MEDICAL CHALLENGES · STRESSFUL SEX · LIFE TRANSITIONS
“My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style.”
- Maya Angelou
MEDICAL CHALLENGES
Health issues affect a person’s sexuality and sexual expression, as well as their partner’s. Sometimes, the impact is minimal and insignificant... other times health issues will profoundly disrupt one’s sex life. Every individual deserves a satisfying sex life.
Chronic Pain | Pelvic Pain | Cancer | Aging | Post Surgical Changes | Arousal and Orgasmic Issues
Chronic Pain
Sexual function can be affected by health in subtle ways, or in very obvious ways. For example, medications can have side effects that indirectly affect sexual function. If a patient’s medication results in frequent urination at night, he or she will have reduced quality or quantity of sleep, which can lead to reduced interest in sex. Sex may become less spontaneous and then infrequent, and neither partner may identify the medication side effect as a source of dysfunction.
Some illnesses will directly affect an individual’s sexual function. Conditions like arthritis, chronic pain, ulcerative colitis, and Multiple Sclerosis, (and many others) will change sex dramatically. When sex changes, individuals may noticed increased stress, worry, and/or guilt about sex. Many couples don’t know how to talk about the feelings that these health challenges bring up. Sex therapy teaches patients and partners what to expect and how to talk about these really sensitive topics, and how to move toward a new normal that is pleasurable and satisfying to both partners. Sex can still be great, even as it changes over time.
Pelvic Pain
Pelvic pain is complex, often multifactorial, and medical treatment is rarely straightforward. Regardless of where in the pelvis the pain originates (bladder, uterus, prostate, etc), most pelvic pain patients feel a sense of confusion and “brokenness” about their reproductive lives.
Pain during intercourse is an unwelcome intrusion that reinforces feelings of inadequacy and guilt for many patients. When pain becomes chronic, a couple may struggle to maintain intimacy as the cycle of sexual fear, guilt, and avoidance becomes their new normal. To complicate things, chronic pelvic pain often leads to hypertonic pelvic floor muscles, which then worsens the pelvic pain and dysfunction.
In these cases, sex therapy works best in combination with pelvic floor physical therapy -- the PT works on the muscles and the sex therapy works on managing the stress/anxiety/worry of the pain. If desired, Dr. Modjoros will collaborate with your medical providers to develop a comprehensive care plan.
Regardless of which partner has pain, both partners are affected, so whenever possible, couples are encouraged to participate in the counseling process together. In therapy, Dr. Modjoros will guide you through your recovery process, helping you and your partner better understand the original health issue, the sexual stress associated with it, and the pathway to full recovery with the mind and body in harmony.
Cancer
Every individual deserves a satisfying sex life.
A cancer diagnosis usually translates to many medical office visits, lots of imaging and/or biopsies, and often surgery or hospitalizations. Body changes, feeling ill, and grappling with mortality will affect an individual’s sex life initially. However, with modern medicine cancer is often a chronic disease….with symptoms that affect sex. Prostate cancer survivors may have urinary incontinence or erectile dysfunction postoperatively. Breast cancer patients may receive medication to block all estrogen, which has a profound effect on the vulva and vagina. Cancer diagnosis and treatment may affect how a man or woman sees themselves as a sexual being -- or how their partner views them. There can be grief and anger in this process, but there can also be healing through pleasure and connection with their partner. People with cancer can enjoy sex, and they should!
When health challenges seem insurmountable and incompatible with sex, Dr. Modjoros can work with you to bring new dimension and fulfillment to your sex life.
A cancer diagnosis changes things – instantly.
Every individual’s journey is unique, but figuring out sex and intimacy while treating or recovering from cancer is confusing for most. For example, cancer treatments may interfere in frequency or quality of sexual pleasure for an individual or for a couple. Or, the partner with cancer may avoid sex due to body image, energy, or mortality concerns, etc. Sex therapy can help redefine sex to maintain intimacy when cancer has changed the body and the way it looks, feels, and/or works.
Aging
As people age, sex changes. But it doesn’t have to stop! For many individuals and couples, sex remains a prominent part of their life well into 80s and beyond. Sex and pleasure are for everyone. Aging bodies may introduce some challenges into sex, but positions can be modified and sex can be shifted to include more of one type of touch and less of another challenged type of touch. Sex therapy can hep to revitalize sex within a long term relationship, or develop ways to enjoy sex when faced with physical or medical challenges. Retirement is more fun with more sex!
Post Surgical Changes
Most people will experience surgery at some point in their lives.
Appendectomies, spine surgeries, Caesarian sections, knee replacements — every surgery changes an individual's body -- how it looks and how it moves. Sometimes postoperative changes, including scar tissue, affect the patient's sexual experience. Following surgery, the details around sex may need to change. Dr. Modjoros helps individuals and couples work through redefining their sexual script to develop a new norm that is pleasurable and satisfying for both.
Arousal & Orgasmic Issues
Arousal and orgasmic dysfunctions are relatively common. Delayed ejaculation, anorgasmia (not able to reach orgasm), and painful orgasms are just a few examples. For any new symptom or pain related to orgasm, a sexual medicine provider should be your first evaluation. He or she can figure out if the nerves and blood vessels are working properly.
Dr. Modjoros works closely with the local community sexual medicine physicians to provide comprehensive management for patients with these issues. In sex therapy, individuals and couples learn how to relax into pleasure and stay focused on their body sensations to optimize their sexual connection.