SEXUALITY

Sexuality is a subject that even most health care professionals are uncomfortable with, so, it is not surprising that couples dealing with trauma may have trouble communicating their needs and complaints in this area.

Sexual intercourse is only about 10% of sex. Hugging, cuddling, talking, playing, and doing special things together make up the majority of one's sexual activity. Other things that contribute to a healthy sexual climate include feeling comfortable with one's self, acting consistently with one's feelings, having the ability to respond, having effective relationships with both sexes, and a value system--knowing how one wants to act with others.

It is important to remember that when dealing with a partner who is sick or recently post-operative, it can be hard to get restarted again in normal sexual activity. Pain is a major turn-off. Sexual response is not always spontaneous; it is a learned behavior. Trying too hard can result in frustration or failure to perform, which may lead to panic or desperation, and in an attempt to try even harder, an artificial and nervous response may result, a sure way to fail again. Other things that thwart a good sexual response are fatigue, and over-indulgence in alcohol or food.

Various medical reasons can result in an inability to perform sexually, as well. Nerves damaged during surgery may prevent males from achieving an erection or an ejaculation. Retrograde ejaculation means that the semen is ejected backwards into the bladder, but that orgasm is still possible with this condition.

After surgery, it can take up to one year to regenerate nerves, etc. so one should not be too impatient waiting for function to return. Give yourself plenty of time. Rarely in females a nerve may be cut that would decrease sensation in the genital area, but orgasm may still be possible if the woman is adequately stimulated. Lubrication in a woman parallels an erection in a male as far as sexual response and readiness are concerned. A safe and practical lubricant that may be used is safflower oil. Stimulus and performance are also influenced by visual and mental involvement, by acute awareness and by knowledge of one's self and one's partner, as well as of the factors that have been discussed here.

Some hints that may be helpful to ostomates: a sense of humor is great medicine, talk things over with your partner; a "homerun" is not necessary every time. A shower curtain is a cheap alternative to a plastic sheet--cover it with an old blanket for comfort, and do not worry about springing a leak. Even if a pouch should loosen, a change of linen, a change of appliance, an intimate shower, and an assurance that love is still there can mend a difficult situation. If worry about the consequences of eating inhibits sexual activity, avoid gaseous foods or eat earlier if possible, but do not let that be the deciding factor, opt for spontaneity--everyone has gas occasionally. Learn to laugh. Emptying the pouch first can lessen any problems as well as being more attractive. Use pouch covers, fancy undies, pouches rolled up and taped (not to your leg) and other devices if they help. Take care of odor in the usual ways. Once in a while plan a special intimate "appointment" if your schedule is apparently too busy for this important time--do not put off intimacy, work together to find time. The rewards are worth the effort.

If an ostomate's partner is overwhelmed by the ostomy surgery, talking about feelings and sharing concerns usually solves the problem. Do not spring the ostomy on a new sexual partner without preambles. Talk first to "old" partners and discuss what might happen. Perhaps the partner is afraid of hurting the stoma. Talking to an E.T., doctor, or nurse about physical aspects can be a great help, as well as a visit from another ostomate and/or spouse.

The main thing is to go for it! Try it out and do not have too high expectations at first. Just enjoy yourself.