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Young Survivors Sexuality and Fertility
Dr. Christie Ganas M.D. Penn State Health St. Joseph
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Difficult topic
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Difficult topic to discuss
Uncomfortable to talk about patient and partner Health care provider Taboo subject Myths about sex Significant impact on quality of life Barriers
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What is normal?? Orgasm Arousal Desire
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Normal Sexual Response
Emotional intimacy Sexual stimuli Sexual arousal Arousal and sexual desire Emotional and physical satisfaction
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Intimacy-Based Model
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Factors Affecting Sexual Function
Medical history, illness, medications, hormones Family, cultural, society Partner relationship, sexual image, sexual experience External stressors, Psychological well-being
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Body Changes and Cancer Treatment
Surgery Chemotherapy Radiation Anti-hormonal Medications
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Psychological Effects
Body Image Depression Anxiety Fear Guilt Partner’s fears/concerns
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Predictors of Sexual Health after Cancer Diagnosis
Poor vs good emotional well-being Presence or absence of vaginal dryness Quality of the partnered relationship
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Issues Vaginal dryness Arousal Desire Orgasm
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Vaginal Dryness Lubricants and moisturizers
Lubricants are a temporary measure to relieve vaginal dryness during intercourse Water oil silicone based Moisturizers provide long-term relief of vaginal dryness ?? Role of local estrogen- discussion with oncologist and gynecologist Personalized and individualized plan Risk of recurrence????
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Arousal Vibrators Dilator therapy Pelvic floor physical therapy
Eros clitoral therapy device
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Behavior modification
Lifestyle modification Exercise Nutrition Social support Stress, Time, Life management
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Prepare Get comfortable with scars, changes Look, touch New normal
Communicate with partner Setting the scene
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Reduce anxiety Make it a priority Start gradually
Ways to feel less self-conscious Setting the scene Goal is pleasure -not performance
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Alternative forms of physical love
Hugging Fondling Caressing Cuddling Kissing Hand holding Manual/oral stimulation Intra thigh or intra mammary intercourse
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Medication Flibanserin- nonhormonal therapy that works on key sexual pathways in the brain FDA approval Efficacy on desire and satisfying sexual evidence Bupropion -effects norepinephrine and dopamine uptake Increase sexual responsiveness and orgasmic activity Sildenafil – used to treat antidepressant associated sexual dysfunction, not FDA approved
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Contraception Condoms Diaphragms IUD Permanent sterilization
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Thank you
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