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Chapter 13: The Sexual Body in Health and Illness

The Sexual Body in
Health and Illness

Living in our bodies: The quest for physical perfection
Alcohol, drugs, and sexuality
Sexuality and disability
Sexuality and cancer
Additional sexual health issues

Living in Our Bodies:
The Quest for Physical Perfection

Sexual health - State of physical, emotional, mental and social well-being related to sexuality
Not merely the absence of disease, dysfunction or infirmity
Requires a woman to feel at ease with the sight, feel, and smell of her vulva
Be comfortable with and aware of her breasts
Requires a man to accept his body, including his genitals
Be aware of physical sensations such as lower back pain or a feeling of congestion in his bladder

Eating Disorders

Behaviors and combinations that include compulsive overeating and compulsive overdieting
Traits
Low self-esteem
Perfectionism
Difficulty dealing with emotions
Unreasonable demands for self-control
Negative perceptions of self in relation to others
Fear of becoming fat
Lacks adequate skills for dealing with stress
Anorexia nervosa - Relentless pursuit of excessive thinness

Eating Disorders

Bulimia - Uncontrolled, often secret, overeating (binge eating)
The person tries to counteract by purging—fasting, excessive exercising or dieting, or using laxatives or diuretics
Binge eating disorder - Similar to bulimia except that there is no purging, excessive exercise, or fasting
Treatment strategies – Comprehensive treatment plan that involves:
Medical care and monitoring
Psychosocial intervention
Nutritional counseling
Possible medication

Body Image and Its
Impact on Sexuality

Causes behind eating disorders are complex and interrelated
Genetic predisposition
Environmental triggers
Personal experience
Treatment is complex, prolonged, and multifaceted

Anabolic Steroids:
A Dangerous Means to an End

Anabolic steroids - Synthetic version of the hormone testosterone
Used by bodybuilders and other athletes to enhance their strength and add bulk to their bodies
Adverse effects - Some irreversible
Sterility
Heart attacks
Strokes
Liver damage
Personality changes - The most common being pathological aggressiveness

Alcohol and Sexuality

Alcohol use and sexuality
Belief that alcohol and sex go together reinforced by popular culture
Disinhibition - Phenomenon of activating behaviors that would normally be suppressed
Alcohol affects the ability of both men and women to become sexually aroused
Alcohol is associated with dangerous consequences such as unwanted sexual intercourse and sexual violence

Drugs and Sexuality

Other drug use and sexuality
Aphrodisiacs - Substances that purport to increase sexual desire or improve sexual function
Most recreational drugs actually have the opposite effect

Alcohol, Drugs, and Sexuality

Marijuana
Amyl nitrate - Also known as “poppers”
Cantharides - Referred to as ‘Spanish fly’
LSD and other psychedelic drugs
Cocaine
Ecstasy
Methamphetamine - Referred to as ‘crystal’
Sextasy - Ecstacy + Viagra

Figure 1: Most Commonly Cited Drugs Used by a Sample of 18–39 Year-Olds Who Reported Ever Using a Drug to Improve Sexual Functioning

Sexuality and Disability - Physical Limitations and Changing Expectations

Many people are subject to sexually limiting conditions owing to
Congenital conditions, appearing at birth, such as cerebral palsy and Down syndrome
Spine injuries
Vision and hearing impairment
Chronic illness

Diabetes - Characterized by an excess of sugar in the blood and urine, due to a deficiency of insulin, a protein hormone

Cardiovascular disease

Arthritis

Developmental disabilities

The Sexual Rights of
People With Disabilities

Sexual rights of persons with disabilities should be the same as those for persons without disabilities
Sexual expression
Privacy
Be informed about and have access to needed services
Choose one’s marital status
Whether to have or not have children
Make one’s own decisions and develop to one’s full potential

Sexuality and Cancer

Types of tumors
Benign - Slow growing and remain localized
Malignant - Cancerous
Metastasis - Process by which the disease spreads from one part of the body to another, unrelated part

Figure 13.3: Percentage of U.S. Women
Developing Breast Cancer Over 10-, 20-, and 30-Year Intervals, by Age

Women and Cancer

Most lumps and bumps are benign conditions
Uterine fibroids
Ovarian cysts
Fibroadenomas of the breast
Factors influencing risk of developing a solid tumor that invades breast tissue:
Age
Genetic makeup
Lifetime exposure to estrogen
Risk is higher when the biological relationship of the affected relative is closer

Women and Cancer

No epidemiological data exist indicating that lesbian women are at increased risk for breast cancers
Detection
Mammography screening
Additional tests like magnetic resonance imaging, or MRI
More frequent exams
Early detection an important part of preventive care

