Roundups Sexual Health

Sexual Health Roundup: The Sexual Power of Penicillin, the Importance of the First Time, and Testosterone Release

Martha Kempner

In this week's sexual health roundup: A pill may have led to the sexual revolution, but it was penicillin - not birth control; new research says the first time a person has sex really is important; and testosterone release is immediate upon mutual attraction. 

A Pill May Have Led to the Sexual Revolution, But it Wasn’t *The* Pill

A common refrain since the 1960s has suggested that the birth control pill was responsible for the sexual revolution. The argument tends to propose that the new-found control over their fertility took away the fear of pregnancy and gave women the freedom to explore their sexuality. A new analysis from economists at Emory University challenges this long-held notion and suggests that another pill—penicillin—was actually responsible for a more gradual increase in sexual behavior during the 50s and 60s. The analysis published in the Archives of Sexual Behavior points to the decrease in syphilis during the late 50s as the true beginning of the change in sexual norms.

In its primary and secondary phases syphilis causes sores on the mouth, vagina, or anus and rashes to appear elsewhere in the body. When it reaches its later stages, however, syphilis can cause a host of serious health problems including difficulty coordinating muscle movements, paralysis, numbness, blindness, and dementia. It can also damage everything including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Ultimately, this can lead to death. 

Penicillin, which can easily cure Syphilis if taken early, was invented in 1928 but not used clinically until 1941 when the military began using it treat infected World War II soldiers. Syphilis reached its peak in the United States in 1939 when it killed 20,000 people. As the use of penicillin grew, the incidence of and deaths from the disease shrank rapidly; from 1947 to 1957 the incidence fell by 75 percent and the death rate fell by 95 percent.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Andrew Francis, who conducted the analysis, theorized that the lifting of the fear of syphilis and death led to more risky sexual behavior in this country. He based this theory on simple economic principles

People don’t generally think of sexual behavior in economic terms but it’s important to do so because sexual behavior, just like other behaviors, responds to incentives.

To test his theory, Francis looked at data from the 1930s through the 1970s on three measures of sexual behavior: illegitimate births; teen births; and gonorrhea. He found that: 

As soon as syphilis bottoms out, in the mid- to late-1950s, you start to see dramatic increases in all three measures of risky sexual behavior. 

Francis noted that the parallels between this and the changes in sexual behavior around the AIDS epidemic—safer sex increased when the disease was at it scariest but the advent of antiretroviral therapies has led to decreased the risk and complacency. In fact, some of this complacency has undermined efforts to eliminate syphilis which seemed possible just a few years ago until the incidence began to rise again, especially in men who have sex with men. 

Francis concludes that:

Policy makers need to take into consideration behavioral responses to changes in the cost of disease, and implement strategies that are holistic and longsighted. To focus exclusively on the defeat of one disease can set the stage for the onset of another if preemptive measures are not taken.

New Research says the First Time is Important 

I’ve always resisted our society’s fixation on virginity and the “first time.” It probably comes from the years I spent reading abstinence-only-until-marriage curricula which refer to virginity as a “present” that can only be unwrapped once and suggest that doing it on any night other than your wedding night (which by the way is the most important day of your life) will be a disaster and ruin the experience, the wedding, and, most importantly, you. While I will never belief virginity is something you give to someone else, there is some good research that suggests your first experience is important.  

New research in the Journal of Sex and Marital Therapy suggests that a positive first time can set one on a course toward a happy sex life whereas negative experiences can lead to depression and other issues. Researchers at the Universities of Tennessee and Mississippi recruited 206 women and 113 men. They asked participants about the first time they had sex. Possible word associations included “anxiety,” “negativity,” “connection,” and “afterglow.” The also asked participants to rate how content they were with the experience or how much they regretted it. Researchers then turned to participants’ current sex lives asking them about satisfaction, general well-being, and sense of control. Finally, participants kept a sex diary in which they recorded their feelings about all sexual interactions.

The result found that positive first times “reliably predicted physical and emotional satisfaction in later sexual interactions.” Similarly, those who experienced anxiety and negativity during their first time were more likely to have lower overall sexual functioning.

The authors note that: “These results suggest that one’s first-time sexual experience is more than just a milestone in development. Rather, it appears to have implications for their sexual well-being years later.” 

As writer Lindsay Abrams points out on Atlantic.com, however, these participants were still young and that first experience was really not that long ago (at most seven years and at the least a few months). There are still years of sexual experiences ahead of them and it’s not clear whether this association with the first time will continue as it becomes a more distant memory. 

Speed Dating Boosts Testosterone

I was already married when the speed dating craze began but it always seemed like fun to me. I can imagine that presenting your best, most- interesting self, over-and-over again, could be an adrenaline rush (exhausting but fun). New research suggests that it also causes a rush of hormones.  

