Girls ask – Experts answer

On this website you will find answers to questions from refugee girls about sexuality, desire and protection. Terms you don’t know, you can read again here:

Youth4Youth (girls ask) is also available as a bilingual brochure in German/Arabic, German/Dari. The boys’ edition is also available bilingual in German/Arabic and German/Dari.

The web versions in English (girls / boys) and Ukrainian (girls / boys) are also available in PDF format.

 

 

Menstruation, period, days

1. Why do I get my period?

 

For most girls, periods (also called menstruation) start between the ages of 11 and 15. They get their periods during puberty because their bodies are changing and producing sex hormones. This leads to the so-called menstrual cycle, which lasts about a month and begins on the first day of bleeding.

Here you will find more about the internal sex organs and the cycle.

At the onset of puberty, girls have about 400,000 tiny immature eggs in their ovaries. In the first 14 days after the start of the bleeding, hormones allow at least one egg cell to mature in the ovary. During this time, the uterus prepares for a possible pregnancy. The top layer of the uterine lining thickens, allowing a fertilized egg to implant itself.

Approximately in the middle of the cycle (two weeks before the period) the so-called ovulation takes place, an egg cell jumps out of its egg sac (follicle). The follicle turns into the corpus luteum. The egg is transported from the ovary into the fallopian tube, where it is fertile for around 12 to 24 hours[i]. The corpus luteum produces hormones that prepare the lining of the uterus for a possible implantation of a fertilized egg cell. If fertilization and implantation do not take place, the corpus luteum regresses. The egg cell dies in the fallopian tube. Hormone levels drop and the top layer of the uterus lining peels off. This causes bleeding about two weeks after ovulation. Then a new cycle begins. However, if the egg cell in the fallopian tube is fertilized by a sperm cell, it migrates further into the uterus and can nest in the mucous membrane there. Caution: sperm can survive up to seven days in the uterus, so the time span in which you can get pregnant is longer than the 12 to 24 hours mentioned above!

You can learn more about it here.

[i] BzgA (Hg): Ein kleines Wunder: Die Fortpflanzung, Fruchtbarkeit bei Frau und Mann, 2018, Auflage 4.8.07.18, S.6.

2. How many days does the period usually last?

The period is part of the menstrual cycle. The period itself usually lasts three to seven days. The menstrual cycle, on the other hand, covers the time from the first day of the period to the first day of the next period. A normal cycle lasts between 25 and 35 days.

In young girls, the menstrual cycle is often irregular. The body has to adapt to the changes. The duration, intensity and frequency of periods can vary greatly, especially during the first few years.

 

3. Is it normal to miss a period?

For girls going through puberty, periods are often irregular and can sometimes be absent, see question 2.

However, if your menstrual cycle has been quite regular for a long time and suddenly changes, it can be due to various reasons, such as stress, a change of location or weight loss. So you don’t have to worry. However, if the irregularity persists for several months, you should definitely have it checked out by a doctor.

If you think you might be pregnant, you should take a pregnancy test or see a gynecologist.

4. Can you use a tampon while still a virgin?

From a biological point of view, it is possible for all girls and women to use a tampon during menstruation. It doesn’t matter whether the girls have had sex or not. You don’t have to worry about your “virginity” either. The stretchy tissue at the edge of the vagina (vaginal corona) allows you to insert a tampon without causing injury, see question 17. Tampons come in different sizes. Try out which size tampon you are comfortable with. You can also simply use pads or other products.

5. Why don't boys menstruate?

Boys cannot have periods because periods require certain hormones, a uterus, fallopian tubes and egg cells. Boys don’t have any of that. Because of this they can also not bear children.

6. Why do women get mucus (discharge)?

The vagina is lined with a mucous membrane. All mucous membranes in the body need to be moist to stay healthy and protect them against infection, including those in the mouth and nose.

It is normal for women to have vaginal discharge, which means that some secretion (or mucus) comes out of the vagina. Normal discharge is whitish or yellowish and relatively odorless. How much discharge a woman has and what it looks like varies and also depends on the menstrual cycle. The discharge cleans the vagina and prevents infection. Lactic acid bacteria create an acidic environment and thus prevent harmful bacteria and fungi from multiplying. Therefore, you should not wash your vagina with soaps, vaginal lotions, or anything similar. They destroy the beneficial bacteria and make your vagina more susceptible to disease. Girls can also have a discharge before their first period because hormones cause changes in the body and signalize the first menstruation.

