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SEXUALITY
AND SEXUAL
HEALTH
Presented By,
Ms. Ekta. S.
Patel,
st
INTRODUCTION:
• According to WHO, reproductive and
sexual ill-health accounts the global
burden of ill-health
For women 20%
For men 14%
• It is closely related to other aspects of
health. Love, affection and sexual
healthy
intimacy, all pay a role in
relationship.
• Sexual health is not just limited to
absence of disease or dysfunction
during the reproductive years
• It impacts on sexual practice and
action and must be practice free from
sexual abuse, or discrimination and
requires integration into the whole life
cycle.
• The word sex denotes whether a
person is male or female or sex
difference. But sexuality is related
to sexual behaviour, gender
consciousness, and sexual nature.
DEFINITION:
Sexuality:
• The characteristic
male and female
quality of the
reproductive
elements.
Sexual health:
• In 1975 WHO defined sexual health
as, “integration of somatic,
emotional, intellectual and social
aspect of sexual being, in ways that
are positively enriching and that
enhances personality,
communication and love.”
COMPONENT OF
SEXUAL HEALTH:
SEXUAL GROWTH
AND
DEVELOPMENT:
Chromosomal
linkage:
• XX chromosomes
combination products
of female.
combination is
• XY
male.
Establishment of
gonadal sex:
• Second stage of
sexual differentiation
occurs by about the
10th to 12th week of
gestation.
• The male determining factor is Y
chromosome leads to development
of internal testes from gonad
medulla; without the male factor
there is development of internal
ovary from the gonad cortex.
Establishment of
phenotypic sex:
• When additional internal and
external genital organs develops
and result in actual characteristics
of biologic sex.
differentiation because each
• This is critical time in sexual
fetus
develops both Wolffian and
Mullerian genital duct system, one
of which must develop other regress
to product actual male or female
external genitalia.
• The Wolffian duct system in the
presence of testosterone give rise to
epididymis, the vas difference and
seminal vesicle in male.
• The Mullerian duct gives rise to the
female fallopian tubes and the
uterus and upper part of vagina.
AGE GROUPAND
SEXUAL HEALTH
BEHAVIOUR:
Childhood sexual
behaviour:
• Curiosity about sex organ of
opposite sex.
• Masturbation.
• Question regarding pregnancy,
childbirth and related to sexual
matters.
Adolescence sexual
behaviour:
• Self masturbation.
• Sex experimentation.
• Desire for partner.
• Love affair.
• Chating or surfing on computer.
Adult sexual
behaviour:
• Problems of adjustment in sexual
behaviour.
• Extramarital relation.
• Divorce.
• Sexually transmitted disease.
• Unwanted pregnancy.
Old age sexual
behaviour:
• Lack of sexual stimulation.
• Degeneration of organs.
• Death of life partner.
• Disease relate to sexual glands.
CHARACTERISTIS
OF SEXUALLY
HEALTHY PERSON:
• Person who have knowledge about
sexuality and sexual health.
• One who has positive attitude towards
body image.
• Ability to express one’s full sexual
potential.
• Capability to express sexuality.
• Right to make free and responsible
reproductive choice.
• Ability to access sexual health.
• Maintain balance between life style
and sexual behaviour.
develop
relation
effective
with both
• Capacity to
interpersonal
sexes
FACTORS
AFFECTING
SEXUAL HEALTH:
Biological factors:
• Congenital abnormality.
• Old age and sickness.
• Injuries.
• Less secretion of hormones.
• Pain and fatigue.
Environmental
factors:
• Change n life style.
• Lack of proper place and privacy.
Psychological factors:
• Disturbance and obstacle in family
relationship.
• Incomplete sexual knowledge.
• Initial sexual experience being bitter.
• Disinterest and disliking for partner.
• Unnecessary hopes and expectation from
partner.
• Tension and pressure.
• Death of beloved one.
Hormones and genetic
factors:
• Can affect sperm quality.
• Production of ovulation (failure to
ovulate, irregular menstrual cycle)
Sexual health history:
• Multiple partners
• Infectious disease such as mumps
after puberty causes sterility.
