Bags for sexual interest-ABC of sexual health: A woman’s sexual life after an operation

Fluctuations and changes in hormone levels eg, at menopause, during pregnancy, with the menstrual cycle can affect sexual desire. For example, atrophic vaginitis and hyperprolactinemia may contribute. If factors that limit trust, respect, attraction, and emotional intimacy between partners are the cause, the couple should be counseled that emotional intimacy is a normal requirement for female sexual response and needs to be enhanced with or without professional help. Education about sufficient and appropriate stimuli may help; women may need to remind their partner of their need for nonphysical, physical nongenital, and nonpenetrative genital stimulation. For patient-specific psychologic factors, psychologic therapies eg, cognitive-behavioral therapy may be required, although simple awareness of the importance of psychologic factors may be sufficient for women to change patterns of thinking and behavior.

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Or you might consider connecting the bag to a night drainage bag on a stand beside the bed, again to prevent problems that could be caused by lying directly on the leg bag. She was sifting through data from her study of genital and subjective responses to audiotaped sex scenes. But there is a period of adjustment after surgery. Not surprisingly, you might not have the focus and energy required for a dynamic sexual experience. Type keyword s to search. For the discord, in women, between the body and the mind, she has deliberated over all sorts of Bags for sexual interest, the simplest being anatomy.

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Meredith Chivers is a creator of bonobo pornography.

  • It was due, partly, to one of my Psychology classes at Liberty University.
  • Sexual attraction is attraction on the basis of sexual desire or the quality of arousing such interest.
  • The urge to reproduce is powerful in all higher animals, including dogs.
  • Masturbating old bag gets busted and screwed.

Meredith Chivers is a creator of bonobo pornography. The bonobo film was part of a series of related experiments she has carried out over the past several years. She showed the short movie to men and women, straight and gay. To the same subjects, she also showed clips of heterosexual sex, male and female homosexual sex, a man masturbating, a woman masturbating, a chiseled man walking naked on a beach and a well-toned woman doing calisthenics in the nude.

While the subjects watched on a computer screen, Chivers, who favors high boots and fashionable rectangular glasses, measured their arousal in two ways, objectively and subjectively. The participants sat in a brown leatherette La-Z-Boy chair in her small lab at the Center for Addiction and Mental Health, a prestigious psychiatric teaching hospital affiliated with the University of Toronto, where Chivers was a postdoctoral fellow and where I first talked with her about her research a few years ago.

The genitals of the volunteers were connected to plethysmographs — for the men, an apparatus that fits over the penis and gauges its swelling ; for the women, a little plastic probe that sits in the vagina and, by bouncing light off the vaginal walls, measures genital blood flow.

An engorgement of blood spurs a lubricating process called vaginal transudation: the seeping of moisture through the walls. The participants were also given a keypad so that they could rate how aroused they felt. Males who identified themselves as straight swelled while gazing at heterosexual or lesbian sex and while watching the masturbating and exercising women.

Gay males were aroused in the opposite categorical pattern. Any expectation that the animal sex would speak to something primitive within the men seemed to be mistaken; neither straights nor gays were stirred by the bonobos. And for the male participants, the subjective ratings on the keypad matched the readings of the plethysmograph.

All was different with the women. No matter what their self-proclaimed sexual orientation, they showed, on the whole, strong and swift genital arousal when the screen offered men with men, women with women and women with men. And with the women, especially the straight women, mind and genitals seemed scarcely to belong to the same person. Among the lesbian volunteers, the two readings converged when women appeared on the screen. But when the films featured only men, the lesbians reported less engagement than the plethysmograph recorded.

Full of scientific exuberance, Chivers has struggled to make sense of her data. She struggled when we first spoke in Toronto , and she struggled, unflagging, as we sat last October in her university office in Kingston, a room she keeps spare to help her mind stay clear to contemplate the intricacies of the erotic.

The cinder-block walls are unadorned except for three photographs she took of a temple in India featuring carvings of an entwined couple, an orgy and a man copulating with a horse. She has been pondering sexuality, she recalled, since the age of 5 or 6, when she ruminated over a particular kiss, one she still remembers vividly, between her parents.

And she has been discussing sex without much restraint, she said, laughing, at least since the age of 15 or 16, when, for a few male classmates who hoped to please their girlfriends, she drew a picture and clarified the location of the clitoris. In , when she worked as an assistant to a sexologist at the Center for Addiction and Mental Health, then called the Clarke Institute of Psychiatry, she found herself the only woman on a floor of researchers investigating male sexual preferences and what are known as paraphilias — erotic desires that fall far outside the norm.

