Communication and sexual function and frequency in breast cancer patients 2 years after diagnosis: results from the VICAN 2 study.

BACKGROUND: Breast cancer treatments may have impacts on several aspects of sexual health, including psychological, psychosexual, physiological, physical, and relational. AIM: In this study we sought to assess sexual function and sexual frequency in breast cancer patients 2 years after diagnosis. METHODS: We selected all breast cancer participants from the the French national VIe après le CANcer 2 (VICAN 2) longitudinal study. Data sources included patient and medical questionnaires, along with medico-administrative databases. OUTCOMES: Outcomes assessed were the dimensions of sexual function and frequency from the Relationship and Sexuality Scale and communication about sexuality with healthcare providers. RESULTS: Out of 1350 participating women, 60.2% experienced a decrease in sexual desire, 61.4% reported a lower frequency of intercourse, and 49.5% faced decreased ability to orgasm. In contrast, 64.8% had engaged in sexual intercourse in the previous 2 weeks, 89.5% were "Somewhat" to "Very much" satisfied with the frequency of intimate touching and kisses with their partner, and 81.6% expressed satisfaction with their intercourse frequency. However, a mere 15% of women discussed sexuality with the healthcare providers. Independent factors associated with increased communication about sexuality included age younger than 50 years (OR = 1.90 95% CI [1.28-2.82], P = .001), being in a partner relationship (OR = 2.53 95% CI [1.28-2.82], P = .003), monthly income above 1,500 euros (OR = 1.73 95% CI [1.15-2.60], P = .009), and absence of diabetes (OR = 6.11 95% CI [1.39-26.93], P = .017). CLINICAL TRANSLATION: The study findings underscore the need for continuing education in oncosexology and dedicated sexual health interventions that should involve a holistic approach that takes into consideration age, treatments, relationship status, and whether the patient has diabetes. STRENGTHS AND LIMITATIONS: Strengths of the study are the sample size, the national representativeness, and data reliability. However, the cross-sectional design could introduce potential recall, recency, or social desirability biases. Also, social determinants influencing sexual health, such as ethnicity or geographic locations, have not been considered in the analyses. CONCLUSIONS: This study revealed that sexual disorders persist 2 years after a breast cancer diagnosis, with a noticeable communication gap regarding sexuality between patients and medical teams. These findings underscore the necessity for tailored sexual health interventions, particularly designed for women who are single, older aged, and diabetes patients.

Grieving multiple losses: Experiences of intimacy and sexuality of people living with inflammatory bowel disease. A phenomenological study.

AIM: To explore patient experiences of intimacy and sexuality in those living with inflammatory bowel disease. DESIGN: An interpretative phenomenological study guided by van Manen's framework. Thematic analysis was conducted through interpretation and reflection on four existential domains: body, relationships, time and space. METHODS: Data were collected during 2019-2021 from 43 participants via face-to-face or telephone interviews, as well as anonymous collection of narratives submitted via Google Forms. RESULTS: Four themes were identified: Sexuality as lived incompleteness was the overarching theme representing the essence of the experiences of intimacy and sexuality. This theme covered the four main themes: Otherness of the body, Interrupted connectedness, Missing out on life fullness and Fragmented openness and each corresponded to an existential domain. Intimacy and sexuality are negatively affected by inflammatory bowel disease, with impact on quality of life. Patients experienced grieving multiple losses, from body image and control, to choice of partners and future opportunities. The four domains were difficult to separate and a close inter-relationship between each domain was acknowledged. CONCLUSIONS: A model was developed to draw new theoretical insights to understanding the relationship between sexual well-being and psycho-emotional distress similar to grief. IMPACT: First qualitative study to explore intimacy and sexuality experiences of those living with inflammatory bowel disease. Illness impact on sexuality has negative psycho-emotional implications as a result of losing the old self and capacity to have the desired relationships/sex life. A theoretical model was developed in an attempt to illustrate the close relationship of intimacy, sexuality and psycho-emotional well-being. PATIENT OR PUBLIC CONTRIBUTION: Patients were involved in the study design.

