Sex and Chronic Illness

4. Look for new opportunities. Having a chronic condition means grieving the loss of things you can no longer do, among them, how you had sex. But if you stop there, you wind up depressed — and depression kills libido and erotic enjoyment. As time passes, look for new opportunities for fun and personal growth — including new approaches to making love.

5. Try lubricants and toys. Diabetes and other conditions may decrease genital sensitivity. Lubricants often help. They're inexpensive and available over the counter. In addition, vibrators might help women and vibrating penis sleeves might help men. Depending on your situation, other sex toys might also enhance your lovemaking. Try a few. You can find them at adult shops or various online sites.

6. Consider sex therapy. Sex therapists are psychotherapists with advanced training in sex problems. They never have sex with clients, and they don't watch you have sex. They discuss your situation, suggest ways you can enjoy sex and assign erotic "homework." The process typically takes a few months of weekly appointments, and studies show that two-thirds of people who consult sex therapists report significant benefit. To find a sex therapist near you, visit the American Association of Sexuality Educators, Counselors and Therapists, the Society for Sex Therapy and Research or the American Board of Sexology.

Michael Castleman, a journalist who has specialized in sexuality for 36 years, publishes GreatSexAfter40.com .