Who am I to study women, when I am a man? But the discipline remains male-dominated. But soon the AIDS epidemic engulfed the attention of the field, putting a priority on prevention and making desire not an emotion to explore but an element to be feared, a source of epidemiological disaster.

Intriguing glimmers have come not only from female scientists. Investigating the culmination of female desire, Barry Komisaruk, a neuroscientist at Rutgers University , has subjects bring themselves to orgasm while lying with their heads in an fM.

But Chivers, with plenty of self-doubting humor, told me that she hopes one day to develop a scientifically supported model to explain female sexual response, though she wrestles, for the moment, with the preliminary bits of perplexing evidence she has collected — with the question, first, of why women are aroused physiologically by such a wider range of stimuli than men.

Chivers has tried to eliminate this explanation by including male-to-female transsexuals as subjects in one of her series of experiments one that showed only human sex.

These trans women, both those who were heterosexual and those who were homosexual, responded genitally and subjectively in categorical ways. They responded like men. This seemed to point to an inborn system of arousal. Still, she spoke about a recent study by one of her mentors, Michael Bailey, a sexologist at Northwestern University : while fM.

For Chivers, this bolsters the possibility that the distinctions in her data between men and women — including the divergence in women between objective and subjective responses, between body and mind — arise from innate factors rather than forces of culture. One manifestation of this split has come in experimental attempts to use Viagra-like drugs to treat women who complain of deficient desire. Desire, it seems, is usually in steady supply.

In women, though, the main difficulty appears to be in the mind, not the body, so the physiological effects of the drugs have proved irrelevant. As with other such drugs, one worry was that it would dull the libido. Yet in early trials, while it showed little promise for relieving depression, it left female — but not male — subjects feeling increased lust. Testosterone, so vital to male libido, appears crucial to females as well, and in drug trials involving postmenopausal women, testosterone patches have increased sexual activity.

For the discord, in women, between the body and the mind, she has deliberated over all sorts of explanations, the simplest being anatomy. So there are hints, she told me, that the disparity between the objective and the subjective might exist, for women, in areas other than sex.

And this disconnection, according to yet another study she mentioned, is accentuated in women with acutely negative feelings about their own bodies. Lust, in this formulation, resides in the subjective, the cognitive; physiological arousal reveals little about desire. Besides the bonobos, a body of evidence involving rape has influenced her construction of separate systems. She has confronted clinical research reporting not only genital arousal but also the occasional occurrence of orgasm during sexual assault.

And she has recalled her own experience as a therapist with victims who recounted these physical responses. So, in an attempt to understand arousal in the context of unwanted sex, Chivers, like a handful of other sexologists, has arrived at an evolutionary hypothesis that stresses the difference between reflexive sexual readiness and desire.

You need something complementary. That receptivity element. But it will offer too a glimpse into the role of relationships in female eros. Chivers is perpetually devising experiments to perform in the future, and one would test how tightly linked the system of arousal is to the mechanisms of desire. She would like to follow the sexual behavior of women in the days after they are exposed to stimuli in her lab. If stimuli that cause physiological response — but that do not elicit a positive rating on the keypad — lead to increased erotic fantasies, masturbation or sexual activity with a partner, then she could deduce a tight link.

Though women may not want, in reality, what such stimuli present, Chivers could begin to infer that what is judged unappealing does, nevertheless, turn women on.

The relationship with DeGeneres ended after two years, and Heche went on to marry a man. After 12 years together, the pair separated and Cypher — like Heche — has returned to heterosexual relationships. Diamond is a tireless researcher. During that time, she has followed the erotic attractions of nearly young women who, at the start of her work, identified themselves as either lesbian or bisexual or refused a label.

Among the women in her group who called themselves lesbian, to take one bit of the evidence she assembles to back her ideas, just one-third reported attraction solely to women as her research unfolded. And with the other two-thirds, the explanation for their periodic attraction to men was not a cultural pressure to conform but rather a genuine desire. She acknowledged this. But she emphasized that the pattern for her group over the years, both in the changing categories they chose and in the stories they told, was toward an increased sense of malleability.

