Sexuality and sexual health

sexuality, sexual health, sexual orientation, gender identity, body image...

1. SEXUALITY AND SEXUAL HEALTH Ms. Sonali katoch

2. SO GOD CREATED MAN IN HIS OWN IMAGE. IN THE IMAGE OF GOD HE CREATED THEM. MALE AND FEMALE HE CREATED THEM. GOD BLESSED THEM AND SAID TO THEM, “BE FRUITFUL AND INCREASE IN NUMBER; -Genesis

3. Cont…. Where does sex live? And where does sexuality reside? “In our minds, bodies… in our cultures, attitudes, laws, in our pants, our wallets, in our politics, identities, in our very beings. Wherever we go sex and sexuality follow”. They are there, everywhere, obvious by their presence and conspicuous by their absence.

4. Meaning and Definitions SEX – Sex is the term most commonly used to identify biologic male or female status. The more appropriate and descriptive term, however is “Gender” The term ‘sex’ is also used to describe sexual behaviour in general such as “ when is the last time you had sex?”

5. Sexuality The term “human sexuality” concerns the ways in which we experience and express ourselves as sexual beings. ‘Sexuality’ includes how you feel about your body, interest in sexual activity, your need for touch, the ability to communicate your sexual needs to a partner and the ability to engage in satisfying sexual activity.

6. Sexual Health Definition: The world health organization defined ‘sexual health’ in 1975 as “ the integration of the somatic, emotional, intellectual and social aspects of sexual being, in ways that are positively enriching and that enhance personality, communication and love”.

7. SEXUAL WELL BEING “sexual well being” is defined as capacity to enjoy and control sexual behavior in accordance with a social and personal ethic. - Freedom from fear, shame, guilt, false beliefs and other psychological factors inhibiting sexual response and impairing sexual relationship - Freedom from organic disorder, disease and deficiencies that interfere with sexual and reproductive functions.

8. COMPONENTS OF SEXUAL HEALTH SEXUAL SELF CONCEPT BODY IMAGE GENDER IDENTITY SEXUAL ORIENTATION

9. SEXUAL SELF CONCEPT One’s self concept (how one values oneself as a sexual being). A positive sexual self-concept enables people to form intimate relationships throughout life.

10. BODY IMAGE Body image, a central part of the sense of self, is constantly changing People who feel good about their bodies are likely to be comfortable with and enjoy sexual activity.

11. Gender Identity Gender identity is one’s self image as a female or male. -Cross dressers - intersexed -Preoperative transsexuals- hormonal treatment and gender reassignment surgery.

12. SEXUAL ORIENTATION One’s attraction to people of the same sex, other sex or both sexes is referred to as sexual orientation. -Heterosexuals -Homosexuals -bisexuals

13. CHARACTERISTICS OF BEING SEXUALLY HEALTHY Behavior consistent with gender identity Being knowledgeable about sexual phenomenon Physical and emotional ability to engage in a sexual relationship Willingness to make adjustment in sexual functioning Ability to communicate about sexual issues

14. FACTORS AFFECTING SEXUALITY Developmental factors Intrauterine Infancy Toddler Preschooler School age Adolescence Young adulthood Middle adulthood Late adulthood

15. Cont… Relationship Cognition and perception Environment Culture , values, Beliefs Life style Ethics Self concept Previous experiences Pregnancy infertility Health status

16. Cont… Health status- Diabetes mellitus Cardiovascular diseases Prostate cancer Hysterectomy Spinal cord injury Sexually transmitted diseases Mental disorders Surgical procedures Joint diseases Chronic pain

17. SEXUAL RESPONSE CYCLE “HE WANTS TO DO SHE WANTS TO TALK ”

18. Cont… Masters and Johnson found that the physiological responses of men and women to sexual stimulation are quite like. Both experience vasocongestion and myotonia in the response cycle.

19. Sexual cycle has four phases Excitement Plateau Orgasm Resolution

20. Sexual cycle

21. Excitement phase Also called as arousal phase, the initial phase, occurs as a result of any erotic physical or mental stimulators such as kissing, petting. sexual excitement is characterized by erection in the male and vaginal lubrication in the female.

22. Plateau Phase The Plateau phase is advanced state of arousal that precedes orgasm where clitoris retracts in females and secretions from Cowper’s gland appear at glans of penis in males Increases in circulation and heart rate Muscle tension increases further

23. Orgasmic Phase The conclusion of Plateau phase in a release of sexual tension. Both males and females experience quick cycles of euphoric sensation.

