Frequently Asked Questions
Chapter 46: Sexuality

What are the three components of sexuality?

The three components of sexuality are gender identity (male, female, intersexed), gender role (masculine, feminine, transgendered), and sexual orientation (straight, gay or lesbian, or pansexual or bisexual).

In what way do physiological factors affect sexual health?

Hormones, medications, and physical disease can affect sexual health. For example, estrogen is responsible for secondary sex characteristics, the libido (sexual desire), and the preparation of the endometrium. Both depressants, such as alcohol and narcotics, and antidepressants may decrease the libido. Numerous illnesses and disabilities can interfere with sexual activity, either through pain or interference with sexual practices or through their effects upon sexual organs. For example, chemotherapy can decrease lubrication in the vagina, causing painful intercourse, and diabetes can cause impotence in males.

What are the effects of developmental factors on sexual health?

Sexual awareness begins as early as age 6 months, manifested as indiscriminate genital touching, which, by age 5, becomes intentional. From age 5 until puberty, children are more secretive about genital stimulation. Physical changes begin at puberty, when sexual experimentation often begins. Adolescents also engage in sexual fantasy and are interested in sexual activity. Intimacy and connection become more important in adulthood.

What is the affect of pregnancy on sexual functioning?

Sexual desire normally fluctuates during pregnancy, but sexual intercourse can continue until labor begins, as long as the woman has no vaginal bleeding and a comfortable coital position can be found. The contractions stimulated by orgasm are not harmful. The immediate postpartum period can be stressful since the woman may experience a variety of moods and the partner may feel displaced by the infant.

How do various symptoms and medical conditions contribute to sexual dysfunction?

Pain decreases the libido, and a partner may fear causing further pain with sexual activity. Medications and drugs (alcohol, narcotics, and antidepressants) can decrease the sexual response. People with amputations (including the loss of the breast or genital parts) or colostomies/ileostomies experience body image changes that cause anxiety. Cardiovascular disease can cause fear that the person won’t be able to perform or may experience chest pain or even death. Chronic pulmonary conditions can interfere with oxygenation and stamina during sexual activity. Chronic renal problems may interfere with libido and cause erectile dysfunction.