Associação da educação sexual, cinesioterapia e terapia manual no tratamento de mulheres anorgásmicas: um estudo de caso / Association of sex education, kinesiotherapy and manual therapy in the treatment of anorgasmic women: a case study

O orgasmo é o ápice da excitação sexual e, quando comumente não experienciado, denomina-se anorgasmia, segunda queixa sexual mais frequente entre mulheres. A fisioterapia é um recurso que visa beneficiar a qualidade de vida das mulheres anorgásmicas por meio da prevenção, reparação de função e tratamento de quadros álgicos. O estudo teve como objetivo avaliar os efeitos da associação das técnicas de cinesioterapia aplicada à musculatura do assoalho pélvico, massagem perineal e conscientização acerca da sexualidade das participantes. Os métodos utilizados foram educação sexual, massagem perineal e cinesioterapia associada ao uso da sonda uroginecológica New PelviFit Trainer, como biofeedback visual, para promover conscientização e estimar os efeitos sobre a condição da musculatura do assoalho pélvico de mulheres com relato de anorgasmia. O resultado obtido com o protocolo da associação das técnicas terapêuticas em mulheres com disfunção orgásmica apresentou melhora da função sexual feminina, aumento da força e do estado de relaxamento da musculatura do assoalho pélvico, avaliados pelo questionário Índice de Função Sexual Feminina, quantificados por meio da escala de Oxford modificada e da escala de avaliação de flexibilidade vaginal, respectivamente. Como conclusão, a aplicação das técnicas fisioterapêuticas aliadas ao tratamento humanizado, com enfoque na conscientização das mulheres, autopercepção corporal e manutenção da função sexual, promoveu melhora da disfunção sexual orgásmica. Apesar de necessário maior embasamento científico relativo ao tema, a presente abordagem para o tratamento em questão apresentou-se promissora e pertinente à base de dados. (AU)

Orgasm is the peak of sexual excitement, when not commonly experienced, it is called anorgasmia, second most frequent sexual complaint among women. Physiotherapy is a resource that aims to improve the quality of life of anorgasmics women through prevention, function repair and pain management. The purpose of the study was to evaluate the effects of kinesiotherapy techniques applied on the pelvic floor muscles, associated with perineal massage and the participants' sexual awareness. The methods used were sexual education, perineal massage, kinesiotherapy associated with the use of the New PelviFit Trainer urogynecological probe, as a visual feedback, to promove awearness and estimate its effects on the pelvic floor muscles condition in women reporting anorgasmia. The result obtained with the protocol of association of therapeutic techniques in women with orgasmic dysfunction showed improvement in the female sexual function, assessed by the Female Sexual Function Index questionnaire, increased strength and pelvic floor muscles relaxation, quantified using the Modified Oxford scale and the vaginal flexibility assessment scale, respectively. As a conclusion, the application of physiotherapeutic techniques combined with humanized treatment, with a focus on awareness of women, body self-perception and maintenance of sexual function, promoted improvement of orgasmic sexual dysfunction. Despite the need for a greater scientific basis on the subject, the present approach to the treatment in question was promising and relevant to the database. (AU)

The Effect of Mindfulness-Based Sexual Counseling on Sexual Distress, Attitude Toward Sexuality, and Body Image Concerns in Pregnant Women: A Randomized Controlled Trial.