24. Sexual cycle

25. Cont….

26. Resolution Return to normal body functioning present before the excitement phase. Feelings of relaxation, fatigue and fulfillment Also known as the “refractory period”

27. Cont…. “Couples who have good sex over the years learn to play at it rather than work at it. They have fun with it.”

28. Sexual expression The methods by which people gain satisfaction through stimulation is “sexual expression” It can be classified into Normal forms of sexual expression altered forms of sexual expression

29. Normal forms of sexual expression Sexual intercourse - Vaginal intercourse Anal intercourse - orogenital stimulation -cunnilingus -fellatio Masturbation Celibacy

30. Alternate forms of sexual expression Voyerism Sadism Masochism sadomasochism

31. OTHER PARAPHILIAS FETISHISM EXHIBITIONISM FROTTEURISM PEDOPHILIA ZOOPHILIA

32. SEXUAL DYSFUNCTIONS MALE 1.Erectile dysfunction or impotence 2. Rapid ejaculation 3. Retarded ejaculation FEMALE -Hypoactive sexual desire disorder -Sexual arousal disorder -Orgasmic disorder -Sexual pain disorders Dyspareunia Vaginismus

33. Male sexual dysfunctions Sexual Erectile dysfunctions(Impotence) The inability to achieve or maintain an erection sufficient for oneself or one’s partner. - physiologic factors: spinal cord injuries, injury to the genitals, diabetes mellitus, multiple sclerosis and prolonged use of drugs, alcoholism, antipsychotics - Psychological factors- doubts, fear & anxiety, anger or stress

34. Cont…. Rapid Ejaculation(premature ejaculation) It is a condition in which a man consistently reaches ejaculation or orgasm before or soon after entering the vagina.

35. Cont…. Retarded ejaculation: It is also called as ejaculatory incompetence, refers to a man’s inability to ejaculate into the vagina, or delayed intravaginal ejaculation.

36. Female sexual dysfunction Hypoactive sexual disorder: - It involves a persistent or recurring absence of sexual thoughts or disinterest in sexual activity. - e.g. - during pregnancy, postpartum hormonal changes, menopause

37. Cont….. Sexual arousal disorder: when a woman is unable to attain or maintain adequate vaginal lubrications and/or has decreased clitoral and labial sensations. - factors include a decreased vaginal or clitoral blood flow, damage to the genital nerves, or a clinical depression.

38. Cont…. Orgasmic disorder: Defined as a difficulty or inability to achieve orgasm in spite of stimulation and arousal. - If it has always been a problem for a woman, it is referred

39. Cont…. Sexual pain disorders: -Dyspareunia : pain experienced by a woman during intercourse because of inadequate lubrication, scarring, vaginal infection or hormonal imbalance. - Vaginismus : Involuntary muscle spasms of the lower third of the vagina make insertion of the penis very painful

40. Sexual Harassment Harassment is or any annoying or distressing comment or conduct that is known or should be known to unwelcome. - eg ., Sexual jokes - Unwelcome sexually oriented and gender based behaviors - Offensive pictures(Pornography) and language

41. Issues Rape, sexual abuse and Prostitution Sexual abuse- statistics Statistics of prevalence of sexual abuse in India The first ever National Study on Child Abuse in April 2007 , covering 13 states in India and a sample size of 12,446 children was released by Minister for Women and Child Development showing these stark reality figures:

42. Cont…. • More than 53% children report facing one or more forms of sexual abuse • Almost 22% faced severe sexual abuse, 6% sexually assaulted • 50% of sexual offenders were known to the victim or were in positions of trust (family member, close relative, friend or neighbour).

43. Cont… • 5-12 years group faced higher levels of abuse, largely unreported • Boys were equally at risk as girls. • Severest sexual abuse in age group of 11-16 years. • 73% of sexual abuse victims were in age groups of 11-18years.

44. BASIC SKILLS NEEDED BY NURSE Self-knowledge and comfort with their own sexuality Acceptance of sexuality as an important area of nursing intervention. Knowledge of sexual growth and development through out life cycle. Knowledge of basic sexuality Therapeutic communication skills Ability to recognize and intervene in the needs of client and family with their sexual problems

45. PLISSIT MODEL FOR COUNSELLING P – Permission giving L I – Limited Information SS – Specific suggestion I – Intense Therapy

46. Nursing Diagnoses Sexual dysfunction, erectile failure related to antihypertensive medications Sexual dysfunction, dyspareunia related to effects of menopausal process Altered sexual pattern; loss of desire related to change in body image Altered sexual patterns, change is sexual expression related to loss of privacy due to hospitalization

47. Golden rules in good sex One is “ don’t do anything you don’t really enjoy” The other one is “ Find out your partner’s needs and don’t balk them if you can help it”

48. Cont…. “For some sex still remains a non-issue, for some others it is paramount to their very existence. For some it’s beautiful, dazzling, brilliant… for others it’s depraved, decadent, immoral, and for many it’s all that falls in between dazzle and decadence.”

49. The Greatest Gift The greatest gift one human being can give to another is love. It is not trust. Neither is it compassion or forgiveness. “It is respect”. The rest comes later. Without the of respect, none of the others would last. “NEVER UNDERESTIMATE THE VALUE OF A SINGLE SOUL”

50. Thank You