Archive for February, 2012

11 February 2012

Sexuality & chronic illness

Lately I was asked to do a  conference for the Canadian Liver foundation in Montreal. Much of my work that evening was to open the discussion, listen to their concerns and questions about sexuality and to answer to the best of my ability. Living with a liver condition can mean living with a chronic illness. And this is how I prepared that evening.

People living with chronic illness, elders, people living with disabilities or mentally challenge are very often denied a sexual life. When they meet their doctors, they don’t really talk about sexual concerns. On the doctors side, if the patient says nothing, the doctor  don’t come up with the subject.  That situation makes people give up on the topic even when the situation could improve more easily with some adjustment with the medication.

If you are living with a chronic disease, you might have to deal with some problems, whether it’s from your medical condition,  because of all the medication you take or just plain sexual dysfunctions that has nothing to do with your condition.  For all these reasons, its important to talk with your doctor and to meet a sexologist to talk about your sexual concerns. If it is important for you to have a sexual life, its  a good idea to learn to maximize your sexual potential to your satisfaction.  Sexuality is not only about genitals, it includes many more aspects of life. Health Canada (1)  defines sexual health in these terms:

Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction of infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.

Here are some situation that can be present when you have a chronic illness. Check it out, you and your partner may want to try a few tips to prevent or diminish the impact of your medical condition.

Self-image: Because of illness, your body may change . It is not always easy to deal with it  and many adjustments are needed.  Sometimes it is psychological, you have to deal with the loss of your old self and/or  you need to deal with the loss of the body you use to have.

  • You may need the help of a friend to buy new clothes that will fit your new shape better or seek the help of a seamstress.
  • If your hair  fall or go thinner: you can wear a wig, use Nioxin® or Nutricap®, they are good hair products to use in that situation.
  • Use a a large comb, avoid using a brush, use a satin pillow;
  • Avoid hair dye, avoid using the hair dryer if possible.
  • If you feel depress, tell your doctor, you may need to adjust your medication or you may need to see a psychologist for a few sessions.

Sexual script: Sexual scripts are those little stories and movies we play in our mind. « That’s what I will do when I meet my lover (…) he will be so surprise that he will (…). These stories keeps our sexual desire alive. When sickness comes in , your sexual desire can go away at the same time. Keep in mind that sexual desire is the  anticipation of a pleasant activity to come.

Sexual desire: Your libido might be affected very fast when you face illness. Sometimes its your medical condition or medication that affect your libido or it can also be psychogenic. With all your body changes, with the extra difficulties you have, you may have given up on sex. Remember that everyone no matter their size, their age or color is entitle to have a sexual life. Make sure that you are not giving up because of what other think about it. This decision is about you and your partner.

Remember your sexual script? Think about it, feel what it would feel, talk about it with your partner, get in the mood…

Pain during sex: Be more present to yourself and to your partner and less acrobatic, you can have intensity without using strength.  Intensity and passion is the way your intention passes in your hands to your partner’s body .  Find a comfortable and enjoyable position and stick to it for awhile. Pain medication is not the best for sex but take it well before you have sex to avoid drowsiness.

Fatigue: Its important to plan ahead for a sexual encounter with your lover. If extreme fatigue is part of your symptoms, you need to take a nap before that intimate moment. Be careful with alcohol and medication, it might make you sleepy. A hot bath before you have sex will do the same.

To avoid extreme efforts, have you ever consider using a vibrator for Madame or a (Cautious, content may be offending) masturbator for Monsieur?  The idea is to have fun and still be curious and innovative in your sex life. It can also be easier to reach an orgasm or to give one to your partner.

These are suggestions,  if you don’t need or want to reach an orgasm, this is your full right. What I hear sometimes in private is Her or Him wanting to please the healthy partner.  These sex toys can be very useful in that situation. Talk together about that alternative.

Dryness of the skin:  Put a lot of cream on your body every day, put a little  oil in your bath, use less soap.

Vaginal dryness: You have to talk with your doctor about this because he might have a solution for you. When women reach menopause, the level of estrogen (female hormones)  drop down. When women take medication, it can do the same thing. Side effects include: vaginal dryness, vaginal atrophy(your vagina shrinks), the loss of elasticity of the vagina, itching, etc.  If you lubricate enough at the beginning of intercourse but you «dry up» during sex, you can use a water base lubricant. If you use a sex toy, always use lubricant for comfort.

Erectile dysfunction: This is a problem that have many possible roots: too much cholesterol in the bloodstream, medication,  too much anxiety, diabetes, etc. You definitely need to talk about this to your doctor. He will ask you questions, he may even request some tests and he could even prescribe some medication like Viagra® if its ok with your condition.

Remember, your sexual life can improve even with a medical condition. People with chronic diseases, elders or people with an handicap think about sex too. Sexuality is great to show  your love and attachment to someone. Its a good way also to be intimate and close to your partner. I am very grateful  for the little crowd present at the Canadian Liver Foundation that night. I want to thank them for their willingness to discuss openly about what it means to have a liver disease in this Over Sex Society and how they managed it so far. Its only when people talk about what is really going on that its possible to understand and help.

Next on your list, have that talk with your doctor!

Please feel at ease to make any comment, suggestion or to ask me a question. This blog helps me to stay tune to what is going on in my field and I enjoy receiving feedbacks.

Meriza

1. Canadian Guidelines for Sexual Health Education, Revised Edition of the 2003.

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