Chronic illness and sexuality.ppt1 1
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Dr. Stephanie BuehlerFollow
Dec. 5, 2014•0 likes•1,314 views
Chronic illness and sexuality.ppt1 1
Dec. 5, 2014•0 likes•1,314 views
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Want to learn how to reclaim sexual intimacy in the wake of a chronic illness? This informative SlideShare will guide you through ways to re-connect with your partner in ways that will enrich your sex life. Learn how medications and illnesses can impact your sex life and what you can do to move forward and reclaim the intimacy that may have been lost to chronic illness.
Dr. Stephanie BuehlerFollow
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Chronic illness and sexuality.ppt1 1
- 1. Chronic Illness & Sexuality Reclaiming Intimacy
- 2. Chronic Illness & Sexuality: Reclaiming Intimacy Dr. Stephanie Buehler, Founder and Director of the Buehler Institute Newport Beach, CA www.thebuehlerinstitute.com
- 3. How Can I Reclaim Intimacy? YOU MAY BE ASKING YOURSELF… • How can I continue to be a sexual person if I am challenged by a chronic illness? • How can I get myself in the mood when I feel so tired or overwhelmed? • What do I do if my sexuality has changed? • What can I do about my partner’s needs?
- 4. INTIMACY & SEXUALITY: WHY SHOULD I BOTHER? • Sex can help you feel normal and alive • Sex provides you with pleasure • Sex creates a connection with your partner • Sex affirms your gender roles
- 5. WHAT CHRONIC CONDITIONS AFFECT INTIMACY & SEXUALITY? • ARTHRITIS • BREAST CANCER • CARDIOVASCULAR DISEASE • CHRONIC PAIN • DIABETES MELLITUS • DYSPAREUNIA • FIBROMYALGIA • GYNECOLOGICAL CANCER • HIV • HYPERTENSION • INTERSTITIAL CYSTITIS • IBS • MULTIPLE SCLEROSIS • OBESITY • PARKINSON’S DISEASE • PELVIC PAIN • RENAL DISEASE • SPINAL CORD INJURY • VULVODYNIA
- 6. WHAT PSYCHOLOGICAL CHANGES AFFECT INTIMACY & SEXUALITY? • DEPRESSION AND ANXIETY • FEAR AND EMBARRASSMENT • GRIEF AND LOSS • MYTHS ABOUT SEX, AGING, AND ILLNESS • CHANGES IN ROLES • CHANGES IN BODY IMAGE
- 7. HOW CAN MEDICATIONS AFFECT YOUR SEXUALITY? • MEDICATIONS CAN AFFECT • SEXUAL DESIRE • SEXUAL AROUSAL • ORGASM • ENERGY • MOOD
- 8. WHAT AREAS OF FEMALE SEXUALITY ARE AFFECTED BY ILLNESS? • DESIRE • AROUSAL • ORGASM
- 9. Not everything that is faced can be changed, but nothing can be changed until it is faced. --James Baldwin • Your sex life may look different than it used to be, or different than anyone else’s.
- 10. SEXUAL DESIRE • INNATE DESIRE VS. CREATED DESIRE • PLANNING MAY BE THE KEY
- 11. SEXUAL AROUSAL • PROBLEMS EXPERIENCING PLEASURE • LACK OF LUBRICATION
- 12. PROBLEMS WITH ORGASM • DIFFICULTY REACHING ORGASM • NO ORGASM • LESS PLEASURABLE ORGASM
- 13. COMMUNICATION IS ESSENTIAL!
