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Expert Shares Tips for Talking Sexual Health With Cancer Survivors

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by KATIE KOSKO

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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!

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How To Have The ‘Sex Talk’ with Your Kids

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USA, New Jersey, Jersey City, Mother with daughter (8-9) talking on bed

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Let’s talk about “the talk.” Yep! The birds and the bees.

At some point, every parent needs to give their kids a heads up on what’s going on with their bodies and their sexuality, right? In a perfect world, that would be true, but even well-meaning parents may not know how to approach the topic. In my family, for example, I never even heard my mother or father say the word “s-e-x” until I was in my 30s!

I want to equip ESSENCE moms with a cheat sheet on how to give your kids “the talk.” After all, sexuality is a natural part of life, and loving your sexual self is important to having high self-esteem overall. Since I’m not yet a mom, I called on a friend who is also a parenting specialist to weigh in on the topic.

Parenting expert Erickka Sy Savané was once an international model and host of her own video countdown show on MTV Europe. These days, the woman who has also written for almost every major publication can be seen as the host of a new digital series called POP MOM. She says that the show and accompanying blog is a way to get African American mothers to share and discuss hot topics. Erickka lives in New Jersey with her husband and two daughters, ages 6 and 4.

Sex ed is such an important topic. Consequences of poor sexual education at home may include unintentional pregnancies, sexually transmitted diseases, body hatred and low self-esteem. My parents told me absolutely nothing about love, sex, dating and relationships. Were your parents open about sex and sexuality?

I grew up with a single mom talked to me about my period after it happened, and I vaguely remember her telling me something about sex when I was in high school. She might have mentioned getting on birth control pills if I felt like I was going to have sex. But it wasn’t a talk that started when I was young, like I’m starting to do with my daughter who is 6 years old. For instance, my daughter asked me about my current POP MOM episode that talks about ‘the sex talk and dads,’ so I had a conversation with her.

I want to be honest and I want sexuality to be something that is viewed as normal, while also letting her know that it is something for when she is much older. I wish my mom would have talked to me about sex as I was growing up so by the time I was in high school it wouldn’t have been such a big deal. I think it’s important to take the taboo out of it because as humans we are here to reproduce.

When parents ask me about how to talk to their kids about their bodies and sex, I generally advise them to begin early with age appropriate topics, as you’re doing with your daughter. How young is too young to have these conversations?

I say, if they’re asking give them answers that they can handle, while maintaining certain levels of truth. I had to start the sex talk with my daughter when she was in kindergarten because she had a classmate and best friend that started telling her all these inappropriate stories that she was observing either in her home or on TV. I didn’t want my daughter learning about sex through a 5-year-old. Psychologist Dr. Kristin Carothers says that appropriate sex conversation should begin as early as 8 or 9 years old.

Whenever we have thought about sex ed at home previously, as a culture, it has been mom talking to girls and dad talking to boys. I am so grateful for you approaching the topic of daddies talking to daughters as our relationships with our fathers define, to some extent, our de facto relationships with men.

I decided to address the sex talk from a dad’s perspective when I realized that, “Oh! I have a husband.” Unlike my mom, who was a single parent and had to do it alone, I was able to see that I can share this experience with him so it made me ask my own husband about his plans with our two daughters, and from there I wanted to hear from other dads. I was able to see that dads do have plans, even if they don’t verbalize them. I was also able to see that just by posing the question to dads, they were able to more clearly define their plans. It’s a conversation that moms and dads should be having, and having with their girls together because dads do have a different perspective that girls need to hear. It’s real value.

Growing up, my mom gave me a stack of pamphlets and books to answer my questions. How does a parent who is nervous and uncomfortable about the topic themselves bring up the issue?

Good question. Books and youtube videos give good advice. Also, a parent doesn’t have to go all-in, from the first conversation. They can start by talking about related topics like dating boys and what that means to them and their friends. Start slow and build up.

What do you advise moms say to their sons?

I think they should be honest about how babies are born. Like the technical and emotional aspects of it. I think moms should talk about respecting a woman’s body, the consequences of sex (pregnancy and disease), and I think women and men should be big on discussing consent. I read that Nate Parker [who was accused of rape] had no talks about consent beyond if a woman says yes or no. How about if a woman is drunk, unconscious? It’s still a no. I think that needs to be addressed with boys for sure. Women can do it.

Great conversation, Erickka. I am thankful for your work. Why do you feel that this topic so important?

It’s important because we were put on this planet to reproduce; so sex is a natural part of our lives like eating and sleeping. If we normalize it from a young age by talking about it, with all it’s grey areas, kids will have a better time. I find myself having identity, gay and transgender talks with my daughters because there’s no way around it

Complete Article HERE!

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Science can’t explain sexual orientation. Here’s why

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By Rafi Letzter

first_kiss_still

Why are you so straight? Why are you so gay? Why are you so bi? Science doesn’t have any definite answers.

I reached out to Ritch Savin-Williams, a developmental psychologist at Cornell University and author of several books focused on sexuality. I asked him what we know about why and how people develop their sexual preferences. He explained that the answer is not all that much, and that the problem is that there’s no good way to do the necessary research.