Stress:
• Psychological stress (depression,
anxiety)
• Physiological stress (nervousness,
lack of energy)
 Effects of
medications:
• E.g. Alcohol, alpha blockers,
amphetamines, anti-convulsion,
diuretics, marijuana.
CLASSIFICATION
OF SEXUAL
DISORDERS:
1. GENDER IDENTITY
DISORDER:
These disorders are characterized
by disturbance in gender identity, i.e.
the sense of one’s own masculinity
and femininity is disturbed.
• Transexualism
• Dual role transvestism
• Intersexuality
2. PSYCHOLOGICALAND
BEHAVIOURAL DISORDERS:
• Disorder of sexual development and
maturation includes disorder where
sexual orientation causes significant
distress to the individual or
disturbance in relationships.
• The preference as well as physical
and emotional attraction one
develops for a partner of particular
gender is call sexual orientation.
E.g.
Heterosexuality
Homosexuality
Bisexuality
3. PARAPHILIAS:
• Paraphilias (also known as sexual
perversion and sexual deviation).
• It is used to identify repetitive or
preferred sexual fantasies or
behaviours that involve any of following,
• The preference for use of nonhuman
object.
• Repetitive sexual activity with
human that involves real or
stimulated suffering or humiliation.
• Repetitive sexual activity with non-
consenting partner.
Types of Paraphilia:
• Fetishism: the use of non-sexual or
nonliving objects or part of a
person's body to gain sexual
excitement.
• Masochism: the recurrent urge or
humiliated, beaten, bound,
behaviour of wanting to be
or
otherwise made to suffer.
• Voyeurism: the recurrent urge or
behaviour to observe an
unsuspecting person who is naked,
disrobing or engaging in sexual
activities, or may not be sexual in
nature at all.
• Pedophilia: sexual activity with a child
that is prepubescent (usually 13
years old or younger)
• Gerontophilia: becoming sexually
abused by elderly individuals.
• Incest: sexual attraction to one’s own
children or blood relation.
• Necrophilia: sexual activity with dead
person.
• Zoophilia: aroused by sexual contact
with animal.
Treatment of Paraphilias:
• Psychotherapy:
Long term individual or group
psychotherapy is usually necessary.
• Pharamacotherapy
Anti-androgens:
IM Medroxy progesterone acetate
2.5- 10mg/day
4. SEXUAL
DYSFUNCTION:
• It refers to problem during
phase of sexual response
any
cycle
that prevent individual or couple
from experiencing satisfaction from
sexual activity.
Causes of dysfunction:
• Physical causes:
• Diabetes
• Heart and vascular conditions
• Chronic kidney and liver disease
• Alcoholism
• Drug abuse
Psychological causes:
• Work: related stress and anxiety
• Marital problems
• Feeling of guilt
• Effect of past sexual trauma
Categories of sexual
dysfunction:
Primary sexual dysfunction:
• Person included who have never
sexual
experienced satisfying
response.
Secondary sexual dysfunction:
• Person included who has satisfying
sexual response earlier but is suffering
from sexual dysfunction now.
Types of sexual
dysfunction:
Dysfunction of male:
• Erectile dysfunction
• Premature ejaculation
• Retarded ejaculation
• Inhibited sexual desire
Dysfunction of female:
• Primary orgasmic dysfunction
• Secondary orgasmic dysfunction
• Vaginismus
• Diminished lubrication
• Dyspareunia
• Lack of desire
LIBIDO:
• Libido known as sex drive is a
person's overall sexual drive or desire
for sexual activity.
• Sex drive is influenced by
Biological,
Psychological
Social factors.
• Sigmund Freud defined libido as
"the energy, regarded as a
quantitative magnitude of those
instincts which have to do with all
that may be comprised under the
word 'love'."
