Elephants and Tea - December 2021 - 28

Sexuality INTIMATE ISSUES WITH MARLOE
The Who's Who
of Sexual Health
in Survivorship
BUILDING A SEXUAL WELLNESS RECOVERY TEAM
BY MARLOE ESCH, BSN, RN, OCN, CSC
Changes in sex, intimacy, and relationships are common
after cancer. But if you are experiencing an issue, it can feel
pretty lonely and you may not know who to ask for help. Your
primary care or oncology care teams are always a good place to
start. After all, sexuality is just another aspect of survivorship
care (and health in general), and most clinicians are happy to
have these conversations (although you might have to be the
one to bring it up!).
Sometimes, though, problems are best addressed by a professional with sexual health-related
expertise. If this is the case, your primary care or oncology care team may offer a referral to one
or more appropriate specialists, depending on your specific concern. Let's take a look at some
of the different players that can contribute to your sexual wellness recovery team of experts.
SPECIALTY MEDICAL CARE
Doctors, advanced practice providers such as nurse practitioners (NPs) and physician assistants
(PAs), and nurses can work in specialized areas of medicine that address different aspects of sexual
health, including endocrinology, reproductive system specialties, and urology.
* Endocrinology
Endocrinology is the branch of medicine that deals with diagnosing and treating endocrine
system disorders. Glandular endocrine organs throughout our bodies secrete chemical
messengers (hormones) that regulate a multitude of different body processes, including
reproduction and sexual functioning. For example, parts of our brain (the hypothalamus
and pituitary gland) make hormones that tell our ovaries or testes to produce estrogen and
testosterone, which play a role in various aspects of sexuality. Cancer treatments can disrupt
this process and alter levels of these sex hormones, which may affect sexual desire, physical
arousal, and fertility.
Alterations in the function of other endocrine glands can also impact sexual functioning.
For example, hypothyroidism and adrenal insufficiency in survivors can contribute to problems
with sleep, fatigue, and lack of energy, which may indirectly affect sexual desire and
function. Endocrinology specialists can assess for and help manage many of these issues.
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DECEMBER 2021
* Gynecology and Andrology
These are specialties that focus on diagnosing
and treating problems of the reproductive
system. Gynecologists are experts
in medical care for people with female
reproductive organs and physiology, and
commonly care for women throughout
their lifespan. The lesser-known specialty of
andrology is concerned with medical care
for people with male anatomy and physiology.
Andrology is sometimes considered a
specialty of urology (see below).
Soapbox alert: These sex-specific specialties
raise an important debate about what
being male or female actually means, which
requires a bit of reflection. Adhering to the
conventional idea of biological sex as a male/
female binary can be problematic, because
it's actually not accurate. Check out the
discussion titled " Sex is a Spectrum, Silly! "
to learn why.

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Elephants and Tea - December 2021

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