“We have some sense that some major part of [sexuality] is biological. But what part of biology? Is it a gene? Genes? Hormones? Prenatal hormones?” he said.

This issue is prevalent across the field, he explained. The roots of attraction are a mystery.

“Why are we attracted to what we’re attracted to?” Savin-Williams asked. “For example: pedophiles. How does someone get to be a pedophile? We have no idea. We don’t even really know why someone is straight versus gay versus bi versus all the other pan-sexuals, asexuals, all of the different sexuals. We don’t know why.”

(To be clear, Savin-Williams was not morally conflating pedophilia with being straight, gay or bi — just explaining how little we understand about how attraction forms.)

The problem, he said, is that researchers in his field aren’t able to do good research on children.

“We can’t ask children about their sexuality. Take a 5-year-old and say ‘What are you sexually attracted to?’ and you’ll get put in jail. So we can’t ask children about their sexuality at all.”

There’s are obviously good reasons society frowns on asking detailed sexual questions of children. But the reality is that so much of sexual development happens at that phase of life that it’s impossible to form a complete picture without it.

“We don’t know anything about it. And yet we all know that children masturbate … We know that their sexual attractions are there before puberty. And that they’re sexually interested in themselves and other people. And yet we can’t do research on that,” he said.

What’s more, there’s reason to doubt people’s memories of their childhood sexualities once they grow up, even though that’s usually what the research is relying on.

“All of my data that I’ve collected is on adolescents and young adults, and I struggle even to ask high school kids,” Savin-Williams said. “It’s all retrospective.”

There are a few studies on children from Scandinavian countries with looser cultural norms around sexuality and childhood, Savin-Williams said. But the data is still a trickle. And without it, so much of why we develop the sexual feelings we do remains a mystery.

 Complete Article HERE!

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The Sex Talk You Can’t Skip

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These conversations with children are far more critical than parents think

by Deirdre Reilly

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Moms and dads typically grit their teeth, square their shoulders, and take a deep breath when it’s time for “the birds and the bees” talk with their kids. For many parents, by the time they gather the courage to have “the talk” — it’s way too late.

One father of two from Charlottesville, Virginia, joked to LifeZette, “I had the sex talk with my kids, and it was not bad at all. Sure, they were asleep — but I have to say it really went pretty well!”

There is no reason to avoid or fear the talk with the kids.

“Talking to kids about sexuality does not encourage them to be sexual,” Dr. Rita Eichenstein, a pediatric neuropsychologist in Los Angeles, told LifeZette. “We give our kids all types of information to protect them — why wouldn’t we talk to them about sex? There are a lot of bad things in this world, but sex isn’t one of them. The facts of life aren’t scary — they’re beautiful.”

The best way to discuss a healthy sexual identity with children is to make the topic as normal as possible for both parent and child.

Bobbi Wegman, a Brookline, Massachusetts, clinical psychologist, advocates using the world around you to begin teaching age-appropriate sexual information.

“I’m a mother of three kids, and it is absolutely vital to talk about sex with your children in a direct and 002honest manner that is appropriate for their age,” she told LifeZette. “Personally, the first time this came up in our home, my son was four — he asked where babies came from. We had just finished the summer and he had planted and raised the vegetables in our garden, and I used that as a metaphor for where children come from. ‘Dad planted a seed in Mommy and it grew into a baby, just like the tomato plant you planted,’ I told him. It is best to model that sex and our bodies aren’t shameful, and that sex is completely natural,” she added.

One Boston-area mom recounts how her third pregnancy opened the door for discussion with her first child, a fifth grader.

“He asked me how I first knew I was pregnant, and I said I had missed my period,” this mom of three told LifeZette. “He said, quite casually, ‘Yeah, so what is that?’ We were able to move on from there to a great discussion, which I had been longing to have with him.”

Waiting until your child is a teenager is to late to begin, the experts say.

“Teens, by virtue of their developmental stage, believe they are invincible and thus may not consider the risks associated with their actions,” Laguna Beach, California, psychiatrist Gayani DeSilva told LifeZette. “However, health risks can have lasting implications. For example, teens should be aware that contracting herpes is a lifelong condition that will impact sexual activity for life — and will need to be disclosed to all future sexual partners.”

Other health risks include mental health problems. “Sex in the context of a respectful, loving relationship will not be mentally damaging,” said DeSilva. “But sex in the context of a power struggle, assault, incest, rape, or molestation can have devastating effects on a person’s self-esteem and mental well-being. It may even be the trigger for suicide.”

Adults can hold the view that sexual activity is to be enjoyed only through marriage and still talk to their kids about sex — and the risks associated with it.

“Be consistent in your beliefs — if you are conservative, act conservative,” said Eichenstein. “Be modest, attend church and give them exposure to this topic in a way that is consistent with your morals and values. No closet Puritans allowed — you have to talk the talk and walk the walk of your own family’s moral code.”

Eichenstein understands a parent’s discomfort over “the talk.”