INTRODUCTION: Sexual distress during pregnancy can cause a negative attitude toward sexuality during pregnancy, and this can be seen especially in conjunction with body image concerns. This study was conducted to determine the effects of mindfulness-based sexual counseling (MBSC) on sexual distress, attitudes toward sexuality, and body image concerns in pregnant women. METHODS: A randomized controlled trial was conducted in a sample of women who experienced sexual distress presenting to a Healthy Living Center in eastern Turkey. Women (N = 134) were randomly assigned to receive a 4-week, 8-session counseling program based on mindfulness (experimental group; n = 67) or treatment as usual (control group; n = 67). The primary outcome of the study, sexual distress, was assessed using the Female Sexual Distress Scale-Revised. Secondary outcomes included attitude toward sexuality, assessed using the Attitude Scale toward Sexuality during Pregnancy, and body image concerns, using the Body Image Concerns during Pregnancy Scale. Outcomes were compared postintervention, correcting for baseline using analysis of covariance. The study was registered with ClinicalTrials.gov (NCT04900194). RESULTS: Mean scores for sexual distress (7.69 vs 17.36; P < .001) and body image concerns (57.76 vs 73.88; P < .001) decreased significantly in the mindfulness group compared with the control group. Similarly, mean scores for attitudes toward sexuality significantly improved in the mindfulness group compared with the control group (133.52 vs 105.78; P < .05). DISCUSSION: MBSC is a promising strategy to help women experiencing sexual distress during pregnancy to reduce their levels of sexual distress, raise their positive attitudes toward sexuality, and lower their body image concerns. Larger clinical trials of MBSC are recommended to support introduction of MBSC into clinical practice.

The Case for Space Sexology.

Space poses significant challenges for human intimacy and sexuality. Life in space habitats during long-term travel, exploration, or settlement may: detrimentally impact the sexual and reproductive functions of astronauts, restrict privacy and access to intimate partners, impose hygiene protocols and abstinence policies, and heighten risks of interpersonal conflicts and sexual violence. Together, this may jeopardize the health and well-being of space inhabitants, crew performance, and mission success. Yet, little attention has been given to the sexological issues of human life in space. This situation is untenable considering our upcoming space missions and expansion. It is time for space organizations to embrace a new discipline, space sexology: the scientific study of extraterrestrial intimacy and sexuality. To make this case, we draw attention to the lack of research on space intimacy and sexuality; discuss the risks and benefits of extraterrestrial eroticism; and propose an initial biopsychosocial framework to envision a broad, collaborative scientific agenda on space sexology. We also underline key anticipated challenges faced by this innovative field and suggest paths to solutions. We conclude that space programs and exploration require a new perspective - one that holistically addresses the intimate and sexual needs of humans - in our pursuit of a spacefaring civilization.

Sexual intimacy and aging: An integrative framework to promote intimacy resilience in couple therapy.

In our work at the Intimacies Project at The Ackerman Institute for the Family we became aware of a gap in attention about sexuality and aging in the couple and family therapy field. In this article, we provide an integrative framework to guide therapists on how to address problems of sexuality and aging in the therapy room. Starting from considerations about the social context of aging and the self of the therapist, we contend that when normative sexual challenges become entangled with stigma, misconceptions about sexuality, limiting gender narratives, vulnerabilities, and defensive postures, they often result in emotional and sexual shutdowns. Through a combination of the vulnerability cycle with an expansive definition of sexuality, we demonstrate how we deconstruct impasses, disentangle normative quandaries from reactive dynamics, and help couples transform their sexual narratives. We outline how we conduct individual sessions to obtain relational sexual histories, utilize Sensate Focus as a mindful touch exercise, and help partners expand their sexual menus beyond penetration and orgasms. We also describe relational skills that may need to be strengthened to help aging couples deal with the ebb and flow of intimacy, sustaining resilience over time.

Sexual Fantasy of Cisgender and Nonbinary Individuals: A Quantitative Study.

Sexual fantasies typically represent sexually arousing mental imagery and, thus, are thought to play a role in sexual activation and sexual desire. They are also related to sexual and personal satisfaction. Differences between cisgender men and women's imagery are widely reported in the literature. In contrast, research on sexual fantasies among the trans community is scarce, especially when it comes to nonbinary identified people. The aim of the present study is to explore similarities and differences in the sexual imagery of cisgender women and men and nonbinary individuals, through a checklist of sexual fantasies, the Italian version of the Sexual Fantasy Questionnaire (SFQ). Results highlight that nonbinary individuals rate almost all categories of SFQ fantasies as sexually non-exciting, unlike cisgender men and women. The differences between cisgender men and women only partially confirm the results reported in the literature. In particular, the higher tendency to fantasize about dominance in men and passivity in women is not found in the present sample. Results are discussed in the light of the sexual script theory.