Also, when women are aroused and want to have sex, glands at the entrance to the vagina produce a liquid that acts like a lubricant. It helps that sexual intercourse does not hurt.

7. Why does menstrual blood have different colours?

The colour of blood changes during menstruation, for example it can be dark red, brownish or light red. On the one hand, this depends on the strength of the bleeding: on the days when the bleeding is heavier, the blood looks more light or dark red. At the beginning and end of menstruation, when it is weaker, the blood has more time to react with the oxygen and acidic environment of the vagina (see question 6) and is more brownish. Blood, mucous membrane particles and fluid from the vagina are also mixed in the menstrual blood in different compositions. The colour change is therefore completely normal.

8. Why do we have painful periods?

Not all girls are in pain. For some girls or women, their period comes without them noticing it before. Others feel a tugging in their lower abdomen just before their period or have a headache. Sometimes the breasts hurt too. During the period, some girls or women experience cramps or pain in their lower abdomen or lower back. This pain is caused by certain hormones. They ensure that the uterus contracts and can shed the mucous membrane during the period. Sometimes they also cause nausea and diarrhea. If you are in severe pain, you should see a gynecologist. This is also important to rule out that there are other physical causes behind the pain.

9. What can I do if I have problems with my period (e.g. stomach pain or headache)?

You can do anything that relaxes your body. It can be different for every girl. Exercise and sport often help to make your symptoms more bearable and your body to relax. Maybe just resting will help your body. You can, for example, put a hot water bottle on your stomach or drink some tea. Herbal teas such as chamomile, lemon balm or peppermint are useful. Some people find it helpful to change their posture, such as drawing one knee to their chest while lying down or sitting. You can also massage yourself.

If you often have very severe pain, you should speak to a doctor.

10. Can I have sex during my period?

Yes, if you feel like having sex during your period, the bleeding is no reason not to. Since bleeding is a natural bodily process, there is no need to feel unclean or ashamed. However, as you may also, under certain circumstances, become pregnant during your period, you should consider using contraception (see also question 11).

11. Can you get pregnant during your period?

Yes, it is possible for a girl or a woman to become pregnant through unprotected sex with a boy or man, despite menstruation. To be on the safe side, if you don’t want to get pregnant, you should use contraception for the entire menstrual cycle, including during your period.

That’s because most girls and women can’t tell exactly what day after their last menstrual cycle their next ovulation will occur. The maturation of the ovum can vary for each girl and from month to month. Sperm can survive in the uterus and fallopian tubes for up to seven days. So fertilization and thus pregnancy can occur if you have sexual intercourse during your period and your next ovulation is in less than seven days. You can find out more about this in question 1.

Sex for the first time

12. What is sex?

Sex is sexually arousing acts between people or with oneself (masturbation). For example, sex can include kissing, caressing, and hand or mouth satisfaction with the hand or the mouth. It is therefore more than sexual intercourse, i.e. the penetration of the penis into the vagina or buttocks. It is important that you like it and that it gives you pleasure. If you have sex with another person, then you both have to agree to it. It’s also okay to stop if you don’t like it anymore (see also question 22)!

13. Why do people have sex?

The need for sex is natural and an important part of our personality. This is influenced, for example, by our hormones, upbringing, society and personality. Sexual desire is individually different in every person and changes again in the course of a lifetime. Some people generally have little or no desire for sex.

People can use sex to express love, attachment, or desire. Through a pleasurable, satisfying sexuality, people can get even closer and strengthen their relationship(s). People also have sex to have children.

14. How does sex feel?

Sex can feel very different. During sex you can experience a lot of pleasure, enjoy, feel good or relax. Perhaps you feel desired, accepted, spoiled and very close to your partner.

You may also have an orgasm as the peak of sexual pleasure and excitement. After a phase of strong sexual tension, which increases more and more, there is a feeling of discharge, followed by a state of relaxation. But even without an orgasm, sex can be perceived as very beautiful.

Sometimes, however, sex isn´t so good, for example when you’re not in the mood, feeling tense, or uncomfortable. Then you can end it, or next time you’ll pay more attention to whether it feels good for you.

15. When is a good time for the first time?

You decide when is a good time for your first time. Trust your feelings and don’t let anyone push you! It’s normal to feel a little anxious and insecure. If these feelings are very strong, you may not be ready for sex yet. Maybe you should wait. But the first time can also be exciting and thrilling. It helps if you and your partner have enough time for each other and are undisturbed. Talk to each other about what you want and how you are feeling. For both of you, preparing for a suitable moment also includes getting informed and exchanging information about protection against unwanted pregnancy and sexually transmitted infections. Together you can decide which is the best option for you and who will take care of it, see question 34.

