Healthy Sexuality

Healthy Sexuality


Sometimes we avoid certain topics because they are uncomfortable. Sex and sexuality are two topics that are often uncomfortable to discuss with others, but they can be important to consider and discuss, especially with sexual partners and/or medical providers. Talking about these topics often gets easier with practice.

How do I find the right words to use?

Finding words that you and your partner(s) are comfortable with can be a challenge. It is also important to define ambiguous terms so that everyone is on the same page. For example the word abstinence, for some individuals, means no vaginal-penile intercourse but does include “outercourse” where someone engages in everything but penetration. For others, abstinence means no genital contact. If one partner was using abstinence in a sentence, such as “I think we should practice abstinence,” the meaning would be unclear unless they discussed the definition of abstinence. Additionally, having a clear understanding of terms is important for gaining consent.

How can I communicate intimate thoughts to my partner?

Discussing what is sensual or erotic to you is important. Telling your partner what does and does not feel good will make the sexual experience more pleasurable for everyone.  If you don’t know what feels good, it may be worth considering masturbation or exploring your sexual function on your own as well as with others.

Talking about what you find pleasurable may be easier during a time when you’re not physically involved because you are not distracted. Sometimes, describing what we like sexually may be difficult, so saying “Why don’t you try this? and I like it when…” Showing your partner may be the easiest and most comfortable way to communicate your sexual needs. You know your body better than anyone, so it just makes sense to communicate your sexual desires.

Due to the risk of sexually transmitted infections, it is extremely important to communicate about the sexual histories. Although you may be uncomfortable discussing such experiences, being understanding and nonjudgmental can help ease the tension.  Remember that many sexually transmitted infections have no symptoms so you or your partner may not be able to “tell” if there is an infection present and being passed from person to person.


Orgasm, or climax is often thought of as the pinnacle of sex, or the sole purpose of a sexual experience. This type of thinking can lead to unrealistic expectations that are difficult or even impossible to achieve. There is more to sexual activity than just orgasm. As a society, we have been conditioned to think of sex as vaginal-penile intercourse with orgasm as the goal. In reality, there are many enjoyable sexual activities besides intercourse, some of which may result in orgasm, some of which may not. The fun exists in the exploration.  Additionally, for many people with vaginas, penile-vaginal intercourse is not adequate to achieve orgasm.  Lots of other types of sexual touch are helpful to feel good including oral sex, fingering, or clitoris stimulation with fingers or toys. 

An orgasm is different for everyone, but typically an orgasm involves involuntary muscle contractions associated with a release of built-up tension or pressure within the pelvic area. What an orgasm feels like can vary by partner or by type of stimulation (sensation, penetration, touch) and is due to the different nerve pathways between and among people. Some people with vaginas say they can feel contractions in their vagina, uterus and rectum, whereas others experience just tightness and the sensation of having to urinate. Typically, people with vaginas require some sort of clitoral stimulation for orgasm.

An orgasm for a person with a penis can be (but is not always) associated with ejaculation. Having multiple orgasms is possible but requires a good understanding of your body. A common myth is that partners should achieve orgasm simultaneously. This is often difficult because some people require more time to become aroused than others and therefore more time to achieve orgasm.


What is libido?

This is a word we hear often, but what does it mean? Libido means sexual urge or instinct. You might also think of it as your sex drive.

What is a "normal" amount of libido?

Sexual urge, sex drive, or libido is different for everyone. There is no “right” or recommended amount of libido. Like many other aspects of your sexuality, your libido should be the amount of sexual urges and sex drive that feels right for you.

What affects a person's libido or sex drive?

There are a number of things that can affect someone’s libido, and they can differ from person to person and time to time. For example, for some individuals seeing a partner partially naked may do more to impact sex drive than seeing a partner fully nude. Body chemistry or pheromones may impact your libido, but we do not know the extent to which they influence sexual attraction or behavior in humans. The meanings of specific words or phrases along with hearing certain sounds, voices, and songs may result in an increase or decrease in sexual urges. Touch can also play a big role in libido as it has the most direct effect on sexual arousal and response. In addition to what we have included here, there may be a number of other situations, objects, scenarios, tastes, smells that you notice as affecting your libido. There is variation within and between individuals in terms of the factors that influence libido.

What can I do about a decreased sex drive?

It might be worthwhile to initially consider any life changes that could have led to a decrease in libido. Decreased libido might simply be the result of a busy time at school or work, added stress, hormonal changes, illness, or relationship troubles. Additionally, taking some kinds of medication can also impact your sex drive. If after considering these possible factors, you are still concerned, you should speak with a professional counselor, therapist or health care provider.


Most of us do not sit around talking about masturbation, or self-pleasure. Mis one of those topics that people rarely discuss. When it is mentioned, the remark often causes nervous laughter, which is unfortunate because masturbation is normal and natural for many people.  Many people masturbate, and many people find it a pleasurable, routine part of their lives.  Some people do not masturbate and that is OK too. 

Why don't we talk about masturbation?

Individuals approach the topic of masturbation in a variety of ways due to diverse personal and cultural beliefs. However, it is a topic that is worth learning about and discussing. It may be easier to tell someone else what feels good to us if we have taken the time to explore our own body and sexual potential.

Self-pleasuring is one way that we can get in touch with our bodies. It is a way to explore our bodies without having to worry about the needs and demands of a partner. Masturbation gives us time to discover what feels good to us.

What is masturbation?

Some people spend time touching their bodies or genitalia with their fingers or toys; others may lie still and contract the muscles around their genitalia. Still others don’t touch themselves at all and engage in mental stimulation- fantasies about locations, partners, positions. This is an individual process; what may be pleasuring to one person may not be gratifying to another. Once you’ve discovered what feels good, you can tell (or show) your partner after receiving consent. By knowing what turns you on, other sexual experiences can be even more satisfying. Just like everything else, some people don’t find masturbation enjoyable. Like other sexual activities, if it doesn’t feel good to you – mentally or physically – trust your feelings and don’t do it.


