Sexuality and contraception
By providing you with the following information about how your body works as well as sexuality and contraception, we would like to motivate you to talk to our counsellor and ask any questions you may have. Male counsellors are also available to talk to men seeking advice.
How a woman's body works
It is essential to know how the reproductive organs of the body work, not just in terms of health and a satisfying sex life, but also in order to plan and avoid pregnancy. Women have both internal and external genitalia. The external genitalia, also called the vulva, are the labia, the opening of the vagina and the sensitive clitoris. If you have undergone FGM or female circumcision, it is advisable that you discuss this with your pregnancy counsellor before visiting a doctor, during pregnancy and before giving birth, so that they can get you in touch with a male/female experienced gynaecologist or midwife who understands your situation. The hymen at the opening of the vagina differs from one woman to the next. Its condition is not a reliable indication of whether or not a woman is a still a virgin.
The internal genitalia are well protected inside the lower body. The vagina leads to the cervix that is connected to the ovaries by the fallopian tubes. The ovaries contain a reserve of egg cells that are used up over the course of a woman's life. In the monthly menstrual cycle, one egg cell matures and passes through the fallopian tube to the cervix. On its way there it can be fertilised by a male semen cell. The fertilised egg embeds itself into the thickened lining of the uterus (endometrium) and a baby develops. If the egg cell is not fertilised, the endometrium disintegrates during the woman's next period (during this time, women in Germany usually use tampons or sanitary pads which you can buy in supermarkets and drugstores).
How a man's body works
The visible male genitalia are the penis, the sensitive glans and the testicles. Millions of sperm cells are produced in the testicles. Glands inside the body form fluid that transports the semen cells and keeps them moving when they leave the man's body during ejaculation.
Sexual intercourse
When both partners are sexually aroused, the man inserts his erect penis into the woman's vagina. This intimate act can be both physically and mentally very satisfying. Unprotected sexual intercourse and any other sexual activities during which semen cells enter the vagina or come close to the opening of the vagina can result in pregnancy.
Sexual self-determination
All sexual acts must be self-determined and voluntary. Every women and every man must decide for themselves who they want to share their sexuality with and how. Sexual violence, even in marriage, is forbidden in Germany. Nobody can be forced to partake in sex or to marry a certain person. It is not permitted for adults to have sex with children or adolescents under the age of 16.
Fertile and infertile days
Menstrual cycles can differ from one woman to the next. The fertile days when a woman can become pregnant are roughly two weeks before menstruation begins. The egg cells have a fertilisation window of only 12 to 24 hours while semen cells can survive up to between 4 and 7 days in a woman's body. This means a fertile phase that lasts just a few days and is very difficult to determine, especially for women with an irregular menstrual cycle.
Getting pregnant
If a couple want to have children, it is important to have vaginal sex (through the vagina) without a condom. If the woman has still not become pregnant after one year of unprotected sex, the couple should consult a doctor.
Sex education
In Germany, children and adolescents are appropriately educated by their parents, but they are also taught about how their bodies work and about sexuality at school.
Contraception
If a woman does not want to become pregnant, there are various types of contraception to choose from. The pregnancy counsellor or gynaecologist can advise you on issues of reliability, costs and health effects.
The pill is a hormone preparation that prevents ovulation. It is a very reliable form of contraception, but it does have some side-effects.
The copper or hormonal IUD is inserted into the cervix where it restricts movement of sperm and prevents the fertilised egg cell from embedding itself in the uterus. It is particularly suitable for women who have already given birth to children.
The contraceptive implant, 3-monthly contraceptive injection, the contraceptive patch or vaginal ring are all hormone-based contraceptives that are very reliable when used correctly.
A diaphragm is a flexible dome-shaped cap that is combined with a spermicide and placed at the opening to the uterus in the vagina. Correct use also determines the reliability of this type of contraception.
Natural methods, such as measuring temperature or monitoring cervical mucus, do not provide reliable protection against pregnancy. 'Being careful', i.e. coitus interruptus, is also not a reliable form of protection.
Condoms are the only means of contraception, apart from sterilisation, used by men. Used correctly, condoms provide reliable protection against unwanted pregnancy and additionally protect against HIV and other sexually transmitted diseases.
The 'morning-after pill' is an emergency measure that is taken as early as possible, no later than 3 to 5 days after unprotected sex and prior to ovulation. This 'morning-after pill' delays ovulation by several days.
HIV infection can happen when a sufficient quantity of the virus enters the body (through blood, seminal fluid, vaginal secretion, breast milk, as well as during sexual acts involving injuries to the genitalia, the anus during anal sex or the mouth during oral sex). Condoms provide protection! A woman who is pregnant, giving birth or breast feeding can infect her baby. There are drugs available to prevent the baby from becoming infected. In this situation, the woman should seek medical advice.
Condoms also protect against sexually transmitted diseases, such as syphilis, gonorrhoea or hepatitis B.
More information is available in different languages on the www.zanzu.de and www.bzga.de web portals of the Federal Centre for Health Education (BZgA).