If female eros found its true expression over the course of her long research, then flexibility is embedded in the nature of female desire. One reason for this phenomenon, she suggests, may be found in oxytocin, a neurotransmitter unique to mammalian brains.

For Diamond, all of this helps to explain why, in women, the link between intimacy and desire is especially potent. View all New York Times newsletters. She is now formulating an explanatory model of female desire that will appear later this year in Annual Review of Sex Research.

She spun numerous Hula-Hoops around her minimal waist and was hoisted by a cable high above the audience, where she spread her legs wider than seemed humanly possible. The male, without an erection, is announcing a lack of arousal. The critical part played by being desired, Julia Heiman observed, is an emerging theme in the current study of female sexuality. Meana made clear, during our conversations in a casino bar and on the U. With her graduate student Amy Lykins, she published, in Archives of Sexual Behavior last year, a study of visual attention in heterosexual men and women.

Wearing goggles that track eye movement, her subjects looked at pictures of heterosexual foreplay. The women gazed equally at the two genders, their eyes drawn to the faces of the men and to the bodies of the women — to the facial expressions, perhaps, of men in states of wanting, and to the sexual allure embodied in the female figures.

Meana has learned too from her attempts as a clinician to help patients with dyspareunia. Though she explained that the condition, which can make intercourse excruciating, is not in itself a disorder of low desire, she said that her patients reported reduced genital pain as their desire increased. She rolled her eyes at such niceties. We hug. The generally accepted therapeutic notion that, for women, incubating intimacy leads to better sex is, Meana told me, often misguided.

Like Chivers, Meana thinks of female sexuality as divided into two systems. But Meana conceives of those systems in a different way than her colleague. On the one hand, as Meana constructs things, there is the drive of sheer lust, and on the other the impetus of value.

The ravisher is so overcome by a craving focused on this particular woman that he cannot contain himself; he transgresses societal codes in order to seize her, and she, feeling herself to be the unique object of his desire, is electrified by her own reactive charge and surrenders.

Meana apologized for the regressive, anti-feminist sound of the scene. Earlier, she showed me, as a joke, a photograph of two control panels, one representing the workings of male desire, the second, female, the first with only a simple on-off switch, the second with countless knobs.

Women want a caveman and caring. If I had to pick an actor who embodies all the qualities, all the contradictions, it would be Denzel Washington. He communicates that kind of power and that he is a good man.

The appeal is, above all, paradoxical, Meana pointed out: rape means having no control, while fantasy is a domain manipulated by the self. She stressed the vast difference between the pleasures of the imagined and the terrors of the real.

Chivers, too, struggled over language about this subject. The topic arose because I had been drawn into her ceaseless puzzling, as could easily happen when we spent time together. I had been thinking about three ideas from our many talks: the power, for women, in being desired; the keen excitement stoked by descriptions of sex with strangers; and her positing of distinct systems of arousal and desire.

This last concept seemed to confound a simpler truth, that women associate lubrication with being turned on. We spoke, then, about the way sexual fantasies strip away the prospect of repercussions, of physical or psychological harm, and allow for unencumbered excitement, about the way they offer, in this sense, a pure glimpse into desire, without meaning — especially in the case of sexual assault — that the actual experiences are wanted.

One morning in the fall, Chivers hunched over her laptop in her sparsely decorated office.

Changes in hormones during a female's cycles affect the way she behaves and the way males behave towards her. This slut ass got plugged 18 min Twiddlingsplinter - Masturbating old bag gets busted and screwed 6 min Grandma Friends - 1. Bibcode : Natur. Psychological Bulletin. Something is bound to speak to you. Old Goes Young - Long-legged brunette Geny.

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Bags for sexual interest

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Sociologically , it can cover the cultural , political , and legal aspects; philosophically , it can span the moral , ethical , theological , spiritual , and religious aspects. Which aspects of a person's sexuality attract another is influenced by cultural factors; it has varied over time as well as personal factors.

These preferences come about as a result of a complex variety of genetic , psychological , and cultural factors. A person's physical appearance has a critical impact on their sexual attractiveness. This involves the impact one's appearance has on the senses , especially in the beginning of a relationship:. As with other animals, pheromones may have an impact, though less significantly in the case of humans. Theoretically, the "wrong" pheromone may cause someone to be disliked, even when they would otherwise appear attractive.

The importance of pheromones in human relationships is probably limited and is widely disputed, [ unreliable source? Some people exhibit high levels of sexual fetishism and are sexually stimulated by other stimuli not normally associated with sexual arousal.