16. How will the first time be? How will the first time be for a man and how for a woman?

It may be that you experience the first time as exciting, beautiful, maybe even funny. But it can also be disappointing and hurt a little. Many girls and young women are anxious or nervous about it, but also curious. Your partner can feel the same way too. Again, you should talk about what you like and don’t like. Every person experiences the first time differently, whether man or woman.

17. Is it easy to lose or break the hymen?

No, because the so-called hymen is not a simple membrane, but a stretchy ring of mucous membrane, called the “vaginal corona”. This wreath surrounds the entrance of the vagina but does not close it. The vaginal corona looks different in every woman. Women who have had sexual intercourse also usually still have this vaginal corona. In women who have given birth, the vaginal corona is usually no longer visible as a complete ring. In everyday life, i.e. when doing sports, cycling, using a tampon and other activities, this wreath of tissue cannot be lost or damaged. Also a gynecological examination is possible without damaging the vaginal corona.

By the way: Other people, including a doctor, cannot tell from the appearance of the vaginal corona whether you have ever had sexual intercourse!

You can find out more about this here.

 

18. Do women always bleed the first time?

No, many women and girls do not bleed the first time. Sexual intercourse can cause small injuries to the vaginal corona or inside the vagina, which can then bleed easily. This can happen, for example, when the girl is tense or the boy is not careful enough. However, these small injuries heal without consequences and without visible scars.

Some think the bleeding indicates that the girl is still a virgin. You can find out why this is not true in question 17.

19. Can Sex Cause Pain?

Sex can be something wonderful and beautiful. Sex shouldn’t hurt! However, if you feel pain, this can have several causes. For example, intercourse can be painful if the woman’s vagina isn’t moist enough or the man isn’t careful enough. So men and women should always wait until the woman is ready to take the penis. Sexual intercourse can also hurt women when they are very tense or when they have a vaginal infection, for example.

When people have sex with each other, they should always make sure that the other person is doing well and if in doubt ask if this is the case. This applies to sex in general, not just for the first sexual intercourse!

If you frequently have pain during sex, talk to a gynecologist about it.

20. What happens after you sleep with a boy?

If you’ve slept with a boy, you may feel relaxed, or you may be disappointed if it wasn’t as good as you expected. Maybe you’re feeling more grown up. Maybe you´re also curious about how he is doing. With joy, curiosity and desire you can find out many beautiful things together. The same is true if you’ve slept with a girl.

If you’ve slept with a boy and you haven’t used birth control, you’re probably worried about getting pregnant. If necessary, the morning-after pill can prevent an unwanted pregnancy. You can find out more about this in question 34.

21. How long can a penis be?

A penis in a man can be between seven and ten centimeters when flaccid and up to about 19 centimeters long when erect.[i]

[i] BzgA (Hg): Wie geht’s – wie steht’s?!? Wissenswertes für Jungen und Männer, 2002, Auflage 25.150.05.18, S.12.

22. When are you not allowed to have sex?

You can only have sex if you both want it! You can’t have sex if either of you is under 14 years old. It is also forbidden for a teacher to exploit the dependency of a student who is under the age of 18. In addition, generally you cannot buy sex from someone under the age of eighteen. If someone is forced into a sexual act, that is violence and punishable! You can find more information here.

If you have a sexually transmitted infection (such as chlamydia or gonorrhea) and treatment is ongoing, you should not have sex.

Sex with yourself

23. Is masturbation good or bad for the body?

Masturbation does not harm your health! It is normal and helps you discover your own body. You can find out for yourself which touches you like and are exciting for you. You might also experience what an orgasm is. Knowing yourself is good and it helps later to experience a pleasurable sexuality with a partner. This also applies to boys.

24. Can You Lose Your Hymen Through Masturbation?

No. Many believe that girls who have never had sex have a membrane that seals the vagina and breaks the first time the penis penetrates, for example. We explain why this is not true in question 17.

25. If a girl touches and masturbates herself, is she no longer a virgin?

We speak of virginity when someone has never had sex with another person (boy or girl). Therefore, you do not lose your virginity by touching  yourself or masturbating. See also question 17.

What makes sex good?

