Recently sex toys have been a topic of discussion in many forums in Zambia. Being mainly a conservative society, government leaders have spoken out against the practise of utilisation of sex toys in recreation whilst some members of the public have generally felt it is an infringement on their human rights and what they do in private should be left alone. Lets briefly touch on the position of the law on the issue. A commonly quoted section of the Laws of Zambia with regard to this topic is Section 177(1) of the Penal Code of the Laws of Zambia which provides that any person who makes, produces or has in his possession obscene writings, drawings, prints, paintings, printed matter, pictures, posters, emblems, photographs, cinematograph films or any other object tending to corrupt morals, will be guilty of a misdemeanour and liable to imprisonment or to a fine. Just to get some context lets define obscene. According to the Oxford dictionary ‘obscene’ is defined as 1. (of portrayal or description of sexual matters) offensive or disgusting by accepted standards of morality and decency. 1.1 Offending against moral principles; repugnant.

If we are to come to consensus in a discussion around this topic we need to define what our moral standards are. However, lets not get carried away with the topic, as this is ‘Cancer Watch’. What is the relationship with sex toys and cancer? The subject matter stated so boldly was not part of my syllabus in medical training, however certain general basic principles can be investigated to ensure consumer safety where it is legal. These are

  • Safety of material used to manufacture these toys in relation to human health
  • Infections surrounding the use of sex toys

Lets address the material used in manufacture of these toys. Apparently sex toys do not have the same production standard worldwide. Cheaper brands are said to be made of toxic plastics with high levels of a substance called phthalates, which are classified as a possible human carcinogen, BPA and PVC. Phthalates or phthalate esters are compounds added to plastics to enhance their flexibility, transparency, durability and longevity. Around 2015 a wave of studies showed phthalates have detrimental effects on health including cancer. Other effects were asthma, attention deficit hyperactivity disorder, obesity, type II diabetes, neurodevelopmental issues and many more. BPA is a well-known compound that we avoid in manufacture of goods. With regard to other compounds used in sex toy manufacture, melamine has been implicated in increased risk to kidney stones and kidney failure in extreme cases death. The chemicals from poor quality plastics when absorbed into the body can act like hormones, which can result in major problems such as infertility, breast and prostate cancer.

More expensive toys are made from high-grade silicon. High-grade silicon is the safest form of material in relation to human health. A couple of pointers in recognising silicone-based products are that highly flexible toys are most likely not made of silicon. Silicon is opaque, translucent products are likely not safe.

A major query consumers of such products in Zambia must raise is who is regulating the quality of goods that is being presented to them.

The second pertinent issue surrounding the sex toys is infections. Just as bacteria and viruses are transmittable during sexual intercourse between two human beings sharing of sex toys still poses a risk for the same. A study published in the journal Sexually Transmitted Infection showed that HPV was detected on the vibrators immediately after use, after cleaning and 24 hours after cleaning.  The levels were logically higher after use before washing. However, what was concerning was that the HPV persisted even after washing the vibrator. Interestingly the degree of persistence was linked to the material used in the manufacture of the vibrator, thermoplastic elastomer versus silicone. The vibrators manufactured with thermoplastic elastomer showed higher HPV contamination and persistence after cleaning than those manufactured with silicone (T A Anderson, 2014).

HPV infection as we have discussed is major cause of cervical cancer. The other types of cancer that HPV is implicated are anal, vulval, penis and oropharyngeal cancer.

Another infection issue of concern on use of sex toys is the interchanging between orifices (anal and vaginal). This is a definite no-no as it makes you prone to bacterial vaginosis. The bacteria in the anus do not belong in your vagina and vice versa.

A point of concern from many health practitioners is the long-term hygiene aspect of vibrators. As shown in the study by Anderson et al, HPV virus persisted even after cleaning. For thermoplastic elastomer HPV persisted up to 24 hours after cleaning. Bacteria and yeast can all overgrow on these toys causing problems when introduced into the body. Porous toys are also discouraged as bacteria colonise the pores.

In relation to cancer survivorship and sex toys I found an article about an obstetrician gynaecologist, Dr Mary Jane Minkin, who uses a vibrator-like device for her patients who have been treated for gynaecological malignancies. There was emphasis that she does not prescribe ‘plastic vibrators sold at malls or pink dildos that dye panties pink if kept in an underwear drawer’. They use a special device called We-Vibe, a BPA and phthalate device made out of silicone, which can be charged through a USB cable. Their work surrounds issues of allowing women who have been treated for cancer regain back their sexual health. Some of the side effects of treatment include vaginal dryness and stenosis due to treatment induced menopause. This can have a devastating effect on a survivor’s quality of life and family dynamics.

The focus of the use of this device is to increase blood flow to the pelvis so as to increase natural endogenous oestrogen levels in the vagina. Oestrogen protects the vagina keeping it moist. Most oncologists do not want women, especially those who had cancer to be exposed to high levels of exogenous oestrogen.

The last point I would like to touch on is the psychosocial impact of sex toys. A common intimation in individuals who advocate for the use of sex toys is the escape of dealing complexities of human relationships. In my opinion this should not be the focus as it promotes unhealthy psychological behaviour. Despite the unpleasant nature of certain human relationships, they are necessary for the dynamics of our existence. Certain skills we learn in dealing with our partners assist us on a broader scale in life as adults. So I would be wary of the notion of replacing the human element in sexual pleasure rather look to enhance it.

In a closing note, March is Colon Cancer Awareness Month. Wear your blue ribbons of hope! In other articles this month we shall be going through prevention, treatment and survivorship in relation to colon cancer.

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