The degree to which such fetishism exists or has existed in different cultures is controversial. Pheromones have been determined to play a role in sexual attraction between people. They influence gonadal hormone secretion, for example, follicle maturation in the ovaries in females and testosterone and sperm production in males. Research conducted by Donald G.

Dutton and Arthur P. Aron in the s aimed to find the relation between sexual attraction and high anxiety conditions. In another test, a male participant, chosen from a group of 80, was given anticipated shocks. With him was an attractive female confederate, who was also being shocked. The experiment showed that the male's sexual imagery in the TAT was much higher when self shock was anticipated and not when the female confederate shock was anticipated.

People consciously or subconsciously enhance their sexual attractiveness or sex appeal for a number of reasons. It may be to attract someone with whom they can form a deeper relationship, for companionship , procreation , or an intimate relationship , besides other possible purposes.

It can be part of a courtship process. This can involve physical aspects or interactive processes whereby people find and attract potential partners, and maintain a relationship. Men have been found to have a greater interest in uncommitted sex compared to women.

However, [12] additional trends have been found with a greater sensitivity to partner status in women choosing a sexual partner and men placing a greater emphasis on physical attractiveness in a potential mate, as well as a significantly greater tendency toward sexual jealousy in men and emotional jealousy in women.

In general, they found biological sex played a bigger role in the psychology of sexual attraction than orientation. However, there were some differences between homosexual and heterosexual women and men on these factors. While gay and straight men showed similar psychological interest in casual sex on markers of sociosexuality , gay men showed a larger number of partners in behaviour expressing this interest proposed to be due to a difference in opportunity.

Self-identified lesbian women showed a significantly greater interest in visual sexual stimuli than heterosexual women and judged partner status to be less important in romantic partnerships. Heterosexual men had a significantly greater preference for younger partners than homosexual men.

Gray asexuality includes those who only experience sexual attraction under certain circumstances; for example, exclusively after an emotional bond has been formed.

This tends to vary from person to person. In such, a symmetrical and masculine face outwardly indicates the reproductive value of a prospective mate.

There is evidence that women's mate preferences differ across the ovarian cycle. Female sexual preference for male face shapes has been shown to vary with the probability of conception. In males, a masculine face has been positively correlated with fewer respiratory diseases and, as a consequence, masculine features offer a marker of health and reproductive success.

It is therefore suggested that females are attracted to masculine faces only during ovulation as masculinity reflects a high level of fitness, used to ensure reproductive success. Whilst such preferences may be of lesser importance today, the evolutionary explanation offers reasoning as to why such effects are recorded. Those using the contraceptive pill , and therefore not following regular cyclical patterns, reported no such preference.

As with masculine faces, the ability to determine symmetry via scent was likely designed by natural selection to increase the probability of reproductive success through mating with a male offering strong genetics.

This is evidenced in research focusing on traits of symmetrical males, who consistently record higher levels of IQ, coordination, social dominance, and consequently, greater reproductive fitness. In such, during ovulation, females show a strong preference for symmetrical males as they are reaching peak fertility. It is not necessary for these women to change their mating preferences during their cycles.

Women have been found to report greater sexual attraction to men other than their own partners when near ovulation compared with the luteal phase. Women whose partners have high developmental stability have greater attraction to men other than their partners when fertile. This can be interpreted as women possessing an adaptation to be attracted to men possessing markers of genetic fitness, therefore sexual attraction depends on the qualities of her partner. Hormone levels throughout the menstrual cycle affect a woman's behaviour in preferences and in their overt behaviours.

Similar to the function in animals, it is probable that this ornamentation is to attract potential partners and that a woman's motivations may vary across her cycle. Consequently, they choose to display their increased levels of attractiveness through this method of ornamentation. During periods of hormonal imbalance, women exhibit a peak in sexual activity. Research has also found that menstrual cycles affect sexual behaviour frequency in pre- menopausal women. Changes in hormones during a female's cycles affect the way she behaves and the way males behave towards her.

Therefore, these behavioural adaptations have developed as a form of mate guarding , which increases the male's likelihood of maintaining the relationship and increasing chances of reproductive success. From Wikipedia, the free encyclopedia. Redirected from Sexual interest. This article is about sexual attraction among humans. For sexual attraction among other animals, see Animal sexual behaviour.

