How does chronic disease affect sexuality?

A chronic disease is a long-term health problem. Heart disease, arthritis, diabetes, and COPD are examples of chronic disease. Health problems like these can affect sexuality in different ways. Symptoms like nausea, pain, and fatigue can get in the way of sexual thoughts or feelings that have been a positive part of your life. Hormone changes, poor blood flow, and medicine side effects also can cause problems. They may affect interest in sex, physical arousal, or orgasm.

If you have a chronic disease, some of this may sound familiar. But still, health problems don't change your basic human need for touch and intimacy.

When adjusting to a chronic disease, the idea is to get to a "new normal" that works best for you. With your doctor and your partner, you learn your limits. Then you're free to focus on what you can do, rather than on what you can't do.

What can you do?

Ask your doctor if your health problem or your medicine can cause sexual side effects. Talk about any physical problems that prevent you from having or enjoying sex. And ask for help with symptoms that are getting in the way of feeling sexual. There may be a medicine change or a treatment that could bring you some relief.

If you're having fear or worries that it's not safe to have sex, check with your doctor to be sure. Counselling might also be a good option for you and your partner. It may include support and ways to help you relieve anxiety or fear.

Find new ways to enhance your sexuality

When you feel unwell, it can be hard to feel good about your body. But you can take steps to connect with your body in positive ways. Treat yourself to things that make you feel good and give you energy. This can be anything from self-massage in a warm tub to yoga to daily time outdoors. Seek out positive touch from others, such as massage, hugging, and holding hands.

Having an understanding with your partner about sexuality is key. It can help to tell each other what you want, and what limits you might have. Together, you can figure out what could make you each more comfortable and satisfied.

• Try to be well rested before having sex. You might want to avoid times when you've just eaten, or when it's hot or humid.
• Take your time, take it easy, and enjoy one another.
• Think about trying new ways of doing things. To enhance sexual response, consider trying more foreplay and direct contact with sexual organs. If fantasy works for you, get creative together.
• Let your partner know if you need him or her to take the more active role.

Sexuality and intimacy thrive on affection. Together, think about how best to tend to your relationship. Perhaps set aside some extra couple time. This can be a time for talking, sharing, and maybe finding new ways to enjoy one another.

How can you talk to your doctor?

Sometimes doctors are so focused on health problems that they forget to ask about important parts of your life, like sex. You may have to bring up the subject yourself.

It can be hard to talk about sex, even with the person you are closest to. So it can be even harder to bring it up with your doctor. See if any of these tips work for you.

• If you think you will have trouble bringing up sex, practice how you will introduce the subject. You might say something like, "I have some concerns about sex, and I'd like to talk about them today."
• Before your appointment, make a list of questions to ask your doctor.
• Consider having your partner go with you. For some people, having their partner there makes it easier to talk. And your partner may want to ask questions too.
• Be as specific as possible. Tell your doctor what you have tried, what works for you, and what doesn't work.
• If you have trouble asking the questions directly or you feel rushed, give your list of questions to your doctor. Then ask for another appointment to discuss them.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

• You have pain during sex.