FACTORS THAT AFFECT
LIBIDO:
• Sex hormone levels and the
menstrual cycle
• Psychological and social factors
• Physical factors
• Medications
SEXUAL DESIRE
DISORDERS:
• Hypoactive sexual desire disorder
• Hypersexuality
NURSES
ROLE IN
SEXUALITY
AND SEXUAL
HEALTH:
• Over the past decades nurses have
advanced their role within sexual and
reproductive health care services
• Reproductive and sexual health care
(including reproductive, abortion and
genetic technologies) is an integral
part of individual, family and
community services provided by
professionals and other in health
care system.
• Nurses have a professional
responsibility to provide high quality,
non-judgemental reproductive and
sexual health care for their clients.
• There is now high incidence of teenage
pregnancy and STDs. Nurses are in
ideal position to give sexual health
advice to this age group, because they
often have contact with teenager for
other reason such as chronic disease
management and routine vaccination,
HPV vaccination campaign.
NURSING TASK:
• Sexual and contraceptive history
taking
• Safer/protected sex, contraception
advices/methods
• Understand and be able to discuss
different sexuality and sexual
health.
• Ability to challenge stigma and
discrimination.
• Supply emergency hormonal
contraception.
• Pre conception advices.
• Pregnancy testing
• Abortion care
• Breast awareness
• Menopausal advices
• Testicular and prostate awareness
• STI screening
• HIV testing
• HIV pre and post exposure prophylaxis
• Management of rape/ assault cases
• Examination of skin and treatment of
common genito-dermatologic problems
• Examination of oral cavity and
rectum.
• Cryotherapy microscopy
• Recognise sign and symptoms of
STIs.
TEACHING SELF
EXAMINATION:
Monthly breast self
examination:
• The method involves the woman
herself looking at and feeling each
breast for possible lumps,
distortions or swelling.
1st
• It should be perform week
following menstruation.
SEXUAL
EDUCATION AND
COUNSELLING:
understand their anatomies
• Nurses can asset client to
and
how their body function.
• The importance of open
communication between partners
should also encourage.
physiological
• Details about
changes.
COUNSELING FOR
ALTERED SEXUAL
FUNCTION:
• One technique nurse can use to help
client with altered sexual function is
PLISSIT Model, developed by Annon
1974,
P: Permission giving
LI: Limited information
SS: Specific suggestion
IT: Intensive therapy
REPRODUCTIVE
AND GENETIC
TECHNOLOGIES:
• Nurses with expertise in field of
reproductive health have necessary
knowledge and holistic approach to
contribute to well-informed decision
about: which technologies are
available, who
reproductive
should use
and genetic
technologies and how these
technologies will be monitored and
evaluated.
• Health promotion and disease
prevention strategies that address
the known cause of infertility must
be given priority as effective and
efficient means of increasing
fertility.
SUMMARY
Thank
You!!!!

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  • 3. • According to WHO, reproductive and sexual ill-health accounts the global burden of ill-health For women 20% For men 14% • It is closely related to other aspects of health. Love, affection and sexual healthy intimacy, all pay a role in relationship.
  • 4. • Sexual health is not just limited to absence of disease or dysfunction during the reproductive years • It impacts on sexual practice and action and must be practice free from sexual abuse, or discrimination and requires integration into the whole life cycle.
  • 5. • The word sex denotes whether a person is male or female or sex difference. But sexuality is related to sexual behaviour, gender consciousness, and sexual nature.
  • 7. Sexuality: • The characteristic male and female quality of the reproductive elements.
  • 8. Sexual health: • In 1975 WHO defined sexual health as, “integration of somatic, emotional, intellectual and social aspect of sexual being, in ways that are positively enriching and that enhances personality, communication and love.”
  • 11. Chromosomal linkage: • XX chromosomes combination products of female. combination is • XY male.
  • 12. Establishment of gonadal sex: • Second stage of sexual differentiation occurs by about the 10th to 12th week of gestation.
  • 13. • The male determining factor is Y chromosome leads to development of internal testes from gonad medulla; without the male factor there is development of internal ovary from the gonad cortex.
  • 14. Establishment of phenotypic sex: • When additional internal and external genital organs develops and result in actual characteristics of biologic sex.
