Scientific selection of the timing and frequency of sexual intercourse, and the types and selection of sexual positions.

177.

Scientific selective intercourse time

The most common and most popular time to sleep is before falling asleep at night. This avoids psychological stress caused by external interference and allows for sufficient rest, which is beneficial for physical recovery.

However, if both partners work all day and feel tired and exhausted after get off work, they should rest and sleep first, and then have sex after their bodies have recovered, in order to avoid premature ejaculation and other problems.

If you are physically weak, you can choose to have sex on the night before your day off.

Depending on the specific circumstances of both partners, they can freely choose any time as long as it is conducive to harmonious sexual life.

The following principles apply to the selection of time:

(1) Sexual intercourse is strictly prohibited if either party has an incompletely cured sexually transmitted disease.

(2) Sexual intercourse is not advisable during the woman's menstrual period.

(3) Avoid sexual intercourse during the first three months of pregnancy, and also during the last three months of pregnancy and 6 to 8 weeks after delivery.

(4) It is not advisable to have sex after drinking alcohol, otherwise, if you get pregnant at this time, it is easy to cause fetal malformation.

If one partner suffers from a chronic illness, they should appropriately limit sexual activity based on their physical condition.

178.

Determine the appropriate frequency of sexual intercourse

This is a difficult question to answer: how many times should sexual intercourse be considered appropriate? It varies from person to person and is related to the age, physical condition, occupation, personality, and mental and psychological state of both partners. It is also affected by factors such as health status, emotions, feelings, climate, environment, and season. In other words, there is no absolute number for the frequency of sexual intercourse.

During the honeymoon period, sexual desire is relatively strong and sexual intercourse is more frequent. After a few months of marriage, most couples gradually adopt a regular sexual life of three or four times a week.

As both partners age, their libido gradually decreases, and the frequency of intercourse gradually reduces. Healthy young men and women can have intercourse more frequently, two to three times a week, while the elderly and those in poorer health should have longer intervals.

Harmonious and moderate sexual activity between couples can promote physical and mental health, but excessive sexual activity can have the opposite effect.

The frequency of sexual intercourse can be chosen based on the subjective symptoms experienced by both partners after intercourse. If, after intercourse, one feels refreshed, energetic, cheerful, relaxed, and without fatigue or other discomfort, then the frequency of intercourse is appropriate.

If you experience symptoms such as lethargy, mental confusion, fatigue, weakness, lower back and knee pain, palpitations, and poor appetite after sexual intercourse, it indicates that you have engaged in excessive sexual activity and should exercise restraint.

However, there are a very few couples who have frequent sexual intercourse after marriage, with both partners having plenty of energy and no particular discomfort, and even needing to have sex multiple times a night to be satisfied. This is called repeated intercourse, but the principle should be that they do not feel tired the next day.

How many times should one have sex? Ancient wisdom says, "A man in his twenties should ejaculate once every four days, a man in his thirties once every eight days, a man in his forties once every sixteen days, a man in his fifties once every twenty days, and a man in his sixties should abstain from ejaculation."

In short, the frequency of sexual intercourse varies from person to person, but it should not be excessive.

Excessive indulgence in sexual activity can not only cause discomfort and affect daily work, but also damage the body. Over time, it can lead to inhibition of sexual arousal in the cerebral cortex, resulting in erectile dysfunction, anejaculation, and other problems.

179.

Types and selection of sexual positions

Sexual positions or postures refer to the positions or postures that can be adopted when the male and female genitalia come into contact.

It has a great influence on the nature and intensity of sexual response. In normal sexual life, adopting different positions can make both partners feel physically and mentally comfortable, and make sexual life happy and harmonious.

Based on anatomical characteristics, sexual intercourse positions can be broadly categorized into three main types: front entry, rear entry, and side entry.

Different couples should consider the length, depth, shape, and position of their genitals when choosing a position.

In principle, any posture that feels comfortable and pleasant to both parties is acceptable; conversely, any posture that makes either party feel uncomfortable or somewhat strained should be avoided.

The most common position for male-female intercourse is the missionary position. However, in some special circumstances, the following positions may be used:

(1) On the wedding night, since the groom is nervous because it is his first time having sex, the traditional male-on-top position is appropriate.

(2) For those who are physically weak, chronically ill, elderly, or of different heights, the most effortless side-lying position can be adopted.

(3) To help the woman get pregnant, the position of the woman's uterus should be considered. If the woman's uterus is retroverted, the knee-chest position is recommended, which is conducive to the flow of semen to the cervix. If the woman's uterus is anteverted, the man-on-top position is recommended.

(4) During pregnancy, direct pressure on the abdomen should be avoided during intercourse. The male partner can adopt a sitting, squatting or side position.

