Category Archives: Health Concerns

Disability and desire

Martha explores how to feel loved when you find it impossible to love yourself

'You can't conduct healthy relationships when you don't truly believe that anyone could ever be in love with you'

‘You can’t conduct healthy relationships when you don’t truly believe that anyone could ever be in love with you’

by Martha Saunders

“So, we’re autistic” said the man on the screen, flatly. I played the clip over and over again, searching for the joke. “So, we’re autistic.” “So, we’re autistic.” The meme was a clip from the show The Undateables, and it had surfaced on my news feed because someone I’d recently hooked up with had liked it. I typed out various increasingly explicit formulations on the response “Undateable? that’s not what you said the other night” before deleting them and throwing my phone across the room, furiously wiping tears from my eyes and a warm wave of familiar self-disgust churning through my stomach.

Confession: the main reason I don’t tell anyone about being autistic is that it isn’t very sexy. Disability in all its forms is utterly desexualised in our society – autism particularly so, in part due to it’s inaccurate representation as something which primarily affects young children. Autistic characters don’t have sexual relationships unless their clumsy attempts at doing so are a source of comedy for neurotypical viewers. We are “undateable.”

Young autistic women exist in a strange and dangerous contradiction. Young women are taught their primary value is their sexual attractiveness; disabled people are constantly publicly desexualised. As a result, I spent much of my teenage life obsessively chasing something which would always be, by definition, just a little out of my reach.

No matter how hard I worked to look pretty enough, sound smart enough, deliver flirty and funny enough comebacks, something about me still felt inherently undesirable. I cut my hair a different way every few months and saved my school lunch money for fake nails, a rainbow of lipsticks and boxes of hair dye in bright red, peroxide blonde, jet black, pastel pink and chocolate brown, hoping that one day I’d hit on some magic combination of chemicals that erased what felt like a ugly, rotten core.

Like many young women who’ve always felt something was a little out of place, I was drawn to fourth-wave feminism’s mantra of self-love and body positivity like a moth to a bulb. But while I saw women around me flourish in these spaces, they weren’t what I was looking for. In fact, as a slim, white, blue-eyed blonde, I am slightly incongruous in them; women who look like me are already constantly validated as being physically attractive. My sense of inadequacy hadn’t been coming from my body; conversely, I realised, I had been using making my physical self look as good as possible in order to to compensate for the insecurity I felt about my disability. When your insides feel uglier than your outside, the concept of inner beauty just makes you feel worse.

If it were that easy

If it were that easy

It’s not hard to predict how this deep-rooted sense of undesirability can manifest in unhealthy relationships. While the logical, stridently feminist, #StrongIndependentWoman side of me knows to take no shit from creepy men who feel entitled to my body, there is a part of me, larger and more influential than I’d like to admit, which feels someone like me should be pathetically grateful for sexual or romantic attention. Even when it comes to full relationships, it’s still very difficult for me to separate genuine attraction to a man from intense gratitude at his interest in me. Whether it’s likes on a selfie or a series of incredibly inadvisable involvements with boys I should theoretically despise, I am constantly looking for ways to compile quantifiable proof that I am desirable.

Women with invisible disabilities struggle with sex and relationships in many different ways; some of us become terrified of engaging in sex or dating at all; some of us attempt to fill our deep sense of inadequacy with as many flings and one night stands as possible. Some of us become prime targets for abusive relationships due to our predisposition to self-doubt and our fear that nobody else will accept us; some of us hold partners at arms length or self-sabotage as quickly as possible, fearing that if anyone gets close enough to find out what we’re really like they will be repulsed and hurt us more.

It sounds like a cheesy platitude, but you can’t conduct healthy relationships when you don’t truly believe that anyone could ever be in love with you, and you can’t believe that anyone could be in love with you until you’ve learned to love yourself. It’s hard to do this when you’ve only ever seen people like you degraded and mocked for their efforts to feel wanted. A lot of the people cracking jokes about your disorder will have no idea how many brilliant, captivating, engaging disabled people they’ve been attracted to. If that makes you “undateable” to them? Their loss.

Complete Article HERE!

Does Anal Sex Lead To Anal Cancer?

3 Facts And Myths For Sexual Partners


Anal sex is no longer quite the salacious taboo it once was.

Not only has society steadily become more accepting of sexual relationships between men, but more heterosexual people are trying it and trying it more often than ever before. Recent surveys  estimate that 40 percent of women between the ages of 20 to 24 have tried anal sex, and 20 percent of all women have tried it in the last year.

Our greater societal acceptance aside, you may have heard that anal sex can have some dangerous effects on our health, particularly as a leading cause of anal cancer. So let’s take a brief look at some basic facts and myths about anal sex and its connection to cancer.