  • 15. differentiation because each • This is critical time in sexual fetus develops both Wolffian and Mullerian genital duct system, one of which must develop other regress to product actual male or female external genitalia. • The Wolffian duct system in the presence of testosterone give rise to epididymis, the vas difference and seminal vesicle in male.
  • 16. • The Mullerian duct gives rise to the female fallopian tubes and the uterus and upper part of vagina.
  • 18. Childhood sexual behaviour: • Curiosity about sex organ of opposite sex. • Masturbation. • Question regarding pregnancy, childbirth and related to sexual matters.
  • 19. Adolescence sexual behaviour: • Self masturbation. • Sex experimentation. • Desire for partner. • Love affair. • Chating or surfing on computer.
  • 20. Adult sexual behaviour: • Problems of adjustment in sexual behaviour. • Extramarital relation. • Divorce. • Sexually transmitted disease. • Unwanted pregnancy.
  • 21. Old age sexual behaviour: • Lack of sexual stimulation. • Degeneration of organs. • Death of life partner. • Disease relate to sexual glands.
  • 23. • Person who have knowledge about sexuality and sexual health. • One who has positive attitude towards body image. • Ability to express one’s full sexual potential. • Capability to express sexuality. • Right to make free and responsible reproductive choice.
  • 24. • Ability to access sexual health. • Maintain balance between life style and sexual behaviour. develop relation effective with both • Capacity to interpersonal sexes
  • 26. Biological factors: • Congenital abnormality. • Old age and sickness. • Injuries. • Less secretion of hormones. • Pain and fatigue.
  • 27. Environmental factors: • Change n life style. • Lack of proper place and privacy.
  • 28. Psychological factors: • Disturbance and obstacle in family relationship. • Incomplete sexual knowledge. • Initial sexual experience being bitter. • Disinterest and disliking for partner. • Unnecessary hopes and expectation from partner. • Tension and pressure. • Death of beloved one.
  • 29. Hormones and genetic factors: • Can affect sperm quality. • Production of ovulation (failure to ovulate, irregular menstrual cycle)
  • 30. Sexual health history: • Multiple partners • Infectious disease such as mumps after puberty causes sterility.
  • 31. Stress: • Psychological stress (depression, anxiety) • Physiological stress (nervousness, lack of energy)
  • 32.  Effects of medications: • E.g. Alcohol, alpha blockers, amphetamines, anti-convulsion, diuretics, marijuana.
  • 34. 1. GENDER IDENTITY DISORDER: These disorders are characterized by disturbance in gender identity, i.e. the sense of one’s own masculinity and femininity is disturbed. • Transexualism • Dual role transvestism • Intersexuality
  • 35. 2. PSYCHOLOGICALAND BEHAVIOURAL DISORDERS: • Disorder of sexual development and maturation includes disorder where sexual orientation causes significant distress to the individual or disturbance in relationships.
  • 36. • The preference as well as physical and emotional attraction one develops for a partner of particular gender is call sexual orientation. E.g. Heterosexuality Homosexuality Bisexuality
  • 37. 3. PARAPHILIAS: • Paraphilias (also known as sexual perversion and sexual deviation). • It is used to identify repetitive or preferred sexual fantasies or behaviours that involve any of following, • The preference for use of nonhuman object.
  • 38. • Repetitive sexual activity with human that involves real or stimulated suffering or humiliation. • Repetitive sexual activity with non- consenting partner.
  • 39. Types of Paraphilia: • Fetishism: the use of non-sexual or nonliving objects or part of a person's body to gain sexual excitement. • Masochism: the recurrent urge or humiliated, beaten, bound, behaviour of wanting to be or otherwise made to suffer.
  • 40. • Voyeurism: the recurrent urge or behaviour to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities, or may not be sexual in nature at all. • Pedophilia: sexual activity with a child that is prepubescent (usually 13 years old or younger)
  • 41. • Gerontophilia: becoming sexually abused by elderly individuals. • Incest: sexual attraction to one’s own children or blood relation. • Necrophilia: sexual activity with dead person. • Zoophilia: aroused by sexual contact with animal.