- 14. YOU NEED TO COMMUNICATE… • WITH YOUR PROVIDER • CHANGES IN AROUSAL, FUNCTION, ORGASM • CHANGES IN MEDICAITON • CONCRETE SUGGESTIONS • WITH YOUR PARTNER • ALONE, WITH THE PROVIDER, OR WITH A SEX THERAPIST • BETWEEN YOUR EARS • GIVING YOURSELF PERMISSION FOR PLEASURE • PROBLEM-SOLVING
- 15. Sex is more than body parts and friction. --Masters & Johnson • Broaden your ideas about what constitutes “sex”
- 16. SEX CAN BE SENSUAL . . . • SENSUALITY • NON-SEXUAL PHYSICAL CONTACT • HOLDING HANDS • HUGGING • MASSAGE • BATHING TOGETHER
- 17. INTIMACY IS AS IMPORTANT AS SEX • NONPHYSICAL • EXPRESSING LOVE AND CARING • WRITING NOTES • DOING LOVING LITTLE THINGS • READING A BOOK TOGETHER • PHYSICAL • SNUGGLING WHILE WATCHING A MOVIE • KISS HELLO AND GOOD-BYE • LITTLE TOUCHES
- 18. SEX CAN BE PHYSICAL . . . • Lots of foreplay • Use other senses to increase pleasure and arousal • Explore non-intercourse activities • New positions, using pillows and furniture
- 19. MORE ON PHYSICAL SEX . . . • Make having pleasure together, not orgasm, the goal • Communicate what you like / want / need • Consider self-stimulation for yourself and / or your partner • Consider adding sex toys
- 20. MAXIMIZE THE HEALTH YOU HAVE • PHYSICAL • Maintain flexibility and energy • Eat a healthful diet to maximize energy and maintain weight • Improve body image – focus on what works • MENTAL • If depressed or anxious, seek help • Antidepressants can cause sexual side effects • Try psychotherapy with medications or alone
- 21. THE ANSWER TO RECLAIMING INTIMACY IS . . . • REALIZING YOU ARE STILL A SEXUAL BEING • DESIRE MAY CHANGE, BUT YOU CAN STILL WANT SEX FOR MANY REASONS • SEX CAN STAY SATISFYING IF YOU BROADEN YOUR IDEAS ABOUT WHAT SEX IS • YOU CAN KEEP YOUR PARTNER HAPPY, TOO, WITH COMMUNICATION, LOVE, AND AFFECTION
- 22. There is only one happiness in life, to love and be loved. -- George Sand
- 23. SEXUALITY & CHRONIC ILLNESS 10-HOUR WORKSHOP IN NEWPORT BEACH, CA WITH DR. STEPHANIE BUEHLER AND DR. ANNE KATZ To register, please visit The Buehler Institute: http://thebuehlerinstitute.com/sex-chronic-illness-workshop-featuring-
Editor's Notes
- IN CREATING THIS PRESENTATION I TRIED TO THINK ABOOUT THE KINDS OF QUESTIONS THAT WOMEN WITH CHRONIC ILLNESS MIGHT WANT ANSWERED TODAY.
- ANOTHER QUESTION I THOUGHT WOMEN MIGHT WANT TO HAVE ANSWERED IS, WHY BOTHER WITH SEX WHEN YOU HAVE HEALTH CONCERNS?
- ILLNESSES CAN AFFECT SEXUALITY BOTH DIRECTLY AND INDIRECTLY. ILLNESSES LIKE DIABETES CAN AFFECT FUNCTION, FOR EXAMPLE, BECAUSE OF POOR CIRCULATION AND NERVE DAMAGE, WOMEN MAY HAVE A DIFFICULT TIME EXPERIENCING ORGASM AN ILLNESS LIKE FIBROMYALGIA MAY HAVE A MORE INDIRECT AFFECT BECAUSE OF FATIGUE OR PAIN SOMETIMES A MEDICATION REGIMEN, LIKE THE ONE FOR HIV, CAN HAVE A NEGATIVE EFFECT BECAUSE OF THE SIDE EFFECTS OF THE TREATMENT
- IT ISN’T UNUSUAL TO EXPERIENCE DEPRESSION OR ANXIETY OVER THE DIAGNOSIS OF ANY ILLNESS. YOU MAY MOURN OVER THE LOSS OF HEALTH OR CHANGES IN YOUR LIFESTYLE OR EVEN YOUR FINANCES. YOU MAY HAVE FEARS ABOUT THE ILLNESS RECURRING OR GETTING WORSE. YOU MAY ALSO THINK THAT CHRONIC ILLNESS OR CANCER MEANS AN END TO YOUR SEXUALITY. YOU MAY BELIEVE THAT AS PEOPLE AGE, THEY STOP THINKING ABOUT OR HAVING SEX. ALSO, SWITCHING ROLES, WHERE YOUR PARTNER BECOMES MORE OF A CAREGIVER, CAN MAKE YOU FEEL GUILTY. SOMETIMES CAREGIVING ISN’T VERY SEXY SINCE IT INVOLVES PHYSICAL PROCEDURES LIKE FEEDING OR WOUND CARE. TREATMENT CAN CAUSE CHANGES IN YOUR BODY, LIKE SCARRING OR HAIR LOSS. EVEN IF YOUR BODY IS ESSENTIALLY UNCHANGED IN APPEARANCE, YOU CAN BE ANGRY AT YOUR BODY FOR NOT WORKING PROPERLY. THAT CAN MAKE IT HARD TO FEEL LIKE A SEXY, SENSUAL WOMAN.