The myths and facts behind the connection between anal sex and anal cancer.

The myths and facts behind the connection between anal sex and anal cancer.

1. It Can Cause Anal Cancer

The long and short of it is that yes, anal sex is a risk factor for anal cancer.

Anal sex can transmit the human papillomavirus (HPV), and HPV in turn leaves the cells around our rectum more vulnerable to mutating and becoming cancerous. A similar risk exists wherever HPV rears its ugly microscopic head, including the mouth, throat, and cervix. And because anal sex is generally more damaging to the inner lining of the rectrum than the stereotypical notion of heterosexual sex is to the vagina, HPV and other sexually transmitted infections are more easily spread between people who engage in anal sex. Similarly, the greater number of sexual partners, the greater the risk of cancer.

2. But It’s Rare

Close to 90 percent of anal cancer cases can be traced back to HPV. But the cancer itself is relatively rare.

According to The American Society of Colon and Rectal Surgeons, only 8,000 people will be newly diagnosed with anal cancer this year. And though cases have been slowly increasing in recent decades, only one of every 500 people will develop anal cancer in their lifetime, generally between the ages of 55 to 64 — a stark contrast to the one in every 22 people who will develop colorectal cancer.

3. And Preventable

Like other forms of cancer fueled by HPV, the available HPV vaccine can likely cut down the risk of developing anal cancer in both men and women.

While HPV vaccination rates still aren’t anywhere near as high as we’d like them to be, there is already evidence that the vaccine has lowered the risk of later cervical cancer in teen girls. And though we don’t have any concrete evidence that the same decline has occurred for anal cancer just yet, there is some showing the vaccine reduced the risk of cells in the anus becoming precancerous in young men who have sex with men.

Both teen boys and girls are now regularly encouraged to get the HPV vaccine, but when it comes to anal cancer, it may benefit women more — two-thirds of new cases are diagnosed in women.

Complete Article HERE!

Sexual Health for Singles: Helpful Hints for Having the Sexual History Conversation

By Charles Burton


Unless two people are absolute virgins when they meet, they should sit still for a few minutes and have “the conversation” prior to hopping into bed together. It’s not a pleasant thing to think about, but facts are facts, and STDs are commoner than you might think. If you’re going to engage in adult behavior, it’s imperative that you act with at least a modicum of maturity. Part of that maturity involves open communication with any and all sexual playmates you encounter.

What are STD and STI

According to Mayo Clinic, Sexually transmitted diseases (STD) and sexually transmitted infections (STI) are the same thing with different acronyms. Both terms refer to infections and diseases that are spread by way of sexual contact. Not all STDs are transmitted via sexual activity, however. A number of so-called sexually transmitted infections can be spread via blood transfusion, shared needles and the birth process.

Among the commonest STD are gonorrhea, chlamydia, syphilis and hepatitis. These are not the only diseases that can be transmitted by sexual contact, however. HIV is a dangerous disease that does not have a cure as yet. HPV and genital herpes are other STD infections for which there is currently no effective, long-lasting cure.

How to start the STD conversation

Relationship experts at Psychology Today recommend finding (or making) the time to talk when neither partner is busy or distracted. When there’s a football game on TV, it may not be the right time or place to broach the topic of sexual history. Keep the mood positive, and never express alarm or disgust at the number of previous sexual partners either of you has had. Accept the information offered by your potential sexual partner with grace, dignity and humor.

US News notes that the pre-sex talk doesn’t necessarily have to happen in person. In fact, it may be easier to start the conversation while chatting in a private message or texting on the phone. Starting the conversation and honestly communicating is far more important than the set and setting of “the talk.” Because the STD conversation is so imperative to good health for both partners, anonymous sexual encounters are not recommended.

Things to mention during The Talk

If you’re intimate enough to consider sexual relations with another person, you should feel comfortable enough to broach the subject of sexual history with them. Conversely, if you are too shy to mention condoms, request testing or to reveal a prior STD infection, you may wish to totally reconsider whether to begin a sexual relationship at all. Sex is, after all, a sophisticated form of human communication that works best when both partners are able to be completely open, candid and honest with one another.

Sexual history doesn’t need to divulge every detail, but it is crucial that you advise your partner of any hepatitis, gonorrhea, genital warts or other STD you have ever been exposed to.

How to prevent sexually transmitted infection

The most effective way to eliminate the risk of STD infection is to eschew sexual contact altogether. But, as you probably know, complete abstinence is not a realistic solution. Knowing one’s own body, recognizing symptoms and seeking medical help at the first sign of STD are far more effective methods of reducing sexually related infections.