  • 42. Treatment of Paraphilias: • Psychotherapy: Long term individual or group psychotherapy is usually necessary. • Pharamacotherapy Anti-androgens: IM Medroxy progesterone acetate 2.5- 10mg/day
  • 43. 4. SEXUAL DYSFUNCTION: • It refers to problem during phase of sexual response any cycle that prevent individual or couple from experiencing satisfaction from sexual activity.
  • 44. Causes of dysfunction: • Physical causes: • Diabetes • Heart and vascular conditions • Chronic kidney and liver disease • Alcoholism • Drug abuse
  • 45. Psychological causes: • Work: related stress and anxiety • Marital problems • Feeling of guilt • Effect of past sexual trauma
  • 46. Categories of sexual dysfunction: Primary sexual dysfunction: • Person included who have never sexual experienced satisfying response. Secondary sexual dysfunction: • Person included who has satisfying sexual response earlier but is suffering from sexual dysfunction now.
  • 47. Types of sexual dysfunction: Dysfunction of male: • Erectile dysfunction • Premature ejaculation • Retarded ejaculation • Inhibited sexual desire
  • 48. Dysfunction of female: • Primary orgasmic dysfunction • Secondary orgasmic dysfunction • Vaginismus • Diminished lubrication • Dyspareunia • Lack of desire
  • 50. • Libido known as sex drive is a person's overall sexual drive or desire for sexual activity. • Sex drive is influenced by Biological, Psychological Social factors.
  • 51. • Sigmund Freud defined libido as "the energy, regarded as a quantitative magnitude of those instincts which have to do with all that may be comprised under the word 'love'."
  • 52. FACTORS THAT AFFECT LIBIDO: • Sex hormone levels and the menstrual cycle • Psychological and social factors • Physical factors • Medications
  • 53. SEXUAL DESIRE DISORDERS: • Hypoactive sexual desire disorder • Hypersexuality
  • 55. • Over the past decades nurses have advanced their role within sexual and reproductive health care services • Reproductive and sexual health care (including reproductive, abortion and genetic technologies) is an integral part of individual, family and community services provided by professionals and other in health care system.
  • 56. • Nurses have a professional responsibility to provide high quality, non-judgemental reproductive and sexual health care for their clients. • There is now high incidence of teenage pregnancy and STDs. Nurses are in ideal position to give sexual health advice to this age group, because they often have contact with teenager for other reason such as chronic disease management and routine vaccination, HPV vaccination campaign.
  • 58. • Sexual and contraceptive history taking • Safer/protected sex, contraception advices/methods • Understand and be able to discuss different sexuality and sexual health. • Ability to challenge stigma and discrimination.
  • 59. • Supply emergency hormonal contraception. • Pre conception advices. • Pregnancy testing • Abortion care • Breast awareness • Menopausal advices
  • 60. • Testicular and prostate awareness • STI screening • HIV testing • HIV pre and post exposure prophylaxis • Management of rape/ assault cases • Examination of skin and treatment of common genito-dermatologic problems
  • 61. • Examination of oral cavity and rectum. • Cryotherapy microscopy • Recognise sign and symptoms of STIs.
  • 63. Monthly breast self examination: • The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling. 1st • It should be perform week following menstruation.
  • 65. understand their anatomies • Nurses can asset client to and how their body function. • The importance of open communication between partners should also encourage. physiological • Details about changes.
  • 66. COUNSELING FOR ALTERED SEXUAL FUNCTION: • One technique nurse can use to help client with altered sexual function is PLISSIT Model, developed by Annon 1974, P: Permission giving LI: Limited information SS: Specific suggestion IT: Intensive therapy
  • 68.
  • 69. • Nurses with expertise in field of reproductive health have necessary knowledge and holistic approach to contribute to well-informed decision about: which technologies are available, who reproductive should use and genetic technologies and how these technologies will be monitored and evaluated.
  • 70. • Health promotion and disease prevention strategies that address the known cause of infertility must be given priority as effective and efficient means of increasing fertility.
  • 72.