- VARIOUS MEDICATIONS CAN HAVE SEXUAL SIDE EFFECTS, INCLUDING LOW DESIRE, DIFFICULTY GETTING “TURNED ON,” DIFFICULTY ACHIEVING ORGASM OR INABILITY TO HAVE ORGASM. PAIN MEDICATIONS ARE NOTORIOUS FOR MAKING YOU DROWSY. AND THE EFFECTS OF MEDICATION WAXING AND WANING OVER THE COURSE OF A DAY CAN ALSO AFFECT YOUR MOOD.
- THE MOST COMMON PROBLEM SEXUAL PROBLEM THAT WOMEN WITH CHRONIC ILLNESS HAVE IS A LACK OF DESIRE. OFTEN, THIS HAPPENS EVEN BEFORE YOUR ILLNESS IS DIAGNOSED, BECAUSE YOU ARE PROBABLY FEELING ALL KINDS OF SYMPTOMS, INCLUDING FATIGUE AND A SAD OR ANXIOUS MOOD. ANOTHER PROBLEM IS AROUSAL, SO THAT EVEN IF YOU DO HAVE SEX, YOU MAY FIND THAT YOU CAN’T GET “TURNED ON.” ALSO, IF YOU CANNOT GET AROUSED, YOU WILL PROBABLY HAVE A HARD TIME HAVING AN ORGASM, EVEN IF YOU WERE ORGASMIC BEFORE. AND AGAIN, MEDICATIONS DON’T HELP. I’M GOING TO TALK NOW ABOUT EACH AREA IN TURN, EVEN THOUGH THEY ARE OFTEN INTERCONNECTED.
- SO LET’S BEGIN WITH DESIRE, WHICH IS THE NEED OR WANT TO HAVE SEX. IT IS IMPORTANT IS TO SEPARATE INNATE DESIRE (“HORNINESS”) FROM CREATED DESIRE. INNATE DESIRE COMES FROM YOUR HORMONES, YOUR THOUGHTS ABOUT PAST AND POSSIBLE FUTURE SEXUAL EXPERIENCES, AND YOUR FANTASIES. BUT WHEN YOU’RE ILL, YOU MAY NOT HAVE INNATE DESIRE. YOU MAY NEED TO FIND WAYS TO CREATE DESIRE, OR TO ACCEPT THAT YOUR INNATE DESIRE HAS DISAPPEARED, TEMPORARILY OR PERMANENTLY. JUST BECAUSE YOU NO LONGER HAVE INNATE DESIRE DOESN’T MEAN THAT THERE AREN’T REASONS TO WANT SEX. IT’S PERFECTLY ALL RIGHT TO CONSCIOUSLY REMIND YOURSELF THAT YOU MAY WANT TO HAVE SEX TO FEEL CLOSE TO YOUR PARTNER, TO GET THE KIND OF TOUCH THAT YOU’D LIKE, OR TO HELP YOU RELAX. EVEN THOUGH MOST WOMEN LIKE THE IDEA OF SEX BEING SPONTANEOUS, YOU MAY ALSO NEED TO ADAPT THE IDEA OF PLANNING SEX. PLANNED SEX DOESN’T HAVE TO BE A SAD RUNNER UP TO SPONTANEOUS SEX. AFTER ALL, IF YOU HAVE TICKETS TO A CONCERT OR A PARTY TO LOOK FORWARD TO, YOU DON’T ENJOY IT ANY LESS!