Table 1: Screening Guidelines for the Early Detection of Breast Cancer: American Cancer Society and U.S. Preventative Services Task Force

Women and Cancer - Treatment

Some type of surgery to remove the primary tumor
Finding out whether the cancer has spread to the lymph nodes under the arm
Restoring the breast’s appearance
Relieving symptoms of advanced cancer

Figure 2: Types of Surgical
Treatment for Breast Cancer

Common Breast Cancer Surgeries

The removal of only the breast lump and some normal tissue around it

The removal of more of the breast tissue than with a lumpectomy

Removal of the entire breast, but not the lymph nodes from under the arm or muscle tissue from beneath the breast

Removal of the entire breast and some of the lymph nodes under the arm

Removal of the entire breast, lymph nodes, and chest wall muscles under the breast

Lumpectomy

Partial (segmental) Mastectomy

Simple or Total Mastectomy

Modified Radical Mastectomy

Radical Mastectomy

Women and Cancer

Sexual adjustment after treatment
Woman with breast cancer has worrisome concerns about her sexual identity and attractiveness
She may feel scarred and be fearful of rejection
Breast surgery or radiation does not physically decrease sexual desire in a woman
Breast reconstruction and breast implant surgery
Breast reconstruction of paramount interest to many women
May decrease feeling of pleasure from fondling the breast and nipple
May provide the woman with increased feelings of wholeness and attractiveness

Cervical Cancer and
Cervical Dysplasia

Cervical dysplasia - A condition of the cervical epithelium
Considered a precancerous condition
Cervical cancer - More advanced and dangerous malignancy
Invasive cancer of the cervix
Detection - Pap test
Treatment
Biopsy - Surgical removal of tissue for diagnosis

Women and Cancer

Ovarian cancer
Uterine (endometrial) cancer
Hysterectomy - Surgical removal of the uterus
Oophorectomy - Removal of one or both ovaries, because of endometriosis, cysts, or tumors
Vaginal cancer

Men and Prostate Cancer

Risk factors
Aging
Family history
Being African American
High-fat diet
Obesity
Nationality

Detection
Urination issues (flow, control, frequency, pain)
Erection and ejaculation issues
Blood
Blood in urine or semen
Pain in lower back, pelvis or upper thighs

Men and Prostate Cancer

Prostate-specific antigen test - A blood test
Helps in diagnosing prostate cancer
Prostatic hyperplasia - When the prostate gland enlarges and blocks the flow of urine
Benign condition in which levels of prostate-specific antigen can be elevated
Treatments
Surgery
Radiation therapy
Hormone therapy
Chemotherapy

Table 2: Screening Guidelines for the Early Detection of Prostate Cancer: American Cancer Society and U.S. Preventative Services Task Force

Men and Testicular Cancer

Detection
Testicular exam
Treatment
Surgery
Radiation therapy
Chemotherapy
Man’s fertility a major concern

Men and Penile Cancer

Risk factors
HPV infection
Smoking
Having AIDS
Being treated for psoriasis with ultraviolet light
A drug called psoralen
Age

Treatment
Surgery
Radiation therapy
Chemotherapy

Men and Breast Cancer

Risk factors
Aging
Family history of breast cancer
Heavy alcohol use
Inheritance of BRCA2 gene mutation
Klinefelter’s syndrome
Radiation exposure
Liver disease
Physical inactivity and obesity
Estrogen treatment

Diagnosis
Clinical breast examination
Mammography
Ultrasound
Nipple discharge examination
Biopsy

Anal Cancer in Men and Women

Risk factors
Having numerous lifetime sex partners
History of receptive anal intercourse particularly under age 30
HIV infection
Smoking

Symptoms
Pain in the anal area
Change in the diameter of the stool
Abnormal discharge from the anus
Swollen lymph glands in the anal or groin areas
Bleeding

Anal Cancer in Men and Women

Treatment
Surgery
Radiation therapy
Chemotherapy

Additional Sexual Health Issues

Toxic shock syndrome - Caused by the Staphylococcus aureus bacterium
Vulvodynia - Chronic vulvar pain without an identifiable cause
Endometriosis - Growth of endometrial tissue (uterine lining) outward into the organs surrounding the uterus
Lesbian women’s health issues
Lesbian women at higher risk than other women for uterine, breast, cervical, endometrial, and ovarian cancers
Prostatitis - Inflammation of the prostate gland

Final Thoughts

Living in our bodies: The quest for physical perfection
Alcohol, drugs, and sexuality
Sexuality and disability
Sexuality and cancer
Additional sexual health issues