Symptoms of STD may include sores on the genitals or around the mouth. Painful urination and penile discharge are also symptoms of STD, says Mayo Clinic. Foul-smelling vaginal leakage, abdominal aches, unusual bleeding between periods, and painful intercourse are other signs of sexually transmitted infection.

If you think that you or your partner may be infected with any sort of STD or STI, please make an appointment with a doctor or visit an STD testing center without delay. The sooner you are diagnosed, the sooner you can receive treatments to alleviate symptoms and treat the infection. The worst thing you can do, as far as your own health is concerned, is to feel too embarrassed to visit a clinic to be tested and treated for possible infection.

Lovemaking, sexual intimacy, or hooking up as “friends with benefits” can be a beautiful thing, but sex is fraught with danger, too. Do your best to reveal your truth with humor and grace, and you may be well on the way to forming a blissful interpersonal relationship that can last a lifetime. If not, you’ll at least reduce your risk of becoming infected while enjoying a hot weekend with a special someone.

Complete Article HERE!

Cancer patients and survivors can have trouble with intimacy


People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.

People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.(Photo: Getty Images/Comstock Images)

In the mirror, Kelly Shanahan looks normal, even to herself.


Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health.

But she does not feel like herself.

The breasts she had reconstructed eight years ago look real, the nipples convincing. But her breasts have no sensation. The only time she feels them at all is during the frigid winters of her South Lake Tahoe, Calif., home, when they get so cold, she has to put on an extra layer of clothing.

“For a lot of women, breast sensation is a huge part of sexual pleasure and foreplay. That is totally gone,” says Shanahan, 55, who has lived with advanced breast cancer for three years. “It can be a big blow to self-image, even though you may look normal.”
Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health. (Photo: Kelly Shanahan)

Shanahan is part of a growing group of patients, advocates and doctors raising concerns about sexual health during and after cancer treatment.

“None of us would be here if it weren’t for sex. I don’t understand why we have such a difficult time talking about it,” she says.

Though virtually all cancer diagnoses and treatments affect how patients feel and what they think about their bodies, sex remains an uncomfortable medical topic.

Shanahan, an obstetrician herself, says that until her current doctor, none of the specialists who treated her cancer discussed her sex life.

“My former oncologist would rather fall through the floor than talk about sex,” she says.

Major cancer centers now include centers addressing sexuality, but most community hospitals still do not. The topic rarely is discussed unless the patient is particularly bold or the doctor has made a special commitment.

There’s no question that cancer can dampen people’s sex lives.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Weight gain or loss can affect how sexy people feel. Fatigue is unending during treatment. Body image can be transformed by surgeries and the idea that your own cells are trying to kill you. The constant specter of death is a sexual downer, as are the decidedly unsexy aspects of cancer care, like carrying around a colostomy bag. Then, there are the healthy partners, feeling guilty and terrified of causing pain.

And once people start to associate sex with pain, that can add apprehension and muscle tightness, which makes intercourse harder to achieve, says Andrea Milbourne, a gynecologist at the University of Texas MD Anderson Cancer Center in Houston.

There’s almost never a medical reason cancer patients or survivors shouldn’t be having sex, says Karen Syrjala, a clinical psychologist and co-director of the survivorship program at the Fred Hutchinson Cancer Research Center in Seattle. Even if there is reason to avoid intercourse, physical closeness and intimacy are possible, she says, noting that the sooner people address sexual issues the less serious those issues will be.

“Bodies need to be used and touched,” she says said. “Tissues need to be kept active.” Syrjala recommends hugging, romantic dinners, simple touching, “maybe just holding each other naked at night.”

There are ways to improve sexual problems, starting with doctors talking to their patients about sex. Milbourne and others say it’s their responsibility, not the patients’, to bring up the topic.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Communication between partners also is essential. “A lot of times, it’s unclear, at least in the mind of the other partner who doesn’t have a cancer, what has happened. ‘Why does this hurt? Why don’t you want to do anything?’ ” Milbourne says.

For women who have pain during sex, Milbourne says one study found benefit to using lidocaine gel to numb vaginal tissue.

Jeanne Carter, head of the female sexual medicine and women’s health program at Memorial Sloan Kettering Cancer Center in New York City, recommends women do three minutes of Kegel exercises daily to strengthen their pelvic floor muscles and improve vaginal tone, and to help reconnect to their bodies.

For women sent abruptly into menopause, moisturizing creams can help soften tissue that has become brittle and taut. Carter says she’s conducted research showing that women with breast or endometrial cancers who use moisturizers three to five times a week in the vagina and on the vulva have fewer symptoms and less pain than those who don’t. Lubricants can help smooth the way, too.

