Views on Sex: A Historical Outlook

Reproduction has always been an essential key in the flow of life, and this goes for all living beings. Throughout the centuries of humankind, we have viewed it through various historical and cultural views. Let’s look at the historical views on sex and how it evolved.

- Divine or Biblical View

In the Divine or Biblical view, reproduction resulted from God’s words: “Be fruitful and multiply and replenish the earth.” Children are seen as a gift from God. Sex could be viewed as a double-edged blade. On the one hand, it was a task assigned to humans by God, and on the other, it was a temptation led by the devil resulting in infections and accidents in pregnancy. Various Gods worshipped over the times were divine figures dedicated to fertility. There’s the Egyptian Goddess Nephthys and the Grecian Goddess Aphrodite.

- Societal View

In the societal view, reproduction is deemed necessary. When human beings took a step away from the hunter/gatherer phase and into an agrarian society, it was essential to multiply as it was a time of development. With war and the formation of societies, a steady inflow of human resources was needed.

- Modern View

In the modern view, we are going through another “Sexual Revolution” similar to what occurred in the 60s to 70s. With the rise of various sexualities, feminism, and new forms of contraceptives, the act of reproduction is no longer needed by some. Some of the new generations are even set on not having children in these circumstances. Sex by then is mainly viewed as something to enjoy or express one’s self.

The saying “the only constant is change” has been proven repeatedly, and humankind has reached yet another stage in its approach towards reproduction. Of course, many views remain today in different people, but different norms have been applied in the past. This was the historical outlook on the views of sex. How about through your eyes? In your perspective, how do you see the concept of sex?

by Barry Verkauf

Why Women Prefer the Pill Over LARC?

The introduction of the contraceptive pill to mainstream America in 1960 gave women vaunted freedom over their bodies. 

However, like any other drug, some unwanted side effects can occur making their use for some unpleasant. There were reports that artificial estrogen led to blood clots in some women subjects. You can add incidents of nausea, vomiting, and sometimes breast pain to the list. Many women cited freedom of choice in the search for an alternative to the pill. Ultimately one of the devices that turned heads was the LARCs or long-acting reversible contraceptives that include intra-uterine devices (IUDs) and contraceptive implants.

Intra-uterine devices (IUDs), first introduced in 1909 in Germany, has a slow acceptance history. It even gained a notorious reputation because of the failed Dalkon Shield device in the 1970s when reports of infertility, pelvic infections, and sepsis came to light. It took until 2013 before IUDs became popular again after much-safer versions were released in the market. Although LARCs are said to be highly effective and are considered set-and-forget contraceptive devices, they lag behind the pill in usage.

A big deterrent to the use of LARCs is the cost of the procedure. The insertion may or may not be covered by Insurance. Its removal, when the woman changes her mind, is sometimes not. Some women also do not feel comfortable with an alien device embedded inside their bodies. These and a variety of other reasons make women prefer the contraceptive pill over the LARCs.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

In Vitro Fertilization and Surrogacy - Is It Time?

 In vitro fertilization (IVF) has been the subject of moral and ethical debates since July 25, 1978. It was the date when Louise Joy Brown, the first successfully born baby under the procedure, was introduced to the world. The debates continued to rage when IVF became a vehicle for gestational surrogacy. It is an accepted fact, however, that, for a woman with a damaged uterus, underlying heart condition, or who went through a hysterectomy, IVF and surrogacy may be her only chance to have kids.

IVF is one of the more popular forms of assisted reproductive technology (ART). It involves a minor surgical procedure called follicle aspiration to remove a woman’s eggs from her ovary. The eggs are made to undergo fertilization in a laboratory setting. The resulting embryo is inserted back into the womb 3 or 5 days after. In gestational surrogacy, the surrogate woman receives the embryo in her womb instead of the woman who was the source of the aspirated eggs. The surrogate woman or birth mother carries the child in her womb until its birth. She releases the baby to the biological parents, afterward, following their surrogacy contract.

It is reported that about 750 babies are born every year through gestational surrogacy. With this number of births, it is safe to say that both gestational surrogacy and IVF are here to stay. Though hounded by controversy at every turn, they have become a source of hope for women who cannot conceive naturally.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

How Safe is Sex?

Sex or copulation is the primary tool for the reproduction of the human species. The young man across the street and his girlfriend next door wish that having sex could be structured, in such a way, that there is no attendant risk to it. However, unwanted pregnancies and incidents of sexually-transmitted diseases do occur. These make sexual contact less appealing for some. With the unprecedented advances in technology, what progress have we made in the area of birth control? It seems to be a lot if we based it on the data for the period 2015-2017 of the National Survey of Family Growth. It showed close to 47 million or 64.9% of women in the US in the 15-49 age category using some form of contraception.

Female sterilization or tubal ligation is the most preferred method of birth control at 18.6%. Although it involves a surgical procedure to seal or block the fallopian tube, it is popular because it does not affect sexual libido and does not have the side effects of other methods of contraception. Oral contraceptive pills came in close at 12.6%, mainly because of their convenience and affordability.  Long-acting reversible contraceptives (LARCs) like IUDs were at third with 10.3%. Bringing up the rear is the ever-reliable male condoms at 8.7%.

One can enjoy sex and stay away from unwanted pregnancies by using proven contraception methods. Be well-informed of the advantages and disadvantages of each, however, before making a choice. It is your body, after all.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

What is Holding Back Assisted Reproductive Technologies (ART)?

 According to the Center for Disease Prevention and Control (CDC), 1.9% or 73,254 of the 3,855,500 infant births in the US in the year 2017 were made possible with the use of Assisted Reproductive Technologies (ART). ART is a myriad of procedures that involve the removal of a woman’s eggs from her ovary, the eggs fertilization with a man’s sperm in a laboratory, and the re-insertion of the embryos that form into the woman’s uterus or to that of a surrogate. In vitro fertilization (IVF) is the leading example of ART. Variations have emerged like gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT). Cryopreservation of embryos is an important aspect of ART.

