**9. Adolescent sexuality**

Adolescent sexuality has received much attention in comparison to childhood sexuality. Teens are sexually active but they are hardly prepared for developing responsible sexual behavior. Adolescents reach physical maturity but they are cognitively immature to handle it. A teenager's primary source of exposure to sexuality related information is his or her peer group. Family dynamics may not be strong enough to guide the teenagers in developing healthy and non-risky sexual behavior [20].

Puberty is the time when sexual development can be much clearly delineated especially the physical changes. There is variation in age at which puberty begins although the onset is typically 18–24 months earlier when compared to boys [21]. The average age of first ejaculation in boys is 14 years (range 14–16 years). However, girls' breast development begins between 8 and 13 years of age; menarche starts at an average age of 13 years (age range 10–16.5 years). Adolescents acquire knowledge about sexual intercourse, contraception and sexually transmitted diseases. Adolescents get fondness for dating, kissing and petting; sexual fantasies are common. The issue of greatest concern for parents has been the age at which teens engage in sexual intercourse. The average age of first sexual contact has decreased rapidly. They may make sexual contacts including mutual masturbation and first sexual intercourse may occur in 75% by the age of 18 years. However in India as per National Family Health Survey (NFHS), males are mostly likely to have their first sexual intercourse between 20 and 24 years, whereas in females, the peak age at first sex is lower between 15 and 19 years [5].

Early onset of sexual intercourse affects the psychosocial development. Early onset sexual activity has been linked to delinquent behavior. Chances of unintended pregnancy are higher in teens who engage in sexual activity earlier. Teenage parents are at an economic disadvantage and are more likely to drop out of school. Authoritarian parents, poor communication regarding sexuality and having older siblings who are sexually active can facilitate early sexual activity. Rutter and Rutter refer to early sexual activity as a "turning point" which can change the course of a teenager's life. Understanding early sexual activity can help in planning intervention programs. Other factors which are associated with adolescents who are sexually active include: (1) less educated mother, (2) lower educational expectation, (3) presence of a boyfriend or girlfriend, and (4) higher age. Adolescents are at cross roads as far as sexuality is concerned. A wrong decision can have strong and negative economic and social consequences for the society at large and for the individual in particular. Sex education is an important area which needs to be taken seriously particularly for the adolescent age group [22, 23].

#### **10. Other factors influencing sexuality**

#### **10.1 Nutrition and sexuality**

Mediterranean diet which includes fruits, nuts, legumes, monounsaturated fats from olive oils, vegetables and whole grains is gaining popularity in the last few

**55**

**10.5 Sleep**

*Healthy Sexuality*

*DOI: http://dx.doi.org/10.5772/intechopen.92375*

careful monitoring and supplementation [24].

determined good marital satisfaction [25].

**10.3 Job, vocation and sexuality**

**10.4 Exercise and sexuality**

intervention for dysfunctions [27].

**10.2 Intelligence and sexuality**

decades. Studies have shown that these groups of foods improve or at least diminish the progression of sexual dysfunctions. Paleolithic diet which is an ancestral diet, before agricultural revolution is gaining more attention in the recent past. Paleo diet which includes lean meat, fruits, legume, plant based foods, restricted consumption of dairy, salt and sugar similar to Mediterranean diet have shown to be beneficial, but well-designed studies are not available. Vegetarian or vegan diet which can be classified as pesco-diet (absence of all animal products except fish), lacto-ovo-vegetarian diet (absence of all animal products except egg and dairy products), ovo-vegetarian diet (absence of all animal products except egg) and vegan-diet (absence of all animal products). Vegetarian diet has shown to reduce morbidity due to vascular causes, which in turn may help in healthy sexual functioning. Vegetarian or vegan diet may cause protein and vitamin B12 deficiency which can be prevented through

There is evidence for correlation between intelligence and the age at the first sexual contact. There is inverse correlation between intelligence quotient and the age at first sexual intercourse. Though there is evidence that more intelligent people have more sexual desire, but the frequency of intercourse is less. Emotional intelligence plays a key role in marital relationship. Knowledge, self-competence, secured attachment, emotional processing and self-compassion were few aspects which

Job stressors have significant impact on sexuality. It majorly depends upon the role the individual is having in the job. It depends on working ability of individual for that job. Work ability includes physiological and psychological ability of the individual to cope with the specific type of the job. The managerial and organizational support also played important role in job stress. Job stress significantly affected desire, arousal and orgasm phases of sexual response cycle [26].

