that point, early pregnancy symptoms begin and periods generally stop.

Fertility basically comes down to this: pregnancy is most likely to occur any time someone has unprotected sex during ovulation (or on the days just before ovulation, since sperm can live in the reproductive tract for up to six days). That said, determining when someone is ovulating isn't an exacting process. Since many people don’t have perfectly regular cycles, physical signs of ovulation are often more reliable than an expected calendar date. If you’re interested in becoming pregnant, you may find it useful to learn to recognize the times when you're most fertile. You can learn more about the menstrual cycle and fertility awareness in the Go Ask Alice! Sexual and Reproductive Health archives. A health care provider can also be a useful resource about menstrual history and cycle.
What's the take home message? When sperm and egg cells get to minglin’, pregnancy is a possibility regardless of anyone's previous sexual activity. If pregnancy isn't in your plans, have no fear! Condoms, when used consistently and correctly, can offer reliable protection against pregnancy and many STIs. Lots of other forms of birth control, both hormonal and non-hormonal, are available as well. You can check out the Contraception category for more information about different options. Using this information can help to help plan ahead, whether the goal is to increase or decrease the risk of pregnancy. Having an open conversation with sexual partners can help to ensure that they're on the same page and that they're maximizing pleasure between the sheets.

Masturbating before sex: Males, females, and more

Masturbation is a natural activity that many people enjoy. It can help people discover their sexual preferences, learn about their body, and provide themselves with pleasure.
Some people may have heard that masturbating before sex can desensitize the penis and make males “last longer.” However, there is no scientific proof of this.
It may work for some people, however, and there are plenty of anecdotal claims to support this.
Masturbating before sex can also be enjoyable foreplay. It may help a person become both physically and mentally turned on before sex. Some people believe that masturbating with another person can help them feel more open and connected to their partner.
In this article, learn about the benefits of masturbating before sex for males and females, as well as some of the things to be aware of.

Males
Many males choose to masturbate before sex because they feel that it can help prolong the duration of sex. However, there are some things to consider.
Sexual dysfunctions are common among males.
As a study in the journal Fertility and Sterility notes, ejaculatory dysfunctions are one of the most common types of sexual dysfunction. These types of dysfunctions include premature ejaculation, no ejaculation, or other problems surrounding ejaculation and orgasm.
Many people are familiar with the claim that masturbating before sex can help a male “last longer” during the act of sexual intercourse itself.
There may be a few reasons for this. Much of the issue may be psychological. For example, a person may feel pent up or have unreleased sexual tension. This may cause them to have hurried sex, wherein the person may focus on releasing this tension in the form of an orgasm.
By masturbating beforehand, the person can release that built up sexual energy and then feel that they can focus more on enjoying the entire sexual act, rather than just the orgasm.
Refractory period
A phenomenon called the refractory period may help support this idea. The refractory period is the recovery time a person has to go through after an orgasm before they can orgasm again.
Following an orgasm, males usually cannot have another orgasm right away. Their penis will become flaccid and lose its ability to stay erect. The penis can also be very sensitive to touch after orgasm, causing pain and throbbing if the person or their partner continues with stimulation.
As a study in the journal BJU Internationalnotes, this is partly because the body releases more of the hormone prolactin after orgasm. This hormone seems to block off the sexual pleasure a person can feel during the refractory period.
Because of this, some people think that masturbation can desensitize them to the pleasure of sexual intercourse.