For the Eurodance group, see S. For the Georgio album, see Sex Appeal album. For the film, see Sex Appeal. It was a cycle. We both became healthier in the process. It was made possible by the powerful, transformative work of the Holy Spirit. If you are just beginning your journey of discovering what it means to build sexual interest, search my 6 years of archives. Something is bound to speak to you. Love your blog. Good for you for taking strides to improve your part of the relationship!

Thank you for the kind words. This is wonderful. By whose standards do we define low? I'm Bonny, and here at OysterBed7 you'll find understanding for your struggle with sexual intimacy in marriage because I struggle, too. First Name.

Email address:. It was natural evolution. Sexual interest includes: Willingness to flirt and accept sexual innuendo, even participate in light hearted banter. A view different from yours does not make it bad or negative only different. Willingness to explore what it means to be different not bad. Willingness to understand that sex will benefit your personal physical health and mental outlook. In other words, sex is for you, too!

See Song of Solomon Willingness to become receptive to sexual thought and experience. Developing a closer relationship with God. Intentionally allow the Holy Spirit to mature you toward the character of Christ.

Developing a closer relationship with your husband. Intentionally building a better friendship with him. Developing a prayer and study time with your husband. Spiritual intimacy is the foundation of emotional and physical intimacy. Being healthier allows you to open your heart and mind to exploration of different thoughts and ideas.

Sexual interest increases when: You feel great about your relationship with God. You feel great about sex knowing God approves of it in your marriage and encourages it! You feel great about your husband and your relationship with him. You feel great about increasing your knowledge about sexual intimacy physically, emotionally, and spiritually. The first step in building sexual interest is within you. How do you nurture your sensual, flirty, light-hearted nature?

You start exercising regularly and you give up those sugary sweets. Why should you care about sexual interest? Comments Love your blog.

Sexual Desire/Interest Disorder - Gynecology and Obstetrics - MSD Manual Professional Edition

Sociopsychological aspects of body image form a complex pattern of self knowledge and how one is perceived by others. The invasion of surgery invariably causes temporary or permanent changes, which may not be anticipated by women or may emerge only on discharge from hospital.

Partners who adapt poorly to the new circumstances may also find it difficult to continue sexual activity, but an existing strong and intimate relationship encourages positive postoperative adjustment. Dealing with psychological and emotional states such as anxiety, fear, and depression about surgery is crucial to a woman and her partner.

Rehabilitation is important in promoting adjustment and acceptance by facilitating the grieving process. Healthy adaptation to a stoma depends on preoperative and postoperative counselling and understanding by stoma nurses.

Dyspareunia can be a major problem, not only because of lack of arousal or secondary vaginismus after surgery but because of the amount of scar tissue within the pelvis. Total or partial hip replacement is now a common operation, but when a patient can safely resume sex is often not mentioned. Anatomically, internal rotation is dangerous postoperatively because it can lead to dislocation, but, as intercourse usually requires external rotation of the joint, sex can generally be resumed when the scar is comfortable.

While these are often done as lifesaving operations with very good outcomes, women must be allowed to discuss their fears about when or if it is safe to restart sexual activity. Intercourse can take place when a woman feels like it, provided she can walk up two flights of stairs without difficulty, the equivalent cardiac output of orgasm. Angina may limit her activity, although this is unlikely. After a chest operation, she should take the female superior or another comfortable position until discomfort from the chest scar has eased.

Cataract removal places no restrictions on sexual activity, but intercourse should be avoided for two weeks after a retinal detachment, and patients with vitreous haemorrhages need to wait until their laser treatment has finished or, if they do not have diabetes, two weeks after the bleeding has stopped. The uterus, menstruation, and fertility are seen by many women as fundamental to their femininity.

After hysterectomy women often have great difficulty becoming sexually aroused, particularly when there are signs of depression before the operation and the woman is aged under However, in some women, for whom other treatments have not worked, hysterectomy can be a relief from heavy bleeding, pain, and tiredness, allowing a freer sexual life.

Example of a case history: A 49 year old housewife of average intelligence came to a family planning clinic eight weeks after undergoing a hysterectomy because she was worried about not having had a period yet and to find out when she could resume sexual intercourse.

She had not felt able to ask at the gynaecology clinic because everyone was so busy. Intercourse is usually allowed after six weeks, but this is somewhat arbitrary. Gentle penetration is quite possible after four weeks, although many women prefer to wait longer.