Despite its successes, ART is not yet widely used. One of the main reasons is the cost. A round of IVF will cost $12,000 that is above the reach of ordinary individuals. If the implantation of the embryo is not successful on the first attempt, more rounds will be needed, and the cost escalates. Other than the cost, ART can lead to multiple pregnancies. In the 2017 data, 14.7% of multiple births (twins, triplets) in the US were attributed to ART. Lastly, the emotional toll on failed ART rounds is high. It can lead to extreme anxiety and depression.

ART will continue to play a role in the future of reproduction. To make this a reality, there should be a concerted effort from all stakeholders to address the concerns that are holding ART back.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

Sex, Reproduction, and the Meaning of Life

 Reproduction and propagation of the human species are increasingly leaning toward advanced methods of assisted reproductive technologies, otherwise known as ART.  Under this increasing scenario, a mere skin biopsy from an individual can lead to the normal birth of his clone. With ART as the backbone of human reproduction, sexual copulation for some could graduate into just another form of entertainment.  

Assisted reproductive technologies encompass a gamut of procedures that involve the surgical removal of eggs from a woman's ovary, the subsequent artificial insemination of the egg with sperm in a laboratory setting, and the implantation of the embryo back into the woman's body or into another woman who agrees to be a gestational carrier.  In vitro fertilization as well as freezing and preservation of eggs, sperm, and embryos, are the more widely known aspects of ART.  Because the process can involve genetic testing before the implantation of the embryo, it is a widely held view in the scientific circles that we will eventually start to remove abnormal genes in embryos and/or introduce new ones to improve the quality of life using gene-editing technologies.  

The continuing advances in human reproductive technologies that stare us keenly in the face have caused us to recalibrate our view on sex and reproduction.  Could these eventually alter our beliefs on the meaning of life and what it means to be fully human? 

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

The Pill: How to Make Love Without Worrying About Your Future – Sex and Science

The 1960s was a turning point for a sexual revolution in the United States.  Still reeling from the horrors of the Second World War and the 1930s depression, people in the United States and elsewhere were trying to bring normalcy to their lives and focused on family life.  As a result, the U.S. population shot up from 140,000,000 in 1945 to 180,000,000 in 1960, a dramatic 22% increase.  To answer the unprecedented population growth, the introduction of synthetic progesterone, more commonly known as the birth control pill, was approved by the FDA in 1960.  As a consequence, the introduction of synthetic progesterone and estrogen, coupled with the stirrings of the second wave of women's liberation, gave impetus to heightened sexual liberation for both men and women. At the same time, it enabled women to begin to stand toe-to-toe with men in asserting their rights and desires.

The newfound readiness to engage in sexual activity without worrying about pregnancy made women realize that they could be more in control of their destiny.  The birth control pill, and subsequent effective contraceptives, brought on a new sense of hope and desire among women to realize long-held dreams.  More women entered college, finished their academic degrees, and opted for advanced education.  Currently, there exists an equal number of women and men in medical and law schools.  Many women, having completed their education or often without completing them, entered the workforce and occupied positions traditionally handled by men.  In the hallowed halls of the Fortune 500, 41 women CEOs now occupy the pole position, an all-time high.

However, there were unintended consequences that came to the fore after the introduction of the pill. In 1960, there were 1600 births per 1000 women-years in this country. In 2015, that had dropped to 600 births per 1000 women-years.  Some have expressed concern that with an aging population we will not have enough of a younger population to support and serve the country.  Moreover, women have delayed marriage and childbearing increasing the likelihood of infertility becoming a potentially difficult issue for them to deal with as they age.  Thus, the "contraceptive pill" has affected American lives and society in more ways than can be imagined.  It has opened up a world of possibilities, especially for women.  No longer is sex and pregnancy the limiting factors they once were.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

In Vitro Fertilization-How to get Pregnant without Sex

The birth control pill, and other subsequent contraception, when used appropriately, prevent unwanted pregnancy. For pregnancies which occur and are not desired in the United States, Rowe versus Wade provides opportunity for termination of these pregnancies.  For most couples, pregnancy is a choice they desire, although for some it is as difficult to achieve as scaling Mount Everest. Over time, infertility has generally affected 11 to 15 percent of the population and may be contributed to by damaged fallopian tubes, difficulties with ovulation, inadequate sperm production by the male, and a few other issues.  While improvements in treatment methods of these deficiencies in recent years have increased their efficacy, only about 50% of infertile couples will conceive with their use.  Like a ray of light bursting in with hope, in vitro fertilization (IVF) came onto the scene with the first spectacular live birth in England, initiated by Drs. Edwards and Steptoe in 1978.  In the United States, under the aegis of Drs. Howard and Georgeanna Jones, America's first IVF pregnancy occurred in 1981 in Virginia. 

IVF involves the surgical collection of a woman's eggs and a man's sperm for fertilization, usually by masturbation, and fertilization occurs in the laboratory in a dish.  The resulting embryos are subsequently transferred into a woman's uterus for the pregnancy to proceed.  It may sound like a simple procedure, but it is not.  It is sufficiently convoluted that it requires the skill of a cadre of clinical, laboratory, and radiologic personnel.  The cost is usually about $18,000 per attempted cycle in the United States.  Each attempt has its emotional toll, as well. Nevertheless, it is sought after by most couples who do not conceive with simpler treatments.  IVF accounts for about 2% of babies born in the United States currently.  

It is said that when one door closes, a window somewhere opens. This seems to be the case with IVF, a welcome potential window for couples who can't conceive using traditional therapy methods.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America