1. Copyright ©2008 by the McGraw-Hill Companies, Inc. Chapter Thirteen The Sexual Body in Health and Illness

2. Copyright ©2008 by the McGraw-Hill Companies, Inc. Living in Our Bodies Sexual health is the state of physical, emotional, mental, and social well-being related to sexuality; it is not merely the absence of disease, dysfunction, or infirmity (WHO, 2002)

3. Copyright ©2008 by the McGraw-Hill Companies, Inc. Sexual Health Definition Requires a positive and respectful approach to sexuality and sexual relationships Requires possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence May contradict societal and personal expectations

4. Copyright ©2008 by the McGraw-Hill Companies, Inc. Is Health Incongruent with Seeking Perfection? Penis augmentation Breast implantation What other procedures are routinely performed for cosmetic vs. therapeutic reasons in the U.S?

5. Copyright ©2008 by the McGraw-Hill Companies, Inc. Eating Disorders Common among certain athletic groups Anorexia nervosa Bulimia Binge eating disorder Retreating from sexuality Treatment strategies

6. Copyright ©2008 by the McGraw-Hill Companies, Inc. Anorexia Nervosa Characterized by an all-controlling desire for thinness –Distorted image of ones own body –Diet (and sometimes exercise) obsessively –Sexual dysfunction often accompanies anorexia Amenorrhea May not achieve secondary sex characteristics

7. Copyright ©2008 by the McGraw-Hill Companies, Inc. Bulimia and Binge Eating Disorder Both are characterized by uncontrolled overeating –People with bulimia purge by vomiting, dieting, exercising excessively, or taking laxatives –People with binge eating disorder may overeat without the purging Many people with eating disorders are ambivalent toward their bodies and their sexual natures in general

8. Copyright ©2008 by the McGraw-Hill Companies, Inc. Anabolic Steroids Used to promote the fast development of skeletal muscle Used to enhance body image and athletic performance May occur in non-athletes Can cause serious and permanent body damage

9. Copyright ©2008 by the McGraw-Hill Companies, Inc. Alcohol, Drugs, and Sexuality Drugs and alcohol are commonly perceived as enhancers of sexuality –They rarely enhance sexual performance –Alcohol decreases the ability of men and women to become physically aroused –Effect of disinhibition, activating behaviors that would otherwise be suppressed

10. Copyright ©2008 by the McGraw-Hill Companies, Inc. Alcohol, Drugs, and Sexuality Used by some to give themselves permission to be sexual –Increases exposure to risky sexual situations –Alcohol use is a significant factor in sexual violence of all types –Plays a role in 90% of rapes and sexual assaults –Binge drinking by college students

11. Copyright ©2008 by the McGraw-Hill Companies, Inc. Other Drug Use and Sexuality Aphrodisiacs Marijuana Amyl nitrate Cantharides Priapism Ecstasy

12. Copyright ©2008 by the McGraw-Hill Companies, Inc. Sexuality and Aging: Women Perimenopause: menstrual periods become irregular prior to menopause Menopause: complete cessation of menstruation Hot flash: period of intense warmth, flushing, and perspiration Osteoporosis: loss of bone mass Postmenopausal Hormone Therapy (PHT)

13. Copyright ©2008 by the McGraw-Hill Companies, Inc. Sexuality and Aging: Men Refractory period is extended Decrease in testosterone production Benign prostate hypertrophy Testosterone supplement

14. Copyright ©2008 by the McGraw-Hill Companies, Inc. Sexuality and Disability A wide range of disabilities and physical limitations can affect sexuality People with these disabilities need support and education so they can enjoy their full sexual potential Men and women with disabilities differ in the self view of sexuality identity

15. Copyright ©2008 by the McGraw-Hill Companies, Inc. Physical Limitations Spinal cord injury Changing expectations Vision and hearing impairment Diabetes Cardiovascular disease Arthritis Developmental disability

16. Copyright ©2008 by the McGraw-Hill Companies, Inc. Sexuality and Cancer: Women Breast cancer –Mammogram: low-dose X-ray of the breast to detect cancer –Mastectomy: surgical removal of the breast –Lumpectomy: surgical removal of the tumor and lymph nodes –Breast reconstruction or implant surgery Cervical cancer –Cervical dysplasia: condition that may lead to cancer Pap test: test for detection of cervical cancer

17. Copyright ©2008 by the McGraw-Hill Companies, Inc. Sexuality and Cancer: Women Ovarian cancer –Oophorectomy—removal of one or both ovaries Uterine cancer –Hysterectomy—surgical removal of uterus Vaginal cancer

18. Copyright ©2008 by the McGraw-Hill Companies, Inc. Sexuality and Cancer: Men Prostate cancer –Detection –Treatment Testicular cancer –Detection –Treatment Penile cancer Breast cancer

19. Copyright ©2008 by the McGraw-Hill Companies, Inc. Other Sexual Health Issues Toxic shock syndrome Endometriosis Anal cancer Lesbian women’s health issues Prostatitis

20. Copyright ©2008 by the McGraw-Hill Companies, Inc. Summary Living in our bodies Alcohol, drugs, and sexuality Sexuality and aging Sexuality and disability Sexuality and cancer Other sexual health issues