In reality, the refractory period is typically short — though it can vary. As the International Society for Sexual Medicine note, the refractory period of younger males is usually only a few minutes. However, older men may need 12–24 hours to recover. After this, they can achieve erections and have orgasms again.
Everyone is different. Some males do feel that it is harder to have a second orgasm than the first one, and they may last much longer during sex because of this.
For older males who experience refractory periods that last hours, masturbating before sex may help prevent them from having an orgasm during sexual intercourse. This may allow them to enjoy much longer periods of sexual intercourse.
This may make masturbating before sex beneficial for some males who tend to experience early ejaculation.
Other issues
For males who experience softer erections or who find it difficult to achieve an erection, masturbating before sex may make it even more challenging to get a second erection in time for intercourse.
People who find it difficult to get or maintain an erection may want to avoid masturbating before sex.
Masturbating before sex may also be a good way for females to reduce tension and find release before the act of sex.
Some females also experience a refractory period after orgasm. However, females have a slightly different experience to males.
Most males can only have one orgasm before their refractory period, and they experience a long refractory period.
Females, on the other hand, tend to experience much shorter refractory periods. During these short phases, the vagina and clitoris may still be very sensitive, and the person may not enjoy stimulation.
However, this phase tends to end quickly. This is why it is not uncommon for females to experience multiple orgasms per sexual encounter.
Some may experience a longer refractory period than others, and they may feel less sexual desire during this time. In these cases, masturbating before sex may not be a good idea, as it may reduce how much a person wants to have sex.
Benefits
Masturbating before sex does have some additional benefits for both males and females, though each person may experience them in different way.
We cover some of these benefits in the sections below:
Stress or tension relief
Pleasuring oneself before a sexual encounter may help reduce stress, as the brain releases feel-good endorphins after orgasm. This may be helpful for people who are nervous around their partner or who experience sex anxiety.
Masturbating before sex may also help remove any tension from the situation, as a person no longer feels that they have to orgasm to enjoy themselves sexually.
This may be beneficial for both partners, as the sex may become more about the act itself rather than simply orgasm.
Comfort and avoiding premature ejaculation
In males who experience premature ejaculation, masturbation before sex may help them last longer, as it may take them longer to reach their second orgasm. This is not a guarantee, however.
Those who masturbate before sex may also feel greater relaxation and less tension about the act of sex itself.
For females, the vagina may also be more lubricated following sufficient arousal, making sex a more enjoyable experience.
Intimacy and achieving orgasm
Masturbating before sexual intercourse may also help some people achieve orgasm.
People who find it difficult to climax from sexual stimulation may find that masturbation warms them up to sexual intercourse. This may make it more enjoyable or make it easier for them to orgasm.
Masturbating with a partner before sex can also bring two people closer together.
For many people, masturbation is something done alone. However, masturbating with a partner is very intimate, and it allows each person to understand what stimulates their partner.

Masturbation before a workout: Is there any effect?

Masturbation before a workouMasturbation is a healthy and safe sexual activity that has links to numerous health benefits, such as pain relief and stress reduction. Opinions on how masturbation affects exercise vary, but there is not enough evidence to support one view over the other.
Some members of the health and fitness community are in a debate about the potential risks and benefits of masturbation before a workout.
Some people believe that masturbation can influence levels of testosterone, which plays a crucial role in promoting overall physical fitness. They also think that masturbation and other sexual activities can lead to improvements in mood and lower stress, which can indirectly improve physical performance.
However, other people think that masturbation adversely influences physical performance due to excess energy expenditure. Continue reading to learn about the possible benefits and side effects associated with masturbating before a workout.

How masturbation and abstinence affect testosterone
The debate about whether masturbation is beneficial before exercise seems to focus on how masturbation influences testosterone.
Testosterone is the primary male reproductive hormone, but females also produce it. It plays a crucial role in promoting physical fitness among both males and females. According to one animal study, it plays a vital role in muscle protein synthesis.
Another review that included studies on humans suggests that testosterone also plays a role in bone formation.
With that said, the question remains whether masturbation significantly affects testosterone levels.
What do the studies say?
Testosterone levels naturally increase during sexual arousal and decrease after orgasm, but it appears that masturbation does not significantly impact a person’s level of testosterone.
The findings of a 2001 study showed that orgasm due to masturbation did not affect plasma testosterone levels. However, the authors observed higher concentrations of testosterone in men who abstained from sexual activity for 3 weeks. This was a small study with only 10 participants.
In another early study from 2003, researchers observed that testosterone levels fluctuated minimally during the first 5 days of sexual abstinence, peaked at 7 days, and then remained constant. The findings of this study suggest that short periods of abstinence may result in temporary fluctuations in testosterone levels.
Benefits of masturbation
Although masturbation has little to no effect on testosterone levels, it may still benefit a person’s workout performance.
However, there is not enough scientific research to support a direct link between masturbation and better physical performance.
Current scientific research does suggest, however, that sexual activity may enhance people’s overall health.

A recent study on adults who had experienced a heart attack suggests that those who frequently engaged in sexual activity had better long term survival rates.
Hormones, such as dopamine, norepinephrine, and oxytocin, increase during and following sexual climax
. These hormones positively affect mood and could influence the mental aspect of exercise by improving a person’s frame of mind and motivation during a workout.
Side effects of masturbation
Masturbation is a safe sexual activity that has few, if any, long term side effects.
One 2016 review looking at sexual activity and competitive sports concludes that there is not any evidence to suggest that masturbation has a direct adverse effect on overall physical fitness or sports performance in males or females. Anecdotal evidence also indicates that having sexual intercourse about 10 hours before taking part in a sports competition may have a positive effect on performance.
Masturbating too frequently can lead to temporary side effects, including:
overly sensitive or tender skin near the genitals
swelling or edema of the penis
decreased sensitivity
fatigue
It appears that masturbation induces similar effects in both males and females. Engaging in sexual activity increases testosterone levels, reduces stress, and relieves pain.
Male and female bodies respond differently to testosterone. Males naturally have higher levels of testosterone than females, which leads to the development of some typical male characteristics, such as body and facial hair.
These characteristics do not usually occur in females producing normal levels of the hormone. Testosterone also plays an essential role in sperm production and egg development.
Currently, scientific research has not revealed a direct relationship between masturbation and exercise performance in males or females.
However, the findings of one recent study
suggest that regular sexual activity may improve levels of life satisfaction and enjoyment among older adults.
Summary
Masturbation has little to no direct effect on people’s workout performance. Although testosterone levels fluctuate immediately after orgasm, the change is temporary and unlikely to affect a person’s physical fitness.
Masturbation may stimulate the release of endorphins and other feel-good hormones. These hormonal changes can help reduce stress and improve mood.
People should structure their routines accordingly. If masturbating makes someone extremely tired, they may want to avoid it before a workout. Masturbating has few, if any, side effects.