26. Why is sex healthy for our bodies?

Sex can trigger feelings of happiness, promote blood circulation, relieve tension and strengthen the immune system. So when people have sex (with each other), it can have a positive impact on their health.

In order for sex to be healthy for you, it is important that you are participating voluntarily and with pleasure and that you protect yourself from illnesses and unwanted pregnancy, for example by using condoms.

27. How do I know if someone wants to kiss me?

Perhaps this person wants to be close to you and will respond to your offers to get closer. If you find the closeness pleasant and you like each other, you may want more, perhaps even a kiss. If you are unsure, you can also ask the other person if you can kiss them. This also applies to sex.

28. How do I know if someone wants to have sex with me?

There can be very different signs that you can use to tell if someone wants to have sex with you, see also question 27. Someone can make their own desire for you clear, for example through words or touch, or you recognise signs of your own physical arousal. If you’re not sure, you can also ask the other person if they want to sleep with you.

29. How do I know if I want to have sex?

If physical closeness and caresses feel great and your body craves for more, this could be a sign of sexual desire. Also, if you notice your vagina getting wet or your clitoris getting swollen, it can mean that you desire sex. Here you can see how the female sexual organs look.

30. How do you know if a woman is ready for sex?

A prerequisite for this is that the woman is aroused and feels a lot of pleasure. The inner and outer labia swell, the clitoris becomes slightly larger. This is due to increased blood flow to the sexual organs. For some, the breasts swell and the nipples become more prominent. Also, if the vagina is wet, it can mean that the woman is aroused. However, signs of physical arousal do not necessarily mean that girls or boys really want to have sex. Sometimes our body reacts differently than we want it to. For example, a woman’s vagina gets wet, but she doesn’t want sex. Or a person wants sex and their body doesn’t cooperate.

31. Why do people feel more inclined to have sex when they're drunk?

Alcohol initially has a disinhibiting and stimulating effect on most people. This can make them confident enough to approach other people and to feel and admit their own needs or desires more clearly. However, after a certain amount of alcohol, our abilities are impaired and we become increasingly tired, unfocused and less responsive. This affects our ability to have satisfying sex. Alcohol consumption can also lead to a loss of control. This creates the risk of something happening to us that we don’t want. We may also forget about pregnancy prevention and protection from sexually transmitted infections.

32. How can a woman be happy in a sexual relationship?

A woman can have a happy and fulfilling sexual relationship if both / all partners are willing to pleasure each other and find out what they like. This takes time and experience and can vary from situation to situation. It is helpful for a woman to already know her body well and know what she likes and doesn’t like. Trusting the other person and knowing that you can share your wishes, needs and fears is important.

33. How long does good sex take?

What people consider to be good sex can be very different. Good sex is not necessarily a question of duration, but of sensation, therefore it may take different amounts of time. Good sex is fun and fulfilling for everyone involved. How beautiful and intense sex feels also depends on other emotions and external influences.

Contraception

34. What can I do if I don't want a child?

 

If you want to prevent pregnancy, it is best to take precautions before having sexual intercourse. There are many different contraceptives, the best known ones being the condom and the pill. Condoms are easily available, and also protect against sexually transmitted infections. You can find out more about condoms in question 36. To buy the pill or most other contraceptives, you need a prescription from a gynaecologist, see question 35. You can also go to a gynaecologist’s practice or a counselling centre to find out which is the best method for you. If you want, it is also possible to bring your partner or another person with you. In Germany, the statutory health insurance covers the costs of prescription contraceptives up to the age of 22.

After unprotected sexual intercourse, you can prevent pregnancy with the “morning-after pill”. The morning-after pill works best if taken within the first twelve hours after unprotected sex. It is available without a prescription in pharmacies. You can get it free of charge up to the age of 22 if you show a prescription from your doctor at the pharmacy. However, the morning-after pill is not a substitute for regular contraception and is only intended for emergencies. You can find more information here.

In the case of an unplanned pregnancy, abortion is possible in Germany without penalty within the first twelve weeks after fertilisation, see question 39.

35. How do you get the pill as a young girl?

A gynaecologist must write you a prescription for the pill and other hormonal contraceptives. With this prescription, you can get the pill at the pharmacy. For girls who are 14 or older, gynaecologists can usually prescribe the pill without parental consent. The pill is free of charge until the age of 22.

