This document discusses various topics related to sexual health and sexuality. It covers definitions of sexual health, issues with body image and eating disorders, effects of aging and disability on sexuality, and impacts of cancer, drugs/alcohol, and other medical conditions on sexual functioning and well-being. The document provides information on common sexual health problems, screening tests, treatments, and how physical and mental health interact with sexuality.

1. Chapter Thirteen The Sexual Body in Health and Illness

2. 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)

3. 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

4. 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?

5. Eating Disorders Common among certain athletic groups Anorexia nervosa Bulimia Binge eating disorder Retreating from sexuality Treatment strategies

6. 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

7. 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

8. 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

9. 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

10. 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

11. Other Drug Use and Sexuality Aphrodisiacs Marijuana Amyl nitrate Cantharides Priapism Ecstasy

12. 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)

13. Sexuality and Aging: Men Refractory period is extended Decrease in testosterone production Benign prostate hypertrophy Testosterone supplement

14. 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

15. Physical Limitations Spinal cord injury Changing expectations Vision and hearing impairment Diabetes Cardiovascular disease Arthritis Developmental disability

16. 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

17. Sexuality and Cancer: Women Ovarian cancer Oophorectomy — removal of one or both ovaries Uterine cancer Hysterectomy — surgical removal of uterus Vaginal cancer

18. Sexuality and Cancer: Men Prostate cancer Detection Treatment Testicular cancer Detection Treatment Penile cancer Breast cancer

19. Other Sexual Health Issues Toxic shock syndrome Endometriosis Anal cancer Lesbian women’s health issues Prostatitis

20. Summary Living in our bodies Alcohol, drugs, and sexuality Sexuality and aging Sexuality and disability Sexuality and cancer Other sexual health issues