These are done mainly for prolapse of the bladder or rectum. Some women complain of postoperative vaginal tightness or dyspareunia because of tender scar tissue. They should be encouraged to restart sexual intercourse when it feels comfortable, using a water based lubricant such as KY jelly or Senselle or an aromatic oil such as peach kernel or sweet almond oil though oils must not be used with barrier contraceptives made from latex rubber as they may render them ineffective.

Sexual expression can be badly affected by incontinence, with fears about odour, leakage, and wetness. If a woman tenses her pubococcygeal muscles and bladder sphincter in order not to dribble urine, the resulting physiological and psychological tension can lead to vaginismus and possibly dyspareunia and interference with sexual arousal and orgasm.

The diagnosis of an abnormal cervical smear can create great anxiety, especially when it is totally unexpected. It is important to let a woman express her anxiety and fears about cervical cancer and its effect on her sex life before referring her for colposcopy. She will then find it easier to resume her sexual life after treatment.

This operation is illegal in Britain, but the obstetric and sexual sequelae are seen in clinics in areas with large African and Middle Eastern communities. Recent arrivals may need deinfibulation because they are getting married or are pregnant. Young women brought up in Britain may feel mutilated compared with their peers.

They need appropriate sexual counselling, and occasionally deinfibulation. Problems with non-consummation of marriage are common, often due to vaginismus. It is important that these women are examined by doctors comfortable with treating psychosexual problems. Episiotomies are routinely done to prevent tears in the perineum during labour. It is essential that midwives and junior doctors are properly trained and take great care in the site and length of incision and its repair to protect the perineum.

Poor repairs that lead to painful scars, malposition of the sutures, narrowing of the introitus, or even extrusion of pieces of catgut can severely affect sexual pleasure. Since low sexual desire, dyspareunia, and secondary vaginismus are common responses after childbirth, women may benefit from postnatal referral to a therapist to discuss sexual dysfunction.

Psychological reasons are varied, but tiredness, especially when breast feeding, and fears of a further pregnancy can have a negative effect on a sexual relationship. Some women feel relieved after a termination, and it has little impact on their psychological wellbeing, but others may feel a deep sense of loss and grief. This causes anxiety, depression, loss of sexual desire, and difficulties within an existing relationship.

When this happens, the reasons why the termination was wanted need to be explored, and all the emotions of that loss need to be counselled. Intercourse can be resumed when the woman has stopped bleeding after the termination if she feels like it. Women aged over 30 who have completed their family, and especially those who have had problems with contraception, may find that their sexual activity improves after elimination of the possibility of unwanted pregnancies, and they can resume intercourse as soon as they feel physically comfortable after the operation.

On the other hand, women coerced into unwanted sterilisation may retreat sexually. The pressure to perform to a calendar gives rise to many sexual problems for both men and women. The low success rate of treatments also increases the feelings of failure, loss, grief, frustration, and depression. Couples need counselling to maintain their sexual intimacy while undergoing medical and surgical interventions and beyond. Operations such as hysterectomy, bilateral oophorectomy, and radical vulvectomy can cause major genital mutilation, often producing difficult psychosexual problems.

Women have to deal not only with the fear and anxiety of the diagnosis, treatment, and prognosis but with the constant fear of recurrence. They often do not know what to expect sexually after an operation because of lack of communication with their doctors as well as with their partners. Partners mainly suffer in silence and find it difficult to make sexual approaches. Some partners find that they cannot cope with the physical differences caused by the operation, and this makes restarting a sexual life a big ordeal.

Women who were aged under 50 or not sexually experienced and those not in a relationship at the time of the operation were worst affected. If at all possible, radiotherapy should be avoided in order to minimise the physical mutilation and to preserve the ovaries. At every follow up visit all women should be asked how their sexual life is progressing, and sexual counselling should be offered early to minimise long term damage. Before an operation takes place it is essential to discuss with the woman, and preferably with her partner, the full implications of the operation on their sexual life.

To allow the full expression of their fears, myths, gains, and losses, discussions should be conducted in private in a frank and empathic way. This helps to minimise sexual dysfunction after the operation. Postoperatively, permission giving and the importance of starting sexual activity early should be emphasised.