36. What is a condom?

A condom is a very thin sheath made of latex, or more rarely, plastic. It is slipped over the stiff penis like a second skin. There is a small bulge at the tip of the condom. It catches the semen to prevent it from getting into the partner’s body. When used correctly, the condom protects against pregnancy and sexually transmitted infections. It is important to roll the condom over the penis before the first contact between the penis and the vagina or anus. You can find out more about condoms and how to use them correctly here.

Condoms can be bought in supermarkets, drugstores or online.

37. Should the man or the woman take care of the condom?

Men and women can both take care of the condom. After all, a possible pregnancy or sexually transmitted infection can also affect them both.

38. How is it possible for a woman to become pregnant despite taking the pill?

Generally speaking, if you use the pill correctly, it is a very reliable contraceptive. But no contraceptive method is 100% effective. For example, the effectiveness of the pill is impaired if you forget to take it for more than twelve hours or if you experience diarrhea or vomiting within three hours of taking the pill [i]. It may also interact with other medication. Seek advice at a doctor’s office or pharmacy if you are taking or want to take other medication.

[i] BzgA (Hg): Sichergehn, Verhütung für sie und ihn, 2017, Auflage: 21.200.11.17, S.28.

Abortion

39. Until when can you get an abortion?

In Germany, abortion is possible without penalty under certain conditions: no more than twelve weeks may have passed since fertilisation. The woman herself must choose to have the abortion. She must seek counselling at a recognised pregnancy conflict counselling centre. The consultation is open-ended, meaning it is ultimately the woman’s decision whether or not to have an abortion. The centre then issues a so-called counselling certificate, which a woman needs if she decides to terminate the pregnancy. The counselling centre also gives advice regarding the procedure and all other regulations, such as the coverage of medical costs.

You can find out more here:

https://www.profamilia.de/en/topics/abortion

https://www.zanzu.de/en/rights-and-law/your-rights/abortion/

40. Does an abortion cause problems for the woman?

An unplanned pregnancy can cause worries and feelings of uncertainty. This is where independent counselling can help you make the right decision.

 A termination of pregnancy (also called abortion) is a relief for some, others experience it as distressing. Sometimes you can experience positive and negative feelings at the same time. Medically, an abortion is a very safe procedure. It can be done either with the help of pills or through a small surgical procedure through the vagina. Generally, having an abortion will not affect later pregnancies.

Love

41. What is love?

Love is a beautiful feeling that can be many things. There is, for example, love between family members or in a close friendship. The love between two people in a romantic relationship is a very intense feeling and a strong affection, often accompanied by physical attraction.

 In the beginning, there is usually a phase of falling in love. During that early stage of a relationship, it is all about getting to know the other person and wanting to spend a lot of time together. In order to learn more about each other, people that are in love  usually want to talk a lot or be physically close.

After being in love for a long time, this state changes. Often this love then develops into a deeper connection. Many people then want to be there for each other and show their trust in the other person. While love can be something wonderful, there will also be difficult moments from time to time. Talking, discussing or even arguing with each other is part of that. Love should never mean that one person dominates the other.

You may have heard a lot about love in songs or films. Maybe you have recognised yourself or a situation you have experienced in them. It is important that you always pay attention to your own feelings and make your own decisions. 

42. What is homosexuality?

Homosexuality means that a person is attracted to and desires a person of the same sex (“homos” is Greek and means “equal”). This means a woman loves another woman or a man loves another man. When a woman and a man love each other, it is called heterosexuality (“heteros” is Greek and means “different”). When a person is attracted to both women and men, it is called bisexuality. The umbrella term for these words is “sexual orientation”. People with different sexual orientations have existed in all cultures throughout time. These feelings sometimes change over time, depending on your life situation, age and above all: who you meet. You may suddenly fall in love with someone you never thought you would before.

Many things are the same for homosexuality, bisexuality and heterosexuality. For example, almost everyone is excited when they are in love and get to meet the person they are in love with. One difference is that homosexual and bisexual people do not yet have equal rights in everyday life. Sometimes they experience discrimination. Everyone can help change this by recognising different ways of life and not excluding anyone, because every kind of love deserves respect.

43. How can I show someone that I love them?

There are different possibilities: You can express love by maintaining eye contact and looking at them more often. You can also increase communication with each other by asking questions.

Showing interest in the other person can help build a closer connection between the two of you. By being attentive and remembering what the other person tells you about themselves, you can show them that they are important to you.  Another way to express love and interest is to be there for each other or to offer help when the other person needs it. Some people are shy when they are in love. But if you feel confident enough, you can tell someone directly that you like them. Writing a love letter or sending a message are other ways, among many others, to let them know about your feelings.