- AROUSAL IS ANOTHER PROBLEM TO OVERCOME. YOU MAY NEED A LOT MORE FOREPLAY, OR EVEN FORE- FOREPLAY, LIKE A BATH OR SHOWER, A MASSAGE, OR BEING HELD OR CUDDLED BEFORE YOU TRY HAVING SEX. WHEN YOU ARE ILL, EVEN IF YOU ARE AROUSED, YOU MAY HAVE PROBLEMS WITH LUBRICATION. DON’T YOU OR YOUR PARTNER TAKE IT PERSONALLY! IT COULD BE YOUR MEDICATION IS CAUSING PROBLEMS. KEEP LUBRICANT BY THE BED AND USE IT LIBERALLY. MOST PHYSICIANS RECOMMEND A WATER-BASED LUBRICANT BECAUSE IT IS LEAST LIKELY TO CAUSE PROBLEMS WITH INFECTIONS LIKE YEAST.
- SOMETIMES IT IS THE CHANGE IN ORGASM THAT IS THE MOST DISTRESSING. I MUST BE HONEST WITH YOU, SOMETIMES A WOMAN MAY LOSE THE ABILITY TO HAVE AN ORGASM AND HAVE A VERY HARD TIME REGAINING THAT ABILITY. AND SOMETIMES WOMEN COMPLAIN THAT THEIR ORGASM LACKS THE PUNCH IT USED TO HAVE. IF YOU FOCUS ON SENSUAL PLEASURE AND NOT ON ORGASM, CHANCES ARE YOU’LL MAKE IT EASIER TO REGAIN ORGASM OR CHANGE IT. YOU CAN ALSO ADD IN MORE MANUAL OR ORAL STIMULATION, OR USE SEX TOYS. I WANT TO TALK ABOUT SEX TOYS FOR A MINUTE. A LOT OF WOMEN AND MEN OBJECT TO USING SEX TOYS, BUT THERE ARE VERY GOOD, VERY REAL REASONS TO USE THEM. SOMETIMES A WOMAN MAY FIND THAT SHE NEEDS TO HAVE A LOT MORE STIMULATION OF THE CLITORIS IN ORDER TO ACHIEVE ORGASM OR TO HAVE A SATISFYING ORGASM—SO MUCH THAT SHE OR HER PARTNER GIVE UP TRYING. AND SOMETIMES WHEN ORGASM BECOMES DIFFICULT, PARTNERS STOP TRYING TO HAVE SEX. A SEX TOY CAN TAKE OVER SOME OF THE “WORK” OF TRYING TO HAVE AN ORGASM. SO EVEN IF YOU’VE NEVER USED A TOY BEFORE, PLEASE CONSIDER TRYING ONE, OR A FEW, TO SEE IF IT MAKES SEX EASIER. FINALLY, WOMEN ARE VERY INTERESTING SEXUAL CREATURES, SO IF YOU WERE USED TO HAVING ORGASM THROUGH DIRECT STIMULATION TO THE CLITORIS OR THROUGH INTERCOURSE, BUT NO LONGER CAN, YOU CAN TRY STIMULATION OF OTHER AREAS OF THE BODY, SUCH AS THE INNER THIGHS OR BREASTS TO SEE IF YOU CAN HAVE AN ORGASM THAT WAY.
- AS WITH MOST CHALLENGES, COMMUNICATION IS THE KEY TO RECLAIMING YOUR SEXUALITY. YOU BOTH MAY NEED TO ACKNOWLEDGE THAT ALONG WITH OTHER AREAS OF YOUR LIFE, LIKE DIET AND ACTIVITIES, YOUR SEX LIFE MAY ALSO BE CHANGED. HOW YOUR SEX LIFE LOOKS AFTER YOU’VE BEEN DIAGNOSED WITH A CHRONIC ILLNESS OR CANCER MAY BE QUITE DIFFERENT GOING FORWARD. BUT IF YOU UNDERSTAND THAT THESE CHANGES ARE NORMAL AND YOU ARE WILLING TO DO SOME PROBLEM-SOLVING, YOU CAN STILL HAVE A REWARDING INTIMATE RELATIONSHIP.
