Man-on-top positions, in particular the “missionary” position, where the man lies between the woman’s thighs, are probably the most widely used of all the sexual positions. They give the man almost total control over intercourse, but the woman is allowed very little freedom of movement. Man-on-top positions are particularly good for couples who are just [...]

For numerous people, the anus and its surrounding area are very sensitive sexually, and for some it is their most erogenous zone. The anal region is well supplied with nerves that follow a similar pathway to the nerves supplying the penis and vagina. Anal stimulation, therefore, gives deep feelings of sexual pleasure unobtainable in other [...]

Discovering and exploring your partner’s erogenous zones should be loving, caring and thoughtful, not simply mechanical. Every woman should try to discover as much as possible about her man’s body, and every man should experiment to find out what exactly will please his partner. Couples should learn to excite each other slowly but surely, and [...]

Sexual relationships usually progress in small steps, with each of you giving and responding to signs of encouragement. Picking up on and responding to the other’s cues correctly will minimize any risk of your social responsiveness being interpreted as sexual encouragement. It is important, too, to know exactly what you want out of a relationship. [...]

As sexual excitement increases, the shape of the vagina changes in readiness for penetration. The inner two-thirds of the vaginal barrel lengthens and distends; in highly excited women, this distension is quite marked. The cervix and uterus are pulled backwards and upwards into the pelvis, further expanding the upper end of the vagina. At the [...]

Warts are caused by infection with human papilloma virus (HPV). So far more than 50 HPV genotypes have been described. Several genotypes are well characterised as occurring mainly in the genital tract causing various lesions including venereal warts or condylomata acuminata and microscopic changes in the epithelium of the cervix, vagina, vulva, penis or rectum. [...]

Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis (serotypes LI, L2 and L3) and is characterised by inguinal lymphadenopathy (buboes) and rectal strictures. Highest prevalence is in the tropics. LGV is rarely diagnosed in Australia but may be seen in people who have come from Asia or Africa. It may be underreported and misdiagnosed because [...]

The diagnosis of chlamydia is commonly presumptive but should be confirmed using laboratory tests. Direct detection using commercially available immunofluorescence or ELISA monoclonal antibody techniques permits rapid diagnosis. False positive and negative results occur; false positive results can be a problem, particularly in patients who deny risk of sexually transmitted infection. Results must be interpreted [...]

Urethritis may present with urethral discharge, tingling, itchiness and dysuria. Posterior urethritis may cause frequency and urgency. The discharge may be watery or sticky or thick and pumlent If the discharge is frankly purulent, the infection is more likely to be gonococcal. Meatal inflammation may be present particularly in gonococcal urethritis. The infection may progress [...]

The importance of pelvic inflammatory disease and its relationship to sexually transmitted infections, particularly gonorrhoea and chlamydia, are more clearly recognised. STDs such as donovanosis, chancroid and lymphogranuloma venereum mainly occur in tropical countries. Donovanosis is commonly seen in Papua New Guinea and is a common cause of ulcerative genital lesions in Aborigines in northern [...]