The Role of Sexual Orientation in the Associations Between Religiousness and Hypertension.

This study assessed the cross-sectional associations between organizational religious activity (ORA), intrinsic religiosity (IR), and hypertension in a US nationally representative sample. Data were from Wave IV of the National Longitudinal Study of Adolescent to Adult Health, collected in 2008. The sample (N = 5115, Mage = 28.96 years, 54% female) was divided into three sexual orientation categories: heterosexual, mostly heterosexual, and sexual minority. Dependent variables were systolic and diastolic blood pressure and binary cut-scores of clinical hypertension. ORA and IR were independent variables, with sexual orientation as the moderator. Multivariable analyses revealed greater ORA was associated with increased blood pressure (BP)/hypertension for the sexual minority group. There was a trend in the heterosexual group where ORA was associated with decreased BP. Generally, ORA was not associated with BP/hypertension in the mostly heterosexual group. There were no significant effects for IR. Future research should continue to examine the complex ways ORA and IR are associated with health based on sexual orientation and use longitudinal methodology to examine how ORA may impact BP/hypertension across the lifespan.

Bodily intimacy and ritual healing in women'stantric retreats.

Alternative health care and holistic spiritual practices have become increasingly popular in many Western countries, especially among women, who often claim them to be deeply transformative. This paper presents an ethnographic study of women's tantric retreats in Northwest Europe that aimed to help women reconnect with their vital sexual energy, rediscover the sacredness of their female bodies, and possibly heal from damaging and even traumatic experiences regarding their femininity and sexuality. It draws on Turner's influential view on ritual as a liminal space in order to account for the transformative potential of these workshops. Specifically, it applies Hinton and Kirmayer's flexibility hypothesis, which suggests that healing rituals shift people's mode of being-in-the-world, including their cognitive, emotional, and physical state or stance, towards openness to new ways of being. First, it highlights different ontological domains where shifts took place, notably somatic state, self-image and relationality. Subsequently, it identifies the main modalities that were used for enabling transformation: the embodiment of the metaphor of the goddess/the divine as present in each woman and the use of intimate, loving touch and meditative awareness. The process of transformation and healing elucidated in this way engaged the physical, emotional and cognitive levels as interacting dimensions, relying foremost on the activation of a vital energy that both gave participants a deep sense of self and connected beyond the self.

Associations of mindfulness with adolescent outcomes and sexuality.

INTRODUCTION: Using an online survey, we evaluated how adolescent trait and state mindfulness was associated with positive adolescent outcomes in non-sexually active and sexually active adolescents. Additionally, we evaluated a newly developed measure, the Sexual Mindfulness Measure (SMM), with adolescents. METHODS: We asked 2000 U.S. adolescents (half boys/girls; 1/3 low, medium, and high incomes) aged 13-18 (one group 13-15, another 16-18) about trait mindfulness, sexual state mindfulness, and adolescent outcomes. Using Confirmatory Factor Analysis and structured equation modeling, we evaluated the reliability and validity of the SMM and its associations with adolescent outcomes. RESULTS: Using a trait mindfulness measure, we found that mindful adolescents with no sexual experience, showed positive associations with self-efficacy, body-esteem, and disclosure with both fathers and mothers. Evaluating adolescents who were sexually active, we confirmed that the SMM had a two-factor structure and demonstrated acceptable reliability for both male and female adolescents. We found that the SMM was associated with positive sexual attitudes, body image, self-efficacy, and disclosure to parents above and beyond trait mindfulness. CONCLUSIONS: Trait mindfulness was associated with positive self-assessments and parental disclosure. The SMM provided an important assessment of how sexually active adolescents' ability to remain aware and non-judgmental during sexual experiences may be positively associated with outcomes such as sexual consent, positive body image, self-efficacy, disclosure to parents, and negatively associated with sexual shame and sexual anxiety above and beyond trait mindfulness.