Researchers at the University of Michigan recruited 200 heterosexual men and women who participated in approximately 2,000 speed dates. Volunteers had their testosterone levels checked using a saliva swab two weeks before the date, then right before the date, and finally right after. The results are interesting: if both people on the date were attracted to each other, their testosterone levels went up. A one-sided attraction, however, did not result in higher testosterone levels.

Though these are preliminary results, the researchers theorize that the hormone may be released to “promote efforts toward establishing a relationship with the other person.” What I find most impressive, though, is our internal sense of when someone is returning our interest. We may try to kid ourselves that he or she might like us, but our pituitary glands seem to know right away. 

News Contraception

New Data: Most Teens Use Contraception the First Time They Have Sex

Martha Kempner

The Centers for Disease Control and Prevention released new data Wednesday that shows fewer teens, especially younger teens, are having sex, and the majority of those who become sexually active use contraception the first time they have sex.

The Centers for Disease Control and Prevention released new data Wednesday that shows fewer teens, especially younger teens, are having sex, and the majority of those who become sexually active use contraception the first time they have sex.

The data also shows that in the past few years, since it has become easier to access, more teens say they have used emergency contraception.

There has been a relatively steady decline in the percentage of teens who have ever had sex over the past 25 years. In 1988, 51 percent of females and 60 percent of males ages 15-to-19 reported having had sex compared to 44 percent of females and 46 percent of males in 2011–2013. Much of this decline reflects the behavior of younger teens who are delaying sex.

Most teenagers are having sex by age 19.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

In 2011–2013, 18 percent of males and 13 percent of females had had sexual intercourse by age 15, 44 percent of males and 43 percent of females had done so by age 17, and, by age 19, 69 percent of males and 68 percent of females had had sex at least once.

The vast majority of these teens (79 percent of females and 84 percent of males) use contraception the first time they have sex. Teens who wait until they are older to have sex are even more likely to use contraception their first time. For example, 93 of female teens who had sex for the first time at 18 or 19 used contraception, compared to 77 percent of female teens who were 17 or younger at first sex.

Almost all male teenagers (99 percent) who had first had sexual intercourse at ages 18 or 19 used a method of contraception, compared with 82 percent of those who were 17 and under at first sex.

Using contraception at first sex is an important indicator of future use. The data shows that young women who did not use a method of contraception at first sexual intercourse were twice as likely to become teen mothers as those who used a method.

Not surprisingly, the most common form of contraception used at first intercourse was the condom. Condoms are inexpensive and easily accessible. And, they are the only method of contraception that also protects against sexually transmitted diseases. Condom use is a nearly universal experience—97 percent of sexually active teen girls said they had used a condom.

The next most popular method was withdrawal, which had been used by 60 percent of sexually active teen girls, followed by the pill at 54 percent. Fifteen percent of sexually active girls had used Depo-Provera (sometimes called the contraceptive shot), 5 percent had used the ring, 3 percent had used intrauterine devices (IUDs), 2 percent had used the patch, and 2 percent had used the contraceptive implant.

One of the more interesting findings was the increased use of emergency contraception. In 2002, 8 percent of female teenagers who had ever had sexual intercourse said they had used emergency contraception, compared to 22 percent in 2011–2013. This 14 percent increase over a decade likely reflects increased access to this important method of preventing pregnancy.

Emergency contraception (EC) is a high dose of hormones, similar to those in birth control pills, that inhibit ovulation. EC can prevent pregnancy if taken within three to five days of unprotected intercourse. The sooner it is taken, the better it works, which is why advocates wanted this drug to be available without a prescription.

Efforts to win FDA approval for over-the-counter status took the better part of a decade. While advocates argued for easy access, opponents suggested that making it more readily available would increase promiscuity, especially in teens and young women.

In 2009, one of the available versions of EC—marketed as Plan B One-Step—was approved for over-the-counter sale, but only to women 17 and older. Younger women still needed a prescription. In April 2013, the age restriction was dropped to women 15 and older. In June of that year, the FDA—complying with a district court ruling—declared that Plan B One-Step would be available without a prescription for “all women of reproductive potential,” regardless of age.

The new data can’t show definitively that OTC access is the reason that EC use is up among teens, but many experts believe it’s a factor. Of course, experts note that rising use of EC is a bit of a double-edged sword. While it has likely helped prevent unintended pregnancy, it is also a sign that some young people continue to have unprotected sex.

Analysis Sexual Health

The State of Sexual and Reproductive Health in Belize

Charis Davidson

Despite its riches of natural and cultural diversity, Belize is not a paradise for all. Women face many unique challenges, including substantial barriers to accessing sexual and reproductive health information and services.

Cross-posted with permission from the International Planned Parenthood Federation (IPPF).