If a woman has had radiotherapy, oestrogen cream should be used in the vagina. Different positions for intercourse may have to be tried to lessen dyspareunia. Clinical depression should be treated first. When there are intrinsic difficulties with a relationship, the couple should be counselled by an appropriately trained person. BMJ ; Before surgery, some couples may have chosen not to be sexually active, and this must be taken into account when discussing sexual activity before and after the operation.

Good communication skills, especially good listening skills, are essential if a doctor is to show empathy, respect, and non-judgmental attitudes when discussing sexual issues with patients. Detail from On Surgery 14th century manuscript by Rogier de Salerne. Healthy adaptation to a stoma depends on adequate counselling for both the patient and her partner. Patients undergoing laser treatment for a detached retina or vitreous haemorrhage should be warned to avoid sexual activity. Examination of a woman who had undergone ritual genital mutilation as a child and who now requires deinfibulation to enable her to reproduce.

Exploration of a six month old episiotomy scar to remove a painful granuloma, probably the result of stitch that was not removed after the original procedure. After an operation, different positions for intercourse may have to be tried to lessen dyspareunia. Man and woman making love, from Love by Mihaly von Zichy. The manuscript by Salerne and the engraving by Zichy were reproduced with permission of the Bridgeman Art Library.

The photograph of a girl undergoing ritual circumcision was reproduced with permission of Carol Beckwith and Angela Fisher. National Center for Biotechnology Information , U. Journal List BMJ v. Asun de Marquiegui and Margot Huish.

Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Factors affecting sexual function after an operation Disfigurement or mutilation altering the body image Previous psychological and emotional states Physical pain and hormonal, vascular, or nervous damage Existing problems with intimacy and quality of relationship.

Hip surgery Total or partial hip replacement is now a common operation, but when a patient can safely resume sex is often not mentioned. Heart operations and angina While these are often done as lifesaving operations with very good outcomes, women must be allowed to discuss their fears about when or if it is safe to restart sexual activity. Eye operations Cataract removal places no restrictions on sexual activity, but intercourse should be avoided for two weeks after a retinal detachment, and patients with vitreous haemorrhages need to wait until their laser treatment has finished or, if they do not have diabetes, two weeks after the bleeding has stopped.

Gynaecological operations Hysterectomy The uterus, menstruation, and fertility are seen by many women as fundamental to their femininity. Vaginal repairs These are done mainly for prolapse of the bladder or rectum. Incontinence and colloid injections Sexual expression can be badly affected by incontinence, with fears about odour, leakage, and wetness.

Minor operations The diagnosis of an abnormal cervical smear can create great anxiety, especially when it is totally unexpected. Female genital mutilation This operation is illegal in Britain, but the obstetric and sexual sequelae are seen in clinics in areas with large African and Middle Eastern communities.

Episiotomies, obstetric tears, and trauma Episiotomies are routinely done to prevent tears in the perineum during labour. Termination of pregnancy Some women feel relieved after a termination, and it has little impact on their psychological wellbeing, but others may feel a deep sense of loss and grief. Possible negative experiences after termination of pregnancy Avoidance, denial, feelings of numbness or worthlessness Anger, tearfulness, depression Dissociation from body, negative thoughts and feelings Recurrent intrusive thoughts, flashbacks, dreams and nightmares Guilt, shame, detachment, loss of positive feelings Suicidal thoughts, feelings of loss of control Psychological problems eating disorders, etc Disinterest in and avoidance of sex, possible vaginismus Symptoms can be immediate, delayed, or chronic.

Sterilisation Women aged over 30 who have completed their family, and especially those who have had problems with contraception, may find that their sexual activity improves after elimination of the possibility of unwanted pregnancies, and they can resume intercourse as soon as they feel physically comfortable after the operation. Operations for infertility The pressure to perform to a calendar gives rise to many sexual problems for both men and women.

Operations for cancer Operations such as hysterectomy, bilateral oophorectomy, and radical vulvectomy can cause major genital mutilation, often producing difficult psychosexual problems. Minimising psychosexual problems after gynaecological operations for cancer Try to involve the partner Avoid radiotherapy if possible Minimise physical mutilation Preserve ovarian function Reconstruct vagina if possible At follow ups check sexual activity Refer for sexual counselling.

Discussing the implications of a gynaecological operation Explain possible risks to sexuality Allow expression of fears, myths, gains, and losses Facilitate communication between partners Help to increase intimacy Genital sex is not the only form of sex Explore other forms of sex and intimacy Offer appropriate support.

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