HER HEALTH - Monique Rainford

When I was a medical student, I met a beautiful woman who had multiple sclerosis (a disease that can cause someone to be physically and, sometimes, mentally disabled).

I remembered her telling me how much she wished that she could dance again. I don't know if she was fortunate enough to fulfil her wish. Years later, when I was working in another hospital, a woman with a similar illness had a serious early pregnancy complication. However, the diagnosis was delayed because the staff at that particular hospital failed to perform a pregnancy test. They made what I suspect is a common and unfortunate assumption that women with disabilities do not have a sexual life.

Research indicates that approximately 70 per cent of disabled women are sexually active. In fact, another survey done among US teenage girls with disabilities showed that they are just as likely as girls without disabilities to have sex. Unfortunately, these girls were twice as likely to be forced into sex. Teenage girls with disabilities also have a higher incidence of sexually transmitted infections and pregnancy. In general, disabled women are at higher risk for physical and sexual abuse.

Teenagers with disabilities

It is important that teenagers with disabilities are well educated on sexuality and the risks of sexually transmitted infections. It is important that educators are aware that these teenagers may have a history of abuse and that this may affect their sexual functioning. An understanding of how a particular disability may affect sexual function is also very helpful in the process of education.

Educators should avoid discriminating and stigmatising teenagers with disabilities. Research done in the United States suggests that many women with disabilities are dissatisfied with the information they receive regarding their sexuality and, unfortunately, both information in this area, as well as the knowledge of health care providers, are still limited. Nevertheless, useful information is still available. For example, 50 per cent of women with spinal cord injuries can still have orgasms.

Sexual desire

Although the specific disability may not directly affect a woman's sexual desire, there are multiple ways that disabilities can affect a woman's sexual functioning. These factors can include lack of mobility, pain, fatigue, depression, low self-esteem, history of abuse and anxiety. Society's lack of awareness of the sexual function of disabled women can also have a negative effect on her sexuality.

There are several medications, which can also affect a woman's sexual function and some of these medications are prescribed more frequently for this sub group of women. These include medications, for high blood pressure, high cholesterol, depression as well as medications that prevent seizures and muscle spasms. Where possible, women with disabilities should have their medications changed to reduce any negative effects on their sexual function. Otherwise, they should be encouraged to try different methods of enjoying a sexual relationship.

Both society and health care providers need to be aware that having a disability does not mean someone is asexual. This may allow women with disabilities to become more comfortable with their sexuality, empower them to avoid abusive relationships and help them to achieve a satisfying sexual life.

Expectant father

Dear Dr Rainford,

Great article on 'expectant' fathers. You mentioned getting information from reputable websites. That's a useful idea, considering many people turn to the Internet much quicker than to a book. Can you suggest any such sites?

Dear Reader,

Thank you for your comment and question. I would suggest information from websites of established institutions or organisations such as the Center for Disease Control and Prevention, the United States Department of Health and Human Services and the National Institutes of Health. Locally, the website for the University of the West Indies provides an extensive list of references related to pregnancy.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.