Exercise releases hormones called endorphins, which has a feel good component as well as analgesic effects. Exercise may be acute as well as chronic exercise. Acute exercise increases metabolic rate, causes muscle activation and increases blood flow. Chronic exercise causes long lasting adaptation and improves performance. Acute exercise improves physiological sexual arousal through increasing sympathetic nervous system activity and endocrine factors. Chronic exercise increases sexual satisfaction by maintaining autonomic flexibility. Autonomic flexibility helps in maintaining cardiovascular health as well mood. Chronic exercise also gives positive body image which in turn gives sexual wellbeing. A couple of small studies have shown the effectiveness of exercise as

Adequate sleep is essential for normal sexual activity. Quality of sleep has significant impact on various phases of sexual response cycle. Desire is a motivational state which drives the individual to search for sexual activity, while arousal prepares individual physically and psychologically for sexual activity. Rapid eye

#### *Healthy Sexuality DOI: http://dx.doi.org/10.5772/intechopen.92375*

*Quality of Life - Biopsychosocial Perspectives*

sex is lower between 15 and 19 years [5].

particularly for the adolescent age group [22, 23].

**10. Other factors influencing sexuality**

**10.1 Nutrition and sexuality**

**9. Adolescent sexuality**

behavior [20].

among boys. There are few physical changes associated with sexual development before the onset of puberty. Just before the teenage years body changes begin, menstruation starts in females and boys may experience wet dreams; fantasizing about sex, interest in media sex, using sexual language with peers is observed [19].

Adolescent sexuality has received much attention in comparison to childhood sexuality. Teens are sexually active but they are hardly prepared for developing responsible sexual behavior. Adolescents reach physical maturity but they are cognitively immature to handle it. A teenager's primary source of exposure to sexuality related information is his or her peer group. Family dynamics may not be strong enough to guide the teenagers in developing healthy and non-risky sexual

Puberty is the time when sexual development can be much clearly delineated especially the physical changes. There is variation in age at which puberty begins although the onset is typically 18–24 months earlier when compared to boys [21]. The average age of first ejaculation in boys is 14 years (range 14–16 years). However, girls' breast development begins between 8 and 13 years of age; menarche starts at an average age of 13 years (age range 10–16.5 years). Adolescents acquire knowledge about sexual intercourse, contraception and sexually transmitted diseases. Adolescents get fondness for dating, kissing and petting; sexual fantasies are common. The issue of greatest concern for parents has been the age at which teens engage in sexual intercourse. The average age of first sexual contact has decreased rapidly. They may make sexual contacts including mutual masturbation and first sexual intercourse may occur in 75% by the age of 18 years. However in India as per National Family Health Survey (NFHS), males are mostly likely to have their first sexual intercourse between 20 and 24 years, whereas in females, the peak age at first

Early onset of sexual intercourse affects the psychosocial development. Early onset sexual activity has been linked to delinquent behavior. Chances of unintended pregnancy are higher in teens who engage in sexual activity earlier. Teenage parents are at an economic disadvantage and are more likely to drop out of school. Authoritarian parents, poor communication regarding sexuality and having older siblings who are sexually active can facilitate early sexual activity. Rutter and Rutter refer to early sexual activity as a "turning point" which can change the course of a teenager's life. Understanding early sexual activity can help in planning intervention programs. Other factors which are associated with adolescents who are sexually active include: (1) less educated mother, (2) lower educational expectation, (3) presence of a boyfriend or girlfriend, and (4) higher age. Adolescents are at cross roads as far as sexuality is concerned. A wrong decision can have strong and negative economic and social consequences for the society at large and for the individual in particular. Sex education is an important area which needs to be taken seriously

Mediterranean diet which includes fruits, nuts, legumes, monounsaturated fats from olive oils, vegetables and whole grains is gaining popularity in the last few

**54**

decades. Studies have shown that these groups of foods improve or at least diminish the progression of sexual dysfunctions. Paleolithic diet which is an ancestral diet, before agricultural revolution is gaining more attention in the recent past. Paleo diet which includes lean meat, fruits, legume, plant based foods, restricted consumption of dairy, salt and sugar similar to Mediterranean diet have shown to be beneficial, but well-designed studies are not available. Vegetarian or vegan diet which can be classified as pesco-diet (absence of all animal products except fish), lacto-ovo-vegetarian diet (absence of all animal products except egg and dairy products), ovo-vegetarian diet (absence of all animal products except egg) and vegan-diet (absence of all animal products). Vegetarian diet has shown to reduce morbidity due to vascular causes, which in turn may help in healthy sexual functioning. Vegetarian or vegan diet may cause protein and vitamin B12 deficiency which can be prevented through careful monitoring and supplementation [24].