“The media and the culture have made sex really sleazy, and that’s what parents are embarrassed about,” she said. “All the ‘Fifty Shades of Gray’ stuff mangles the reality of normal, healthy sex, and that’s why it is critical that lines of communication are open from very early on. Body parts should be correctly named with young children, and parents should work hard to stay natural about sex.”

Chunking sexual information is good, said Eichenstein, beginning with a series of little talks starting very young. “Remember, the older children get, the less likely they are to listen to the information you have to share. Use books or other helpful materials — don’t fly on your own if it’s not working. Leave a book on your child’s night table and they will read it, guaranteed.”

003“Before sexual activity is the time for the talk — after is too late,” Eichenstein emphasized, adding that 4th, 5th and 6th grade is the window in which to share more in-depth information about sex. “It is good to say, ‘I don’t endorse that you become sexually active. But I hope that if and when you are ready down the road, I hope you’ll be open to talking to me — I’m here to help you.’”

Pornography now seems normative, said Eichenstein, which makes “the talk” an uphill battle for parents.

“Pornography desensitizes kids to sexuality, and cheapens it, too,” she said. “They no longer know how to have a healthy relationship, or how to trust their instincts. My guess is that girls actually want the type of relationships people had in the 1950s — a very romantic relationship.”

It is important to help girls have a sense of self when it comes to sexuality, and to always refuse to do what they don’t want to do — and how to say no to overtures from boys that are not welcome. “That’s the most important part of sex education for girls, in my view — knowing how to get out of a bad situation.”

Eichenstein said parents talk to boys a lot less about sex than they talk to girls, and this is dangerous. “Boys can turn into aggressors and they need to be taught by responsible parents,” she noted.

“Simple empathy between the sexes is a huge part of good sexual education for children,” noted Eichenstein. “For boys, it’s the ability to put themselves in a girl’s shoes — and act accordingly.”

Complete Article HERE!

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French Researcher Wants to Make Sex Education More Accurate With 3D Printed Clitoris

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clit

What’s this? Many people still don’t know.

Sex education varies greatly from school to school, location to location – some places don’t teach it at all, while others teach abstinence only; some schools are much more thorough in terms of discussing safe sex and birth control. I went to Catholic elementary school, and I remember getting a textbook called Gifts and Promises, a few awkward anatomical diagrams, and dire warnings about ruined lives and sin. That was more than two decades ago, so I don’t know how the program may have changed since then, but there has been some encouraging news lately about public schools introducing increasingly comprehensive programs that address issues of consent and safety, as well as same-sex relationships and non-binary gender identities.

Then there’s sex ed in France. According to researcher Odile Fillod, the system has a lot of room for improvement, especially when it comes to the female anatomy. She’s not the only one who thinks so – in June, Haut Conseil à l’Egalité (High Council for Equality), a government organization dedicated to issues of gender equality, published a report indicating that sex education in France is still full of woefully outdated and sexist ideas. The information – or lack thereof – about one particular female organ especially concerns Fillod.

She turned to Melissa Richard, mediator of the Carrefoure Numérique Fab Lab at the Cité des Sciences et de l’Industrie in Paris, who took to Blender to create a 3D model of an organ that remains a mystery to many, and one that’s still given little mention in many sex ed programs: the clitoris.

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“The idea came as part of the preparation of videos dealing with non-sexist way of themes SVT program about sex and sexuality,” says Fillod. “In textbooks, the clitoris is often overlooked and is systematically misrepresented when it is. It was therefore able to show concretely what it looks like to talk about sexual anatomical and physiological bases of desire and pleasure remembering women, for once.”

Fillod has been working with V’idéaux, a Toulouse-based documentary film production company, to create a Ministry of Education-supported website dedicated to the promotion of respect and equality between men and women. V’idéaux wanted to include a video about the clitoris on the website, which is set to launch in January 2017, and Fillod realized that she could incorporate a film of the 3D design and printing process onto the site. You can see the video, which probably has the most sensual soundtrack you’ve ever heard in a film about 3D design, below:

It took a bit of work to find anatomically accurate drawings of the clitoris to base the 3D model on, showing that Fillod is correct in her assertion that this organ has been a highly misrepresented one. Once Richard had a realistic model designed, it was printed in PLA on a Mondrian 3D printer, and the open source file has been made available – the world’s first open source, 3D printable clitoris, if I’m not mistaken.clitoris

Fillod is hoping that 3D printed clitorises will be used by teachers and doctors to learn and teach about the actual structure, dimensions and function of this important part of the female body. Even though France has the reputation of being sexually progressive, Fillod told The Guardian, the focus is still mostly on male sexuality, to the extent that women and girls are largely uneducated about their own bodies.

“It’s important that women have a mental image of what is actually happening in their body when they’re stimulated,” she said. “In understanding the key role of the clitoris, a woman can stop feeling shame, or [that she’s] abnormal if penile-vaginal intercourse doesn’t do the trick for her – given the anatomical data, that is the case for most women.”

Will 3D printed clitorises start showing up in the classroom? We’ll see…but at least Fillod and Richard have brought some much-needed attention to the often-downplayed and still-taboo subject of female sexuality and pleasure.

Complete Article HERE!

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