- COMMUNICATION HAS TO HAPPEN IN MORE PLACES THAN JUST THE BEDROOM. IF YOU HAVE A SEXUAL CONCERN, AS LISA AND ____ SAID, IT’S A GOOD IDEA TO BE PROACTIVE WITH YOUR PHYSICIAN. SOMETIMES THE NURSE OR NURSE PRACTITIONER IS ALSO KNOWLEDGABLE AND CAN HELP YOU. YOU MAY FIND THAT CHANGING YOUR MEDICATION, SUCH AS YOUR ANTIDEPRESSANT, OR LEARNING WAYS TO OPTIMIZE YOUR ENERGY CAN BE VERY HELPFUL TO YOU. FOR EXAMPLE, IF YOU ARE UNCOMFORTABLE IN CERTAIN POSITIONS, YOUR PHYSICIAN MAY BE ABLE TO FIGURE OUT WHAT MAY BE MORE COMFORTABLE. YOU ALSO NEED TO BE ABLE TO TALK WITH YOUR PARTNER. BEING HONEST ABOUT WHAT YOU ARE EXPERIENCING—WHETHER IT’S LACK OF DESIRE, DIFFICULTY BECOMING AROUSED, OR A CHANGE IN ORGASM—IS THE BEST WAY TO BEGIN A DISCUSSION. GET YOUR PARTNER’S SUPPORT AND HELP. YOU ALSO NEED TO GIVE YOURSELF PERMISSION TO HAVE PLEASURE, EVEN THOUGH YOU ARE ILL. AND, YOU NEED TO USE YOUR THOUGHTS TO HELP YOU SOLVE PROBLEMS, NOT PUT YOURSELF DOWN BECAUSE YOUR ILLNESS HAS CAUSED A CHANGE IN YOUR SEXUALITY. A FEW VISITS WITH A SEX THERAPIST CAN BE VERY HELPFUL. REMEMBER, I SAID COMMUNICATION IS THE KEY. WELL, IT CAN BE VERY HARD FOR COUPLES TO TALK ABOUT SEX. HAVING ATTENTION CALLED TO THEIR SEX LIFE, HAVING TO ACTUALLY TALK ABOUT SOMETHING THAT THEY JUST NORMALLY USED TO DO, CAN BE REALLY DIFFICULT. AND, IT CAN BE HARD TO COME UP WITH SOLUTIONS ON YOUR OWN. YOU CAN FIND A SEX THERAPIST THROUGH AASECT OR SSTAR, OR ASK YOUR PHYSICIAN FOR A REFERRALS.
- REMEMBER THAT I SAID THAT YOU MAY REALLY NEED TO CHANGE YOUR SEX LIFE. AFTER ALL, SEX IS MUCH MORE THAN INTERCOURSE. SEX INCLUDES INTIMACY, AND THAT CLOSENESS CAN BE CREATED IN OTHER WAYS, SUCH AS HOLDING HANDS, MASSAGING, OR BATHING TOGETHER.
- HERE ARE SOME MORE WAYS TO BE SEXUAL WITH ONE ANOTHER. YOU MIGHT WANT TO THINK ABOUT THESE SUGGESTIONS ANY TIME YOUR CHRONIC ILLNESS ACTS UP. AND FRANKLY, YOUR PARTNER MAY ALSO SOMETIMES BE TIRED OUT FROM HIS (OR HER) RESPONSIBILITIES. ENJOYING LITTLE MOMENTS TOGETHER CAN HAVE A LOT OF MEANING OVER THE LONG HAUL.