When picturing Belize, many people imagine beaches, snorkeling, and Mayan ruins. The Caribbean country is about the same size as the state of Massachusetts, and has a population of just over 324,000. The people who live in Belize are as diverse as its environmental attractions. Because of its natural beauty, Belize has become a popular tourist destination.

Despite its riches of natural and cultural diversity, Belize is not a paradise for all. Women face many unique challenges. According to the World Economic Forum’s measure of gender equality—which is based on women’s economic participation and opportunity, educational attainment, health and survival, and political empowerment—Belize was ranked 102nd out of the 135 countries in 2012. It falls second to last among the Latin American and Caribbean countries. The National Gender Policy in Belize states that women are recruited for jobs and promoted at lower rates than men, and they receive lower salaries and fewer employee benefits then men who hold the same positions. The lack of opportunities for women means they often find themselves financially dependent on their male partners.

In Latin America and the Caribbean, there is an expectation that in order to be masculine men should have many female sexual partners. Conversely, many women have little control over the situations in which they have sex. Women who engage in sexual activity outside of common-law unions or legal marriages often face severe social consequences, including being labeled as promiscuous or even expelled from school. On the other hand, boys and men face little stigma for their sexual activity.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

These contrasting cultural expectations for women and men create sexual and reproductive health challenges for people of both genders. They contribute to a lack of communication between partners about sex, and result in women being hesitant to seek sexual and reproductive health services. When men attempt to establish their masculinity by having sex with many partners, they place themselves and their partners at increased risk of sexually transmitted infections, including HIV.

Belize has the highest HIV prevalence in Central America. In Belize, HIV is spread primarily through heterosexual sex, and women make up almost half the cases of new HIV infections. In 2009, AIDS was the fourth leading cause of death in Belize.

Furthermore, when women are not able to control the terms of their own sexual activity, they are more likely to have unplanned and unwanted pregnancies. According to the Belize Family Health Survey, one in four pregnancies in Belize is unplanned, and almost half of these unplanned pregnancies are unwanted. Meanwhile, over half of the women in Belize who are not using any form of contraceptives do not wish to become pregnant.

By now it should be clear that women face substantial barriers to accessing sexual and reproductive health information and services in Belize. In Part Two of this series, you’ll hear some of the stories Belizean women shared with me about their experiences.


Over the course of a month in San Ignacio, Belize, I spoke with women about their experiences in their relationships and in their communities with regard to family planning. These women, whose ages ranged from 24 to 50, were open and generous when sharing their stories. We talked about a variety of things, like where they learned about sex and their experiences with pregnancy. Although their lives were different, there were similarities in every woman’s story.

When I asked Crystal, who was 24 years old, where she turned for information about sexual and reproductive health, she sighed and said, “Google.” Crystal didn’t have any children, but shared with me that she’d seen a lot of her friends panic when they learned they were pregnant.

“I think most for people, it’s more of a scary situation, rather than a joyful one,” she said. “They wonder what they’re going to do, and if the father is going to sustain the child.”

A Creole woman named Irene agreed. She’d become pregnant unexpectedly at 22 years old. “I really wasn’t making any decision,” Irene said, but took action after giving birth. She spoke to her sister, and then to a doctor. She started taking birth control pills to prevent another unplanned pregnancy.

“Being a single parent, I had to do something,” said Irene. “I thought it would be better not to have a lot of kids.”

When Teresa got pregnant at 19, she was pressured by her religious family to married the child’s father. Although she wanted to use contraceptives, her husband refused, saying family planning teaches women to make decisions that are the right of men. Teresa eventually left him and chose surgical sterilization.

Adela’s husband was also opposed to her using contraception. “My husband said I didn’t have the right to plan anything. He said if I had any time to plan, it was because I was having an affair. Two of my daughters were born in the same year. I was very unhappy.”

Maggie also became a mother as a teen, but when we spoke she was almost 50. Maggie didn’t learn about contraception until after she’d had eight unplanned pregnancies. She told me she wished she’d known how to prevent pregnancy earlier because being a single mother was hard. Maggie’s difficult experiences encouraged her to talk openly with her children about sex.

“My mom wasn’t the sort of person to teach us about birth control, and she wanted to choose a boyfriend for me who I didn’t like,” said Maggie. “I always advise my children, ‘Don’t have a lot of kids, and use birth control.’ My second daughter is 20 and doesn’t even have a boyfriend. But it’s her choice not to have a boyfriend. I don’t stop her. I just tell her to be wise.”

All of the women I spoke with wanted a better future for their children. They believed strongly that their children—especially their daughters—should have access to sexual and reproductive health and services, and the right to choose loving partners. Most of all, they hoped that the next generation of women could avoid the obstacles they had faced in their own lives.

The names in this article have been changed to protect the privacy of these women.