Exploring postpartum sexual health: A feminist poststructural analysis.

Postpartum sexual health has historically been viewed and discussed in specific ways, often dominated by biomedical discourse. There is a need to expand understandings of sexual health for postpartum women in the context of interdisciplinary health care. Research surrounding postpartum sexual health is largely focused on physical measures, such as vaginal lubrication or initiation of intercourse, without accounting for the diverse and subjective ways that sexuality and sexual health are experienced during the postpartum period. This critical analysis uses feminist post-structuralism to critique and analyze current health research and practice surrounding postpartum sexual health. Agency, subjectivity, gender and sex considerations, relations of power, and discourse are essential to understanding postpartum sexual health in a more holistic, woman-centered way. This includes awareness of dominant discourses that have shaped how health researchers, practitioners, postpartum women, and health institutions care for, support, and promote postpartum sexual health. There is a need to move beyond physically focused, reductionist, heteronormative understandings of sexual health to better promote overall postpartum health and wellbeing.

"The night comes early for a woman": Menopause and sexual activities among urban older Yoruba men and women in Ibadan, Nigeria.

This article explores older peoples' perceptions of menopause and sexuality in old age. The research was exploratory, consisting of 12 vignette-based focus group discussions and 18 face-to-face semistructured interviews among older Yoruba men and women (60+). Findings revealed menopause as a biopsychosocial marker of aging that provides gendered spaces for women to abstain from or suppress their sexual desires and avoid a folk pregnancy- oyun iju(folk fibroid). Older men construe menopause and sexual refusals from their wives as opportunities for extramarital relations. Thus, both older men and women have differentiated perceptions and dispositions toward menopause, which have implications for their sexual health and well-being.

'It's just a peripheral issue': A qualitative analysis of mental health clinicians' accounts of (not) addressing sexuality in their work.

Sexuality, relationships, and intimacy are integral parts of many peoples' lives, not negated by mental distress and illness. Yet typically, these needs are not addressed adequately in mental health settings. In-depth interviews were conducted with mental health clinicians with an aim of exploring their perceptions and understandings of sexuality and sexual concerns within mental health settings. Participants were 22 mental health nurses, psychologists, and psychiatrists working with people across a range of settings in four Australian cities. Sexuality or aspects of this were often not addressed in clinical practice, and this was common across participants' accounts. A critical thematic analysis was conducted to explore how participants made sense of or explained this silence in relation to sexuality. Two key themes were 'Sexuality is hard to talk about' and 'Sexuality is a "peripheral issue"'. In positioning sexuality as a peripheral issue, participants drew on three key explanations (sub-themes): that sexuality rarely 'comes up', that it is not pragmatic to address sexuality, and that addressing sexuality is not part of participants' roles or skill sets. A third theme captured the contrasting perception that 'Sexuality could be better addressed' in mental health settings. This analysis indicates that, beyond anticipated embarrassment, mental health clinicians from three disciplines account for omissions of sexuality from clinical practice in similar ways. Moreover, these accounts serve to peripheralize sexuality in mental health settings. We consider these results within the context of espoused holistic and recovery-oriented principles in mental health settings.

