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Chapter Thirteen

The Sexual Body in Health and Illness

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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)

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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

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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?

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Eating Disorders

• Common among certain athletic groups

• Anorexia nervosa

• Bulimia

• Binge eating disorder

• Retreating from sexuality

• Treatment strategies

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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

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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

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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

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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

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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

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Other Drug Use and Sexuality

• Aphrodisiacs

• Marijuana

• Amyl nitrate

• Cantharides

• Priapism

• Ecstasy

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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)

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Sexuality and Aging: Men

• Refractory period is extended• Decrease in testosterone production• Benign prostate hypertrophy• Testosterone supplement

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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

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Physical Limitations• Spinal cord injury

• Changing expectations

• Vision and hearing impairment

• Diabetes

• Cardiovascular disease

• Arthritis

• Developmental disability

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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

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Sexuality and Cancer: Women

• Ovarian cancer– Oophorectomy—removal of one or both

ovaries

• Uterine cancer– Hysterectomy—surgical removal of uterus

• Vaginal cancer

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Sexuality and Cancer: Men

• Prostate cancer – Detection– Treatment

• Testicular cancer– Detection– Treatment

• Penile cancer• Breast cancer

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Other Sexual Health Issues

• Toxic shock syndrome• Endometriosis• Anal cancer• Lesbian women’s health issues• Prostatitis

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Summary

• Living in our bodies

• Alcohol, drugs, and sexuality

• Sexuality and aging

• Sexuality and disability

• Sexuality and cancer

• Other sexual health issues