(5) If both husband and wife are overweight, the wife can lie on her back with her buttocks on the edge of the bed, while the husband stands.

(6) If one of the spouses has lower back pain, the man should be on top and bear the weight with his elbows and waist to avoid putting his whole body on the woman; if the man has lower back pain, the woman should be in a knee-chest position and the man should be standing.

(7) If the husband has sexual dysfunction, the woman-on-top position is preferable.

(8) For couples where one spouse is disabled, appropriate sexual positions should be selected based on the physical condition of both spouses.

180.

The potential impact of surgery on male sexual function

Many surgical procedures can affect male sexual function, mainly by damaging essential components for penile erection, such as the nervous system, endocrine system, and penile circulatory system.

Some are even the result of a combination of factors.

(1) Testicular surgery: The testicles are an important human organ and, together with the penis, are a symbol of male masculinity. Therefore, the removal of the testicles due to many reasons such as trauma, deformity, tumors, etc. has a great impact on sexual function. Although some people believe that testicular removal in adults generally does not cause impotence, testicular surgery can often cause depression, such as low mood, low self-esteem, and personality changes, which can affect sexual function. Therefore, it is worth paying attention to.

(2) Vasectomy: Although physiologically this surgery does not affect the patient’s sexual ability, it often causes psychological pressure due to the influence of traditional concepts in my country. In particular, patients whose sexual function is already unstable are prone to sexual dysfunction after surgery. This sexual dysfunction is entirely caused by psychological factors. Therefore, this point should be explained to the patient before surgery so that they can have normal sexual life after surgery. For patients with doubts, it is best to choose other contraceptive methods.

(3) Prostate surgery: 4% to 30% of patients develop erectile dysfunction after prostate hyperplasia surgery.

Open prostatectomy often directly damages the arteries of the genitals and corpora cavernosa, leading to insufficient penile arterial perfusion, and the corpora cavernosa nerves are easily damaged; during transurethral surgery, urethral dilation can damage the urethra and corpora cavernosa of the penis, causing venous leakage, which are possible causes of erectile dysfunction.

Treatment for postoperative erectile dysfunction includes psychotherapy, oral medications (testosterone, yohimbine, etc.), intracavernosal injection of vasoactive drugs, and negative pressure suction.

Prostate cancer surgery mainly involves radical prostatectomy and pelvic lymph node dissection. However, due to the extensive removal of nerves and blood vessels around the prostate, 90% of patients lose their sexual function after surgery. Secondly, various types of radiotherapy for prostate cancer may cause impotence in patients after treatment, due to vascular fibrosis caused by radiotherapy or damage to pelvic nerves. Many patients with advanced metastases undergo orchiectomy or estrogen therapy because the decrease in testosterone levels and changes in the overall condition of patients with advanced disease can cause sexual dysfunction.

Treatment for these patients includes: penile cavernous body injection, negative pressure suction, repair of cavernous body venous leakage, and implantation of prostheses.

(4) Total cystectomy and urinary diversion: Similar to radical prostatectomy and pelvic lymph node dissection, it causes sexual dysfunction. In addition, the use of ileal bladder or sigmoid colon bladder, although not directly affecting sexual function physiologically, causes great mental stress and worries, which aggravates the occurrence of sexual dysfunction.

(5) Rectal cancer surgery: Similarly, postoperative functional disorders after rectal cancer surgery are easy to understand, mainly due to damage to pelvic nerves during pelvic lymph node dissection, and are usually proportional to the extent of dissection.

Therefore, before surgery, patients should be informed of the potential damage to their sexual function. During surgery, efforts should be made to protect the presacral nerves and pelvic nerves to reduce or avoid postoperative sexual dysfunction.

The treatment is the same as described above.

(6) Neurosurgery: Many types of neurosurgery can affect sexual function. For example, sympathectomy and lumbar fusion can lead to anejaculation and impotence, which is caused by damage to local nerves.

While central nervous system (such as brain and spinal cord) surgery has saved many critically ill patients, it can also cause permanent impotence and ejaculation disorders. In comparison, men will experience a heavier psychological burden from the loss of erectile and ejaculatory abilities than women.

Therefore, when treating patients, doctors should not only emphasize the importance of erection, but also encourage them to achieve orgasm through other means.

(7) Abdominal fistula surgery: Many intestinal patients need to have an abdominal wall fistula after surgery and carry a fecal bag. Although the surgery will not cause the patient to lose sexual function, the patient and his/her partner’s aversion to excrement will affect their sex life. It is necessary to guide the partner to sympathize with the patient and choose an appropriate sexual intercourse method to change this situation.