Manual Sexuality And Fertility Issues in Ill Health And Disability: From Early Adolescence to Adulthood

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Sexuality and Fertility Issues in Ill Health and Disability: From Early Adolescence to Adulthood [Rachel Balen, Marilyn Crawshaw, Adam Balen] on
Table of contents

Young children and children going through a growth spurt at puberty are at especially high risk for effects on growth. Along with stunted bone growth, other late effects related to bone and muscle problems can include:. Some medicines used to treat certain kinds of cancers can also affect the bones. This can cause parts of bones to weaken or die, which in turn can cause pain especially at bone joints or even breaks in the bone. Osteonecrosis can affect any bone, but most often it affects parts of bones around the hips or knees.

Department of Health | Some physical health issues for young people

High-dose chemotherapy as part of a stem cell transplant can also cause osteonecrosis. Surgery for some types of childhood cancers can have obvious effects on muscle and bone growth in certain parts of the body. Heart disease can be a serious late effect of certain cancer treatments. The actual damage to the heart may occur during treatment, but the effects may not show up until many years, or even decades later. Doctors try to limit the doses of these drugs as much as possible while still giving high enough doses to treat the cancer effectively.

Studies are now being done to see if certain drugs shown to help protect the heart in adults getting anthracyclines can also help children. Radiation therapy to the chest or spine, or when given to the whole body total body irradiation , can also damage the heart muscle or cause problems with its rhythm. Radiation can also damage the heart valves or the blood vessels coronary arteries that supply the heart muscle with oxygen.

The total dose and type of radiation and the age of the child at the time of treatment affect this risk. This is especially true in children being treated today, as modern approaches have reduced treatment doses and lowered the risk. When these treatments do affect the heart, the damage does not usually show up right away, but it can raise the risk of heart problems later in life.

Careful monitoring for heart problems is very important in the years after treatment because often there are no symptoms. Special tests, such as an EKG or an echocardiogram an ultrasound of the heart , can help show hidden problems. With routine physical exams and testing, heart problems can often be found early and treated, if necessary. Talk with your cancer treatment doctor about any limits on exercise, now and in the future, and what kinds of activity will be best. This will help you plan exercise programs or increase your current level of activity. Some childhood cancer treatment centers have special programs to get children back into physical activity.

Lung problems can occur in children who have had radiation therapy to the chest or total body irradiation. The risk of problems depends on the dose of radiation, how much of the lungs get radiation, and the age of the patient. The use of certain chemo drugs at the time of radiation may increase the risk. Possible late effects include:. Certain chemo drugs, such as bleomycin, can also cause lung problems, especially fibrosis and pneumonitis. The risk of problems increases with higher drug doses.

Some people who get these treatments may have no noticeable symptoms, but for others, problems may start as soon as within the first few years after treatment. People who have received these treatments need careful follow-up with a doctor, especially during the first few years after treatment.

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Special tests such as chest x-rays or pulmonary function tests may be done regularly in those at high risk for problems. For some, seeing a pulmonologist lung doctor may be helpful. The best way to help keep the lungs healthy is to avoid smoking or being around tobacco smoke. Chemotherapy or radiation therapy in an area that involves the teeth and jaw can lead to late effects, mostly in children who are treated before age 5. But older children may have problems too. Late effects of these treatments can include:.

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Radiation in the area around the mouth can also affect the salivary glands, which can lead to decreased saliva and dry mouth. This can cause tooth decay and gum disease. Regular dental exams are important to find problems early and reduce the risk of infection, decay, and tooth loss. Chemotherapy can contribute to a slow-down in growth. When chemo is given alone, without radiation, the change in growth rate is most often short-term. Over time many children catch up to a normal growth pattern after treatment.

But certain chemo drugs, when given in high enough doses, have more lasting effects.

And some of the long-term effects of intensive chemotherapy are still unclear. Many of the late effects on growth and development are linked to radiation therapy.

5.2 Some physical health issues for young people

Radiation has a direct effect on the growth of bones in the area being treated see Muscles and bones. Radiation and sometimes surgery in the head and neck area can sometimes damage the pituitary gland, which is the main gland of the endocrine system.

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This can sometimes affect overall growth and development. The endocrine system is a group of glands that help control many important body functions, including growth, metabolism, puberty, and responses to stress. Endocrine glands include the pituitary, thyroid, adrenals, testicles in boys , and ovaries in girls. These glands work by releasing hormones into the bloodstream, which can then affect cells throughout the body.

For example, the pituitary releases growth hormone, which stimulates body growth in children. Hormones from the ovaries and testicles affect sexual maturation and fertility. Again, very young children are most likely to be affected. The slowing of growth is usually seen within 5 years of treatment.

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If the pituitary gland is damaged, treatment with growth hormone can often reverse some of the effects on growth. But growth hormone treatment has its own risks. There may be options for limiting or preventing some of these effects. In males, the testicles have 2 main functions. They make male hormones such as testosterone , which influence sexual development and help the body maintain bone and muscle strength. The testicles also make sperm, which are needed to father children.

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Both radiation therapy and chemo can reduce sperm production and might also affect sexual development. In general, the cells in the testicles that make sperm are more likely to be damaged by cancer treatments than are the cells that make hormones. The effects may be short- or long-term, depending on the intensity of the treatment. Radiation therapy aimed at the testicles can affect the cells that make sperm. It might also damage the cells that make hormones if given at higher doses. Radiation aimed at the abdomen belly or pelvis might also have this effect.

Sometimes the testicles may be shielded or moved out of the radiation field during treatment to try to prevent this. Sex hormone levels in the body are also influenced by the pituitary gland, so radiation therapy to the head area can affect sexual development and sperm production as well. High doses of certain chemo drugs are more likely to affect the cells that make sperm, but very high doses can also affect the cells that make hormones.

Mental health issues account for more than half of the total youth health burden of the community. Top of page Between there was a 71 percent increase in the rate of successful suicides for young males. Despite considerable health promotions that focus on the risks of tobacco smoking, 40 percent of year olds smoke and 25 percent of year olds smoke. The death rate for Aboriginal and Torres Strait Islander people is three times higher for young males and twice as high for young females when compared with non-Indigenous young people.

New cases of HIV infection among young males declined from 11 per , population in HIV infection rates have consistently been much lower for young females 1 per , Chlamydia is the most common form of sexually transmitted disease among young females. Most of the health problems highlighted in the above statistics are preventable. The 'catch 22' is that often the activities young people engage in as part of an otherwise normal, healthy development e. Those at most risk who require special attention are young people who are: Indigenous Living in rural or remote areas Involved in the juvenile justice system or in State care e.

Comprehensive responses are needed including health promotion, early intervention and prevention strategies to address the preventable health concerns of young people Australian Institute of Health and Welfare, Workplace learning - group activities Question - What are some of the health issues that young people in your community experience?

These issues might include mental health, suicidality, sexually transmitted diseases, alcohol and other drug use, Indigenous health, obesity or eating disorders etc. Take home exercise Question - Select one of the issues you have identified for further research. Many unhealthy behaviors that start during adolescence, such as consuming a poor diet see Obesity in Adolescents , smoking , substance use , and violence , can lead to immediate health problems, long-term disorders, or poor health later in life.

Merck and Co. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. Common Health Topics. Test your knowledge. Which of the following organs may be damaged by amyloidosis resulting from poor treatment of familial Mediterranean fever? When sound waves reach the ear, they are gathered by the funnel-shaped outer ear and channeled into the middle ear.