Mientras haya vida, hay todo: una mirada en la sexualidad del adulto mayor / While there is life, there is everything: a look at the elderly sexuality

Introducción.Desde un punto de vista integral, la sexualidad comprende aspectos de orden biopsicosocial. Los prejuiciosy el desconocimiento llevan a evitar hablar sobre este tema en la consulta con el adulto mayor (AM).Objetivo.Profundizar en la vivencia de la sexualidad del AM.Metodología.Estudio cualitativo, fenomenológico, realizado en dos centros de actividades recreativas para AM en SanMiguel de Tucumán, que incluyó 13 entrevistas semiestructuradas en profundidad a pacientes mayores de 60 años, 11 desexo femenino, seleccionados en forma intencional y por conveniencia en Agosto de 2018.Resultados.Existe una dicotomía entre quienes hablan del tema y quienes no; sin embargo, todos expresan el deseode naturalizarlo tanto en su círculo social como en la consulta médica. Los AM aceptan el proceso de envejecimiento,tienen una autopercepción positiva de su imagen y pese a los prejuicios, experiencias, comorbilidades y adversidades, seadaptan buscando formas para sentirse bien y disfrutar de una sexualidad plena.Conclusión.El envejecimiento y la sexualidad son conceptos dinámicos que confluyen con las experiencias de vida.Creemos que como médicos de familia es importante brindar una atención integral, abordando las diferentes dimensionesdel ser humano, incluyendo su sexualidad. (AU)

Introduction.Sexuality from an integral point of view includes aspects of biopsychosocial order. Prejudice and ignorancelead to avoid talking about this topic in the medical consultation with the Eldery.Objective.To deepen the experience of the sexuality of the Eldery.Methodology.Qualitative, phenomenological study, conducted in two centres of recreational activities for Senior Citizensin San Miguel de Tucumán, which included 13 in-depth semi-structured interviews to patients over 60 years of age, 11female, selected intentionally and for convenience in August 2018.Results.There is a dichotomy between those who talk about the subject and those who do not; however, all of themexpress the desire to naturalize it in both, their social circle and the medical consultation. The eldery patients acceptthe ageing process, have a positive self-perception of their image and despite prejudices, experiences, comorbidities andadversities, they adapt looking for ways to feel good and enjoy a full sexuality.Conclusion.Aging and sexuality are dynamic concepts that converge with life experiences. We believe that, as familydoctors, it is important to provide comprehensive care, addressing the different dimensions of the human being, wheresexuality is included. (AU)

Betrayal of the Body: Group Approaches to Hypo-Sexuality for Adult Female Sufferers of Childhood Sexual Abuse.

Hypo-sexuality, self-reported hypoactive sexual desire and/or sexual aversion, is a common symptom experienced by women who were victims of childhood sexual abuse. This symptom may be distressing to the patient herself, and may place strain on her romantic relationships in adulthood. Unfortunately, this problem often remains undiscussed between patient and provider, in part due to the provider's lack of comfort or knowledge regarding how best to address this issue. In this article, we explore several strategies that providers may employ in a group setting in order to help women realize their sexuality while minimizing untoward side effects such as feelings of guilt or shame, or flashbacks. We highlight the merits of each technique, and provide insights from clinical experience to guide practitioners to help their patients facing this difficult issue.

Addressing sexual issues in palliative care: A qualitative study on nurses' attitudes, roles and experiences.

AIM: To explore palliative care nurses' attitudes, roles and concrete experience with regard to addressing sexual issues in their daily practice. BACKGROUND: Patients and their partners in palliative care might experience dramatic changes in their sexuality and want nurses to provide the opportunity to address them. Moreover, it is argued that the holistic philosophy of palliative care encourages nurses working in this area to include sexual issues in their daily care. It is, however, unknown how palliative care nurses address sexual issues. DESIGN: A generic qualitative study was performed. METHODS: In total, 21 in-depth interviews were done with nurses from different facilities of palliative care networks in Flanders. Data were collected between September 2014 - September 2016 and thematic analysis was used to analyse the data. RESULTS: It was found that the way palliative care nurses addressed sexual issues was clearly influenced by their own interpretation of the philosophical principles underlying palliative care. The different interpretations of these basic principles create tensions for nurses about how to address sexual issues in the daily practice of palliative care and nurses vary in their reactions to these tensions. The present findings show that palliative care nurses - when they were able to overcome these tensions - use a "sex-positive approach" that fits with their tendency to focus on quality of life. CONCLUSION: Out of the results of this study, we made a list of good practices for palliative care nurses addressing sexual issues. This list can be used in nursing educational programs.

