The rehabilitation management of sexuality and fertility issues in people with disabling health conditions

Abstract

Sexual health is a state of physical, emotional, mental and
social well-being in relation to sexuality. Disabling health
conditions can impact sexual function, identity, self-esteem
and self-image, fertility and pregnancy. People can
experience primary impairments such as a loss of
sensibility or erectile dysfunction, but also consequences
of secondary impairments like incontinence, pain, fatigue,
or spasticity. Moreover, limitations of activities and
participation restrictions can impact intimacy, sexuality and
reproduction. Therefore, sexual issues should be an integral
part of quality rehabilitation care.
Components of a sexual rehabilitation programme are
information/education of patient (and partner), practical
advice, finding new positions, medication, using assistive
devices and aids (like vibrator, sex toys, lubricating gel,
massage oil), pelvic floor training, coping strategies and
addressing self-image and self-esteem. People should be
encouraged to explore their changed bodies and
experiment. Sexual rehabilitation requires a personalized
biopsychosocial and integrative approach by the entire
multiprofessional team, including peer counsellors.

Keywords: Rehabilitation, Disabled Persons, Sexuality,
Sexual Health, Fertility, Erectile Dysfunction, Psychosocial
Functioning.