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Sex and Chronic Illness

Think that your medical diagnosis means an end to your love life? Think again

En español | Your doctor tells you that you have diabetes, heart disease, prostate problems or another chronic condition. "Any questions?" he asks. You ask several, all except for one you're too timid to bring up: "What about sex?"

See also: When Making Love Hurts

Every chronic condition is different, but here are six things you need to keep in mind:

Mature man and woman with heads together

Silas Images /Corbis

A chronic condition doesn't have to put an end to your love life.

1. Find information and support. Don't be embarrassed to ask your doctor about the sexual implications of your condition and the sexual effects of your medications. He no doubt has heard these questions many times before. Next, search the Internet: sexual effects of (blank), then list your medications. You may get different answers. But you'll come away with a useful overview.

Join the organization devoted to your condition. It's a rare chronic condition that doesn't have a national organization. To find the organization, search the Internet, or visit the American Self-Help Group Clearinghouse. Ask the organization for information on coping sexually, and possibly, for a referral to an expert on your condition's sexual implications.

Finally, most chronic-condition organizations sponsor support groups. Consider joining and asking group members how they cope sexually.

2. Be flexible. If you define "sex" as just intercourse, and can no longer do that, you might think that your sex life is history. But if your definition of sex is more flexible, then bidding farewell to intercourse is like passing up one dish at a huge buffet. Even if you can't have intercourse, there are many ways to enjoy physical intimacy, fulfilling lovemaking and orgasm. Men don't need erections to climax. Satisfying sex is based on leisurely, playful whole-body massage. Even those with severe disabilities can often kiss, cuddle, use sex toys, receive massage and oral sex, and perhaps provide it. Focus not on your disabilities, but on your abilities. Where there's a will, there's a way.

3. Stay as healthy as possible. "How can I be healthy?" you ask, "I have this damn disease." Yes, you do. But you'll feel better, have an easier time managing your condition, and retain more sexual interest and ability if your lifestyle is as healthy as possible, so check with your doctor and come up with a plan that will help you maintain a healthy lifestyle.  Here are some things you should consider:

  • If you smoke, quit.
  • Don't drink more than two alcoholic drinks per day.
  • Eat at least five servings of fruits and vegetables a day.
  • Within your abilities, strive for regular moderate exercise, ideally, at least 30 minutes a day.
  • Get at least seven hours of sleep a night.

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 .