Some forms of sexual activity are more strenuous than others and a crisis like this can be an incentive to exploring new ways of sexual expression, like massage, oral sex or manual stimulation of yourself or your partner.

It has been only in fairly recent years that medical researchers have taken a close look at the way different types of surgery affect sexual attitudes and behavior. As our understanding grows, a number of features keep cropping up. Sexuality is an integral part of most people’s lives and just because someone doesn’t ask questions or talk about their concerns doesn’t mean they don’t want to know. In facing a crisis like cancer or other surgery, there needs to be detailed information on what to expect afterwards: physically, emotionally and sexually. An important step in overall patient care has been the emergence of specialized counsellors and nursing staff who are aware of the issues and who have the time and the skills to talk them through with people facing them.

There is also a growing body of evidence that positive thinking can have a powerful impact on the outcome of many different illnesses, including cancers. If a person can face an uncertain future with a degree of optimism that they will still be able to enjoy life, and that includes their sexuality, then the implications will be far-reaching. It may well be a matter of survival.

A social worker who counsels patients with heart disease told me, ‘I generally find that if a couple’s sexual relationship was good before the cardiac event, it will be good again. I must say I worry about the older men with much younger partners, particularly if the relationship is fairly recent. They tend to be more anxious about whether they will be able to perform as well as before. I always bring up the issue of sexuality because we can’t assume that because someone doesn’t ask, they don’t want to know. This is particularly true of women. You know, there are literally no studies that look at the sexual attitudes of women in this situation, so I have to rely on experience.’

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