“We’ve got to make sure we get the tissue quality and pain under control or that will just undermine the whole process,” Carter says.

Sex toys also take on a different meaning after cancer treatment. Specialized stores often can offer useful advice and the ability to examine a product before buying. Rings and other equipment, in addition to medications such as Viagra, can help men regain erections.

Doctors and well-meaning friends also need to stop telling cancer patients that they should simply be glad to be alive, Shanahan says. Of course she is, but eight years after her initial diagnosis and three years after her disease advanced, Shanahan wants to make good use of the time she has left.

And that, she says, includes having a warm, intimate relationship with her husband of 21 years.

Complete Article HERE!

Expert Shares Tips for Talking Sexual Health With Cancer Survivors



Sexual health can be an uncomfortable or embarrassing topic to discuss for many people, and for patients with cancer and survivors it can feel even more awkward. Nevertheless, sex ranks among the top 5 unmet needs of survivors, and the good news is, proactive oncology practitioners can help fill that void.

Sixty percent of cancer survivors—9.3 million individuals in the United States alone—end up with long-term sexual problems, but fewer than 20% get professional help, according to Leslie R. Schover, PhD, founder of the digital health startup, Will2Love. Among the barriers she cited are overburdened oncology clinics, poor insurance coverage for services related to sexual health, and an overall lack of expertise on the part of providers, many of whom don’t know how to talk to patients about these issues.

And, oncologists and oncology nurses are well-positioned to open up that line of communication.

“At least take one sentence to bring up the topic of sexuality with a new patient to find out if it is a concern for that person,” Schover explained in a recent interview with Oncology Nursing News. “Then have someone ready to do the follow-up that is needed,” and have other patient resources, such as handouts and useful websites, on hand.

Sexual issues can affect every stage of the cancer journey. Schover, who hosted a recent webinar for practitioners on the topic, has been a pioneer in developing treatment for cancer-related problems with sexuality or fertility. After decades of research and clinical practice, she has witnessed firsthand how little training is available in the area of sexual health for healthcare professionals.

“Sex remains a low priority, with very little time devoted to managing sexual problems even in specialty residencies,” said Schover. “I submitted a grant four times before I retired, to provide an online interprofessional training program to encourage oncology teams to do a far better job of assessing and managing sexual problems. I could not get it funded.”

In her webinar, she offered tips for healthcare practitioners who want to learn more about how to address sexual health concerns with their patients, like using simple words that patients will understand and asking open-ended questions in order to engage patients and give them room to expand on their sex life.

Schover suggests posing a question such as: “This treatment will affect your sex life. Tell me a little about your sex life now.”

Sexual side effects after cancer treatment vary from person to person, and also from treatment to treatment. Common side effects for men and women include difficulty reaching climax, pain during sexual intercourse, lower sexual desire and feelings of being less attractive. Men specifically can experience erectile dysfunction and dry orgasm, while women may have vaginal dryness and/or tightness, as well as loss of erotic sensation such as on their breasts following breast cancer treatment.

Sexual dysfunction after cancer can often lead to depression and poor quality of life for both patients and their partners.

According to Schover, oncologists and oncology nurses should provide realistic expectations to patients when they are in the treatment decision-making process.

“Men with prostate cancer are told they are likely to have an 80% chance of having erections good enough for sex after cancer treatment,” Schover says. “But the truth is it’s more like 20 to 25% of men who will have erections like they had at baseline.”

To get more comfortable talking about sex with patients, Schover advises role-playing exercises with colleagues, friends, and family—acting as the healthcare professional and then the patient. When the process is finished, ask for feedback.

Brochures, books, websites and handouts are also good to have on hand for immediate guidance when patient questions do arise. But Schover is hoping for a bigger change rooted in multidisciplinary care and better patient–provider communication to find personalized treatments tailored to each individual’s concerns and needs.

Cancer treatment can impact hormonal cycles, nerves directing blood flow to the genitals, and the pelvic circulatory system itself, she explained. In addition, side effects like prolonged nausea, fatigue, and chronic pain also can disrupt a patient’s sex life.

“Simply to give medical solutions rarely resolves the problems because a person or couple needs to make changes in the sexual relationship to accommodate changes in physical function,” Schover stressed. “That kind of treatment is usually best coming from a trained mental health professional, especially if the couple has issues with communication or conflict.”

Schover wants to make sure that those resources are easily accessible to patients and survivors. Thus, she has created the startup, Will2Love, which offers information on the latest research and treatment, hosts webinars, and provides access to personalized services.

“Sexual health is a right,” concluded Schover, and both oncology professionals and patients need to be assertive in getting the conversation started.

Complete Article HERE!