Boundaries

44. Why do boys want to touch or look at us girls?

During puberty a lot changes for adolescents / young people: new feelings emerge and your body changes. Many adolescents discover for the first time that they are attracted to another person. Some people show their interest by looking at this person or by trying to be close to them. So, the boys may be interested in the girls and want to get to know them. If the girls want to as well, this can be a very nice experience.

 It can also happen that a boy makes you uncomfortable by looking at or touching you without asking. If this is the case, tell the boy to stop or ask an adult for help. For more tips, see question 45.

45. What can a girl do when a boy wants to see something and she says "NO" and the boy says "I want to see that”?

It is wrong to do something against another person’s will and to not respect their boundaries. Sometimes even small actions can be uncomfortable. This includes “just” being looked at or touched on the arm. You always have the right to set your personal boundaries and to ask the other person to stop or go away.

In some situations a boy may keep doing something even though you told him not to. Even when it is difficult, stand by your No. You can also repeat your refusal, for example by saying “Stop!” Or “Leave me alone!”. If necessary, keep getting louder. Depending on the situation, you can also leave or ask for help. The important thing here is to remember that the boy is in the wrong if he does not respect your “No”. You do not have to feel ashamed or bad. Trust your instincts, they often tell you when something is wrong. You can also practise how to act in these situations. A girls’ club, self-defence course or empowerment workshop can help make you feel more confident.

 You should always seek help, even when someone tries to pressure or threaten you. The person may be trying to take advantage of the fact that you are too ashamed to talk to someone. However, it is always helpful to speak about any problems you are having.

 You can find more information on the homepage  https://www.hilfetelefon.de/en.html

HIV

46. What does the HI virus (HIV) do?

HIV is short for “Human Immunodeficiency Virus”. This means the virus can only be transmitted from person to person and damages their immune system (defence-system).

If a person has contracted the HI-virus and doesn’t take any medication against it, the viruses destroys their immune system over several years to such an extent that the body ends up defenceless against other illnesses. This stage of the disease is called AIDS (“Acquired Immune Deficiency Syndrome”). There are now effective drugs that prevent the virus from multiplying in the body which would lead to the disease breaking out. With the help of these drugs, the amount of viruses in the blood can even be reduced enough so that the person is no longer contagious.

However, the medication has to be taken consistently for the rest of a person’s life to prevent the virus from multiplying.

47. How do you get infected with HIV?

HIV is a relatively difficult virus to transmit. There are very few bodily fluids that can contain the HI-virus in a quantity that is sufficient for infection. Those fluids are semen, blood, vaginal fluid, the fluid film on the intestinal mucosa and breast milk from women with an HIV infection unless they take medication against HIV. These infected fluids have to come in contact with mucous membranes or open parts of the body of another person for that person to become infected. One of the ways you can get infected is unprotected vaginal or oral sex (sex without a condom). 

During oral sex (sex using the mouth), the risk of transmission is very low. To avoid any risk, sperm or menstrual blood should not be ingested. People can also become infected if they share syringes, for example when injecting drugs, see also question 48

You cannot become infected in everyday life, for example when swimming, in the sauna, when eating or drinking, on the toilet or while working out. This also applies to kissing, hugging and stroking. Body fluids such as saliva, tears, sweat or urine are not infectious because too few HIV viruses are present in them.

48. Can you only get the virus from sex?

No, there are other ways to get infected. HIV can also be transmitted from mother to child through breastfeeding or during birth. This only happens if the mother is not taking medication against HIV. You can also get the infection through blood, for example by sharing syringes when injecting drugs. But when visiting a doctor or going to the hospital you don’t have to worry about an HIV-infection. The materials used there are HIV-free.

49. How can you protect yourself from HIV?

You can protect yourself by using condoms during vaginal or anal sex. This way, none of the mentioned fluids (question 47) can get into the body. Protection from HIV is also knowing that a person has HIV and takes medication regularly. In that case the person is not contagious. 

In a relationship, partners can also take a test together to make sure neither has HIV. In that case, you can have sex without a condom. But it is important that you do not have unprotected sex (without a condom) outside the relationship.

Some people with a high risk of infection also take HIV medication as a preventive measure to protect themselves from an infection when they are having sex without a condom. However, this Pre-Exposure Prophylaxis (PrEP) should only be done in consultation with a doctor. These drugs are also much more expensive than condoms and can have other side effects.