Common sexual concerns and questions

Many people have questions and concerns regarding their sexual health and activity. They wonder what is “normal”. They wonder what is considered a normal frequency for having sex. They wonder if their body works “right.”

Typically, we are born with sexual responses and desires. Sometimes, due to the environment, physical problems or negative sexual experiences, sexual functioning can be impacted and professional help is needed. Generally, all sexual activity is “OK” if between consenting adults and feels good physically and mentally.  If doing an activity that involves pain or dominance, it is important to obtain explicit consent and establish safe words prior to engaging in that activity.  It is a good idea to become familiar with the guidelines of explicit consent (see resources).


Recent studies have indicated that choking during sex has become more common among young adults, including college students. Despite what you may have heard (because there is a lot of misinformation out there), sexual choking is very risky and not safe, even when done with consent. This is because “choking” is actually a form of strangulation – even at light pressures – and it has been associated with short-term and long-term health problems. Being choked during sexual activities can cause neck pain, neck bruising, voice changes, headaches, and loss of consciousness. Although rare, its also the case that being choked/strangled can lead to airway collapse, cardiac arrest, stroke, and even death. We recommend avoiding this sexual practice. So what is choking? Choking involves restricting someone’s blood flow or air flow by placing one or both hands, fabric or another item across or around a person’s neck. Interfering with a person’s ability to breathe, or depriving the brain of blood flow and oxygen, can cause brain damage, and doing this repeatedly can cause cumulative brain damage that can be permanent. Additionally, if a person has difficulty breathing or speaking while being “choked” – or if they are starting to feel dizzy or disoriented – they may not be able to let you know if the choking has become uncomfortable, painful, or if they wish to stop. (Which could mean they cannot withdraw consent.) Many people who have been choked in sexual situations report feeling scared while it’s happening to them, but either being unable to tell their partner or else not telling their partners due to fear of upsetting them. If you are being choked during sex, it is OK to ask your partner to stop choking you. If you are choking your partner during sex, it is a good idea to stop choking them, and to explore other, less risky ways, to find pleasure. If a person loses consciousness from being choked during sex, they should let their nurse or doctor know. Also, if you experience any swelling on your neck from being choked during sexual activities, seek healthcare right away as this can be a potentially life threatening situation. If you have been choked without consent (even if the sexual activities themselves were consensual), you can speak with a confidential victim advocate or sexual assault counselor.

Some of the most common concerns we hear at the Student Health Center include:

  • What is consent?
  • I'm not sure if I have had an orgasm (climax, come). My partner thinks there is something wrong because I don't come every time we have sex.
  • My partner never comes during (vaginal) intercourse – what’s wrong?
  • I can orgasm more easily when I masturbate. Is that OK?
  • Is masturbation harmful?
  • Why does it sometimes hurt when I have sex?
  • Are all skin irritations due to STIs (Sexually Transmitted Infections)?
  • How can I extend the length of time from erection to ejaculation?

All of these can be discussed with a provider at the Student Health Center.



There are many excellent books written for people who are interested in learning more about sexuality or improving their sex life; some of the better ones are included below.

  • The Guide to Getting it On. Paul Joannides, The Goofy Foot Press, 1996, rev 2009.
  • Because it Feels Good: A Woman's Guide to Sexual Pleasure and Satisfaction. Debby Herbenick, Rodale, 2009
  • Drawn To Sex. Erika Moen and Matthew Nolan, Limerence Press, 2018.
  • You Know, Sex. Cory Silverberg, Seven Stories Press, 2022.
  • Queer Sex. Juno Roche, Jessica Kingsley Publishers, 2018
  • Doing it: Real People Having Really Good Sex. Isadora Al-man, Conari Press, 2001
  • Getting Off: A Woman’s Guide to Masturbation. Jamye Waxman, Seal Press, 2007
  • The Good in Bed Guide to: Anal Pleasuring. Debby Herbenick, 2011
  • Great in Bed. Debby Herbenick & Grant Stoddard, DK Publishing, 2012
  • Orgasms for Two: The Joy of Partnersex. Potter/Tenspeed/Harmony, 2003
  • Read my Lips: A Complete Guide to the Vagina and Vulva. Debby Herbenick and Vanessa Schick, Rowman & Littlefield Publishers, 2011
  • Sex Made Easy: Your awkward questions answered-for better, smarter, amazing sex. Debby Herbenick, Running Press, 2012
  • She Comes First. Ian Kerner, Harper Collins, 2009
  • Come as You Are. Emily Nagoski, Simon & Schuster, 2021
  • Becoming Orgasmic. Julia Heiman, Prentice Hall, 1988
  • For Yourself: the Fulfillment of Female Sexuality. Lonnie Garfield Barbach, Signet Books, 1975
  • The Good Vibrations Guide to Sex. Cathy Winks and Anne Semans, Cleis Press, 2002
  • The New Joy of Gay Sex. Charles Silverstein and Felice Picano, Harper Collins, 1992
  • The New Our Bodies, Ourselves. Boston Women’s Health Collective, Simon & Shuster, 1992
  • Sex for One: The Joy of Selfloving. Betty Dodson, Three Rivers Press, 1996
  • Sexual Awareness: Enhancing Sexual Pleasure. Barry and Emily McCarthy, Carol and Grof Publishers, 1993
  • The Whole Lesbian Sex Book. Felice Newman, Cleis Press, 1999


  • Go Ask Alice: Columbia University’s Health Question and Answer Internet Service
  • Dan Savage: The Stranger "Savage Love" column