Illness and Other Health Conditions Affecting Sexuality

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Certain illnesses and health conditions can have a major impact on sexual function. Obviously, people with physically disabling conditions such as multiple sclerosis, spinal cord injury, stroke or cerebral palsy may be limited in their ability to have traditional intercourse. Painful conditions such as arthritis and rheumatism also can take their toll. Other diseases may affect the sexual organs themselves, the nerves and blood vessels that play a role in sexual response and sex hormone levels. Here are four examples of illnesses known to have some effect on sexuality and sexual function.

Cancer: In some cases, cancer can have a direct impact on sexual functioning if it affects hormone production or an organ involved in sex itself, such as the prostate, penis, ovaries, cervix or vagina. Treatment for most forms of cancer, not just those affecting sexual and reproductive organs, can make people feel uncomfortable about their bodies and sexually unattractive. Chemotherapy and radiation therapy are intense treatments that can cause more illness and discomfort than the cancer itself. Patients often experience unpleasant side effects such as fatigue, nausea, hair loss, skin irritation and weight changes. Surgery for cancer, such as removal of a breast or testicle, can make patients self-conscious and affect their sexual self-image.

Diabetes: People with diabetes can develop diabetic neuropathy nerve damage caused by decreased blood flow and high sugar levels. This damage can interfere with sexual response.

Stroke: Along with causing problems with motor function and control, stroke can affect a person’s body image. A stroke survivor may not be aware of one side of the body; the mouth may droop; feeling on the paralyzed side may be different; and speech may be garbled and emotions hard to control. The patient also may be afraid that sexual activity could bring on another stroke. Stroke survivors and their partners need to work together to overcome these physical and emotional issues.

Heart conditions, coronary artery disease, high blood pressure: Treatment of these conditions with medications that lower blood pressure can interfere with the blood flow to the genitals that is necessary for sexual response. Also, people with a history of heart attack or heart conditions may fear that sex could bring on an attack. They should work with their partners and physicians to deal with these issues.

Sexual Dysfunction: a Widespread Problem

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Four of 10 women and three of 10 men experience sexual problems, according to a study in the Journal of the American Medical Association. The most common problems reported by women were low sexual desire (22 percent), problems with arousal (14 percent), and pain during intercourse (7 percent). Men most commonly reported problems with premature ejaculation (21 percent), erectile dysfunction (5 percent) and low desire (5 percent).

Other key findings include the following:

The prevalence of sexual problems in women tends to decrease with increasing age, except for those who report trouble lubricating. As men get older, however, they are more likely to experience sexual problems, such as erectile dysfunction and lack of desire for sex.
Younger women are more likely to experience sexual problems, perhaps due to lack of experience and the greater likelihood that they’re not in a stable relationship (for example single as opposed to married).
Married women and men are at lower risk for sexual problems than their non-married counterparts.
Women and men with lower educational levels report less pleasurable sexual experience and raised levels of sexual anxiety.
Emotional or stress-related problems, as well as financial difficulties, are important risk factors for sexual problems.
Past sexual trauma such as forced sexual contact or sexual assault is associated with long-term sexual problems, whether the person was the victim or aggressor.
Sexual problems are associated with unsatisfying personal experiences and relationships, lack of physical and emotional satisfaction, and low feelings of happiness.
Of course, these results don’t apply to everyone in exactly the same way, but they do create a compelling profile of sexual problems. The authors of the study conclude there is a “strong association between sexual dysfunction and impaired quality of life,” and that sexual dysfunction “warrants recognition as a public health concern.”