- IF YOU DO WANT TO GO FURTHER THAN SENSUAL ACTIVITIES, REALIZE THAT YOU MAY NEED MORE FOREPLAY NOW THAN BEFORE. YOUR BODY MAY FEEL DIFFERENT—MORE OR LESS SENSITIVE—AND YOU NEED TO COMMUNICATE THAT TO YOUR PARTNER. IT IS ALSO HELPFUL TO ENGAGE YOUR OTHER SENSES WHEN YOU ARE HAVING SEX. TURNING ON SOME MUSIC, HAVING SOME FLOWERS BY THE BED, AND FEEDING EACH OTHER A LITTLE BIT OF FRUIT LIKE STRAWBERRIES CAN MAKE SEX MORE ENTICING. ENGAGING YOUR SENSES MAY ALSO HELP DISTRACT YOU FROM ANY WORRIES YOU HAVE ABOUT YOUR HEALTH OR OTHER PROBLEMS. INTERCOURSE MAY NOT BE POSSIBLE, BUT YOU CAN TRY MANUAL STIMULATION, EITHER ON YOURSELVES OR ON ONE ANOTHER. YOUR PARTNER CAN HAVE INTERCOURSE BETWEEN YOUR THIGHS OR BREASTS. THERE IS MORE THAN ONE WAY TO COME TO ORGASM. YOU CAN ALSO TRY PILLOWS, LIKE THE LIBERATOR TO HELP YOU WITH POSITIONING YOUR BODY FOR SEX.
- REMIND YOURSELF AND YOUR PARTNER THAT THE POINT OF MAKING LOVE IS TO HAVE A PLEASURABLE, PLEASANT EXPERIENCE TO SHARE, NOT JUST HAVING AN ORGASM. TELL YOUR PARTNER WHAT YOU WANT OR NEED NOW THAT YOUR BODY—AND QUITE POSSIBLY YOU—HAVE CHANGED. FOR SOME WOMEN, SEX TOYS LIKE VIBRATORS CAN BE VERY HELPFUL. IT CAN MAKE REACHING ORGASM LESS TIRING OR HELP TO RE-TRAIN YOUR BODY TO HAVE AN ORGASMIC RESPONSE. NEITHER YOU NOR YOUR PARTNER NEED TO BE THREATENED BY SEX TOYS IN THE BEDROOM. USING A SEX TOY DOES NOT MEAN YOU OR YOUR PARTNER IS INADEQUATE.
- FINALLY, IF YOU WANT TO RECLAIM YOUR SEXUAL POTENTIAL, YOU CAN WORK ON THE GOAL OF MAXIMIZING YOUR HEALTH. YOU WANT TO TAKE CARE OF YOUR BODY BY FOLLOWING YOUR PHYSICIAN’S RECOMMENDED DIET AND ACTIVITIES. ALSO, IN MY PRACTICE I WORK WITH WOMEN TO FOCUS ON WHAT ABOUT THEIR BODY STILL WORKS. IT’S HELPFUL TO BE POSITIVE, EVEN WHEN YOUR HEALTH ISN’T WHAT IT USED TO BE. AS FAR AS MENTAL HEALTH, IF THE STRESS AND STRAIN OF CHRONIC ILLNESS ARE BECOMING OVERWHELMING. GET HELP. LET YOUR PHYSICIAN KNOW. SEE A THERAPIST. YOU CAN TRY ANTIDEPRESSANTS. ALTHOUGH ANTIDEPRESSANTS CAN CAUSE SEXUAL SIDE EFFECTS, SOMETIMES RELIEVING YOUR DEPRESSION CAN ALSO GIVE A LIFT TO YOU SEX DRIVE, INTEREST, AND PLEASURE.
- HAVING A CHRONIC ILLNESS DOESN’T HAVE TO MEAN BECOME ESTRANGED FROM YOUR PARTNER, OR LOSING YOUR SENSE OF YOURSELF AS A WOMAN. REMEMBER THAT SEX IS MORE THAN BODY PARTS AND FRICTION. SEX IS AN EXPRESSION OF LOVE, AND THAT EXPRESSION CAN COME IN MANY DIFFERENT FORMS. MY HOPE FOR YOU IS THAT YOU CAN FIND A “NEW NORMAL” WHERE YOUR SEXUALITY IS CONCERNED, AND HAVE SOME SWEET PLEASURE TO BALANCE OUT THE CHALLENGES OF HAVING A CHRONIC ILLNESS.