t: Is there any effect?

Some Women Orgasm During Exercise

Some women reach orgasm during exercise, especially those that involve the core abdominal muscles, researcher Debby Herbenick, and J. Dennis Fortenberry, M.D., both from Indiana University, wrote in the journal Sexual and Relationship Therapy. Exercises most likely to be associated with female orgasms are abdominal exercises, weight lifting, spinning/biking, and climbing poles or ropes, the author added.
The researchers explain that “coregasm” – reaching an orgasm from exercising the core abdominal muscles – has been mentioned in the media for some time. However, they add that the findings in this latest study are new.

Herbenick said:Herbenick, and Fortenberry carried out online surveys which included 124 adult females who said they had had an orgasm while exercising, known as EIO (exercise-induced orgasm), and another 246 who reported having experienced exercise-induced sexual pleasure (EISP). They were aged form 18 to 63 years, the majority of whom were either married or in a relationship. Approximately 69% of them said they were heterosexual.The researchers found that:
Approximately 40% of those who had experienced an orgasm or sexual pleasure during exercise had done so at least ten times
Those who reached orgasm while exercising said they felt self-conscious when exercising in public places.
About 20% of those who experienced orgasm while they exercised said they were not able to control their experience
The majority of those who reached orgasm during exercise said they were not having any sexual fantasy or thinking about an attractive person during their experience
In the EIO group, 51.4% said they reached orgasm in connection with abdominal exercises they had done during the previous ninety days
26.5% of those in the EIO group linked their experience to weight lifting
20% of the EIO women associated their experience to yoga
15.8% of the EIO females linked their experience to bicycling
13.2% of the EIO women connected their experience to hiking/running
The most likely abdominal exercise to produce a female orgasm was the “captain’s chair”. The exerciser rests her elbows on padded arm rests with her back against a support – her legs hang free – she raises her knees upwards towards her chest several times.
Herbenick says that nobody is sure what mechanisms are involved during exercise to induce an orgasm or sexual pleasure. Future studies, hopefully, will be able to determine that.

The authors hope that women who experience either orgasm or sexual pleasure during exercise may feel, after reading about this study, that their responses are normal experiences.

Whether or not specific exercises may help improve a female’s sexual experiences was not an aim of this study. The authors caution readers to make no assumptions until other more specific studies have been carried out.Even though they had not set out to determine how common orgasms or sexual pleasure are during exercise among women, the authors believe it is not rare – in just five weeks they managed to recruit 370 adult females who had such experiences.

How do orgasms affect the brain? Study investigates

When it comes to the human orgasm, research has primarily focused on how this intense feeling of sexual pleasure has evolved. In a new study, one researcher has delved into a relatively understudied area of human climax: how orgasms affect the brain.Described as a powerful, pleasurable release of accumulated sexual tension, the orgasm is perceived as the epitome of sexual pleasure for both men and women.
During orgasm, an individual may experience a rise in blood pressure, an increased heart rate, heavy breathing, and rhythmic muscular contractions.
But while the signs and sensations of an orgasm might be clear, the underlying mechanisms of this sexual response – particularly its neurophysiological effects – remain uncertain.
Study author Adam Safron, Ph.D., of the Weinberg College of Arts and Sciences at Northwestern University in Evanston, IL, notes that the majority of research relating to the orgasm has focused on its evolutionary functions.
A study reported by Medical News Today earlier this year did just that; researchers suggested that the female orgasm once played a role in ovulation.
For this latest study – recently reported in the journal Socioaffective Neuroscience and Psychology – Safron set out to gain a better understanding of how the human orgasm affects the brain.