If you inject yourself with drugs, you should only use your own syringes! 

50. How can we know if we have HIV?

You can only find out through medical testing. There are no specific symptoms that appear after an HIV infection. Some people do not notice at all. If you believe you may have contracted the virus you should always get tested. The test can be done at the earliest six weeks after a possible risk situation because the test checks for HIV antibodies. The body does not produce these HIV-specific antibodies until six to twelve weeks after an infection.

If you want to get tested, you can visit the public health department or go to a counselling service.

The addresses are below. Tests are done anonymously and counselling is provided, so no one will know your name. You can also visit a doctor’s practice but the test won’t be anonymous there. You can now also buy HIV self-tests in pharmacies, counselling centres or online. That way you can do the test on your own at home. However, a consultation is very helpful and these services should be taken advantage of. In case of a positive test result (meaning the person has been infected with HIV) another test needs to be done to make sure the first result was correct.

You can find counselling services near you here.

Pregnancy and Birth

51. How is a child created and where do children come from?

A child is created through the fusion of a woman’s egg cell with a man’s sperm cell. For this to happen, sperm cells have to pass through the vagina to the egg cell. This happens when a woman and a man have sexual intercourse without contraception and the man ejaculates in the woman’s vagina. In this case, 50 to 500 million sperm cells can flow towards the fallopian tubes. This can also take place if there is semen from a previous ejaculation on the penis or fingers and sperm cells enter the vagina and from there reach the fallopian tubes.

 If the mature egg cell fuses with a sperm cell, this fertilised egg cell moves to the uterus in the coming days and slowly grows there (see also question 1). In biological terms, this growth is caused by the fertilised egg cell dividing into more and more cells. In the beginning, this ball of cells is called an embryo. The embryo is nourished through the umbilical cord of the pregnant woman. After about nine and a half months, the development of the unborn child is complete and it can come into the world.

52. Is it painful to be pregnant?

Some people experience only very little discomfort during pregnancy, others more.

In general, the body changes a lot during pregnancy. This can lead to uncomfortable symptoms like nausea, fatigue, water retention in the legs and feet, back and breast pain. A lot of women feel  tightness or tension in their breasts. Sometimes, the movements of the child can also be uncomfortable.

It is important for the woman to go to regular check ups with a doctor throughout the pregnancy so she and her unborn child can receive optimal care and support. You can learn more about this here.

53. Can you have sex when you are pregnant?

If you feel like it and there are no other complications, you can have sex without worrying. It will not harm the baby. If you do need to be careful for specific medical reasons, your gynaecologist will discuss this with you.

54. What do I have to consider when I am pregnant and have to take medication?

Some medication can have negative effects on the course of the pregnancy and the development of the baby before birth. If you are pregnant or want to get pregnant, you should only take medication if you have discussed this with your doctor.

55. Why do women have milk in their breasts for their babies to drink?

During pregnancy, different hormones make sure that the breasts change so that they are able to produce milk. During pregnancy, the breasts first produce a colostrum (for the first few days), which is very rich in nutrients and antibodies for the newborn. When the newborn sucks on the breast, hormones are released which stimulate further milk production with the stimulus of sucking. Breast milk has everything a baby needs to grow up healthy.

56. Why is giving birth painful?

Most babies are born through the mother’s vagina. Until birth, the cervix (which is located at the bottom of the uterus and forming the transition to the vagina, see figure 1) is firmly closed. Before birth, certain hormones make the cervix softer and labour begins. This means that the abdomen becomes hard and the muscles of the uterus contract at regular intervals. The contractions cause the cervix to open. At the same time, the baby is pushed down and, with the pressure of its head, it causes the cervix to open. It has to open about ten centimetres so the baby can fit through. There are a lot of nerves in the surrounding tissue, which is why pain is felt during birth.

There are a few ways to relieve the pain, for example certain breathing techniques, different birthing positions, a bath to relax or painkillers.

In Germany, a midwife and possibly a doctor assist the woman giving birth. [i]

[i] Ursachen von Geburtsschmerz, abgerufen am 28.11.2022 von 
www.familienplanung.de/schwangerschaft/geburt/geburtsschmerz/ursachen-von-geburtsschmerz/

vgl. Smith, R.: Das Timing der Geburt, Spektrum der Wissenschaft 6, 1999, S.46.