The character of sexual function of women who have sex with women. / Specyfika funkcjonowania seksualnego kobiet utrzymujacych kontakty seksualne z kobietami.

This paper will discuss the character of sexual relationships between women, considering their social and cultural context. The problem is still little known also to experts dealing with mental and sexual health. This may have serious consequences for the process of correct diagnosis of sexuality-related issues reported by those women. The article focuses on selected factors that have an impact on the character of this group's sexual function. Those factors include sex, heteronormativity and homophobia, as well as social messages related to female sexuality and sexual relationships established by women. The authors take up and subject to critical examination also the issue of "lesbian bed death" and fusion in same-sex relationships established by women. Towards the end, there is a holistic model by Heather L. Armstrong and Elke D. Reissing that describes sexual problems of women who have sexual contact with other women. The authors consider the issues brought up herein to be significant from the clinical point of view. Acknowledgement thereof by professionals dealing with mental and sexual health may contribute to extensive reflection over sexual and relationship problems of women who have sex with women, as well as to providing more efficient help to this group.

Psychological Considerations and Interventions in Inflammatory Bowel Disease Patient Care.

The presence of psychological comorbidities, specifically anxiety and depression, is well documented in inflammatory bowel disease (IBD). The drivers of these conditions typically reflect 4 areas of concern: disease impact, treatment concerns, intimacy, and stigma. Various demographic and disease characteristics increase risk for psychological distress. However, the risk for anxiety and depression is consistent throughout IBD course and is independent of disease activity. Early intervention before psychological distress becomes uncontrolled is ideal, but mental health often is unaddressed during patient visits. Understanding available psychological treatments and establishing referral resources is an important part of the evolution of IBD patient care.

Perceptions of sexuality in individuals with Amyotrophic Lateral Sclerosis (ALS) and their treating clinicians.

INTRODUCTION: Amyotrophic Lateral Sclerosis (ALS) may not affect an individual's sexual function directly, but it can indirectly impact their sexual activity. Sexual partners often become caregivers, diminishing sexuality within a relationship. This can result in decline of quality of life. OBJECTIVE: The study aimed to explore the perspectives of individuals with ALS and their treating clinicians regarding the importance of sexuality in rehabilitation within a multidisciplinary ALS center. We hypothesize that individuals with ALS will express the need for sexuality-related discussions as a therapy. METHOD: Electronic 11-item questionnaires were anonymously completed by individuals with ALS (n = 21) and ALS healthcare professionals (n = 81) between August 2014 to June 2016. Descriptive statistics were performed in STATA 14. RESULTS: Majority (90%, n = 92) of respondents stated that ALS impacts the sexuality of an individual with ALS, and agreed that sexuality-related discussion is needed as a complementary therapy. Over 75% of clinicians reported they were not familiar with any strategies or interventions to help the patients. CONCLUSION: ALS indirectly affects sexuality, thus confirming the need for promoting awareness regarding sexuality-related topics among individuals with ALS and healthcare professionals. ALS multidisciplinary clinics need to improve their delivery of care to address sexual rehabilitation as a complementary therapy.

Sex-Positive Assessment and Treatment Among Female Trauma Survivors.

Sexuality and intimacy difficulties are often a part of the aftermath of sexual trauma. We argue that combining techniques from evidence-based, trauma-focused treatment with sex-positive techniques used in sex therapy can best help survivors reduce trauma-related symptoms and develop or regain comfort with their sexuality. In this article, we illustrate this approach by describing the case of a survivor of sexual assault, who completed 20 sessions of treatment that combined modules of trauma-focused therapies, Cognitive Processing Therapy (CPT), and Prolonged Exposure (PE) with sensate focus therapy, a technique often used in sex therapy. The outcome of this case suggests that clinicians who work with sexual trauma survivors may want to consider a sex-positive approach to conceptualizing and planning the course of treatment, to achieve optimal results.