How rhythmic stimulation can induce a ‘sexual trance’
To reach his findings, Safron analyzed an abundance of studies and literature that have investigated the brain and body’s response to sexual stimulation.
He used the information to create a model that sheds light on how rhythmic sexual activity affects rhythmic activity in the brain.
Safron explains that rhythmic sexual stimulation – if intense enough and if it lasts long enough – can boost neural oscillations at correlating frequencies, a process called “neural entrainment.”
This process may be responsible for what Safron describes as a “sexual trance,” where sole focus is on the immediate sensation experienced.
Brain responses to orgasms and rhythmic music, dance are comparable
Interestingly, Safron also identified similarities between orgasms and reflex seizures, noting that both of these experiences can be triggered by rhythmic stimulation that induces rhythmic activity in the brain.
Additionally, the researcher found that the way the brain reacts to rhythmic sexual stimulation is comparable to the way it responds to rhythmic music and dance.
“[…] although obvious in retrospect, I wasn’t expecting to find that sexual activity was so similar to music and dance, not just in the nature of the experiences, but also in that evolutionarily, rhythm-keeping ability may serve as a test of fitness for potential mates,” says Safron.
He adds that rhythmic music and dance have served as a key part of mating for hundreds of millions of years, and his findings are consistent with this fact.
Safron says much more work needs to be done to fully understand the neurophysiological effects of orgasms, but he hopes his study paves the way for such research.
“Before this paper, we knew what lit up in the brain when people had orgasms, and we knew a lot about the hormonal and neurochemical factors in non-human animals, but we didn’t really know why sex and orgasm feel the way they do,” he says. “This paper provides a level of mechanistic detail that was previously lacking.”

Masturbation: Do Boys Do “It” More and Better Than Girls?

One might argue that given the context of Sweden’s high degree of gender equality, an open and positive approach to sex education, and sexually liberal attitudes, that anything Swedish adolescents might say about sexual issues will not be applicable to U.S. adolescents. Any differences between Swedish and American youth might be the result of reporting styles—perhaps just as many American youth masturbate and begin doing so at about the same age but they are less likely than Swedish youth to report it given the more conservative sexual attitudes and values of American culture. On the other hand, those same attitudes/values might inhibit not only reporting masturbatory activities but also might actually prevent some adolescents from engaging in masturbation, experiencing orgasms, or having positive feelings about their orgasms.

What did Swedish high school seniors report (Driemeyer et al., 2017)?
Over 3,000 seniors (mean age 18.3 years) from public and private schools completed an anonymous questionnaire regarding various aspects of sexual attitudes and behaviors. Nearly all boys (98.9%) and most girls (85.5%) reported that they had masturbated, usually beginning during early adolescence. Most youth had positive attitudes about masturbation and enjoyed the experience. There were several differences between boys and girls.

Boys
1. Began masturbating a year earlier than girls—12.5 versus 13.7 years of age
2. Were more likely to have fantasies during masturbation
3. Were more likely to orgasm during masturbation
Girls
1. Were more likely to experience their most pleasant orgasms during masturbation
2. Were more likely to use objects such as sex toys and vibrators during masturbation

Three Clusters of Masturbation Experiences
The authors found three clusters of adolescents.
The first typified the majority of both boys and girls: they had positive attitudes about masturbation and orgasmed during masturbation. However, their preference was to have orgasms during “other activities” (sex). Some of those who preferred their orgasms alone might have felt this way because they “use a certain technique during masturbation that cannot be, or is not intended to be transferred to sex with a partner.”

The second cluster, characteristic of a minority of boys and girls, was generally the inverse of the first.
The third was experienced by about one-quarter of the girls: they had the lowest frequency of orgasms during masturbation, more orgasms during partnered sex, positive attitudes about masturbation, fantasies and object use about average, late onset of masturbation, and a large number of sex partners. Though orgasm frequency was low, their attitudes toward masturbation remained positive. The authors speculated that these sexually active and open-minded girls connected sexual pleasure (including orgasms) to romantic relationships rather than to solo sex.

Reflections
Although it’s difficult to directly compare these Swedish students with populations of adolescents from other countries and previous generations, the general patterns were consistent with what we know. It is worth noting that the questionnaire administered would be extremely difficult to give in many U.S. school districts because of our fears about asking youth about their sexuality—at least without parental approval.

Although there is value in these massive questionnaires given anonymously, I believe that we should supplement them with in-depth discussions/interviews with adolescents about their sexuality, including masturbation. For example, here are questions that I asked young men regarding their first masturbation:
•How and when did your first masturbation occur? What happened to provoke it? What were the circumstances?
•What did you do?
•Did you fantasize? What was the content of the fantasy?
•How did you learn how to masturbate? Who taught you?
•How did you feel afterwards?
•Who did you tell? How did they react? Why did you choose to tell or not tell others?
•Did this lead to future masturbation? Why or why not? Please elaborate.
•What were the impacts of these activities for you then and now?

I have discovered little information about these issues—for boys or girls. No surprise here.
My hope is that adolescents of all “clusters” will feel, in the words of the authors, “more entitled to experience sexual pleasure just for themselves without feeling selfish, guilty, or dirty.”