There are a multitude of reasons why some couples stop having sex as they age. But a chronic health problem is definitely a big one. Fortunately, it doesn’t have to be that way.

Sexual satisfaction remains within reach for just about everyone who wants it…and most people still do want it. Not only that, sexual activity has its own health benefits—for example, it helps lower blood pressure, improves sleep and relieves pain.


If you’re depriving yourself of sexual intimacy because of a health problem, the key is to start thinking about sex in a new way. Instead of viewing a sexual encounter as a pass/fail test that involves intercourse and mutual orgasm, it’s time to think of it as an opportunity for sharing pleasure. How you achieve this is largely up to you. To get started, you’ll want to talk to…

• Your doctor. Schedule a single consultation for you and your partner to meet with your internist, cardiologist, oncologist or other physician who is treating your health problem. Ask him/her to explain how your condition might affect your sexual intimacy and to give you any advice on what you can do medically to minimize those issues.

• Your partner. It’s crucial for you to be able to talk about sex with your partner. Don’t wait until you’re in bed…or after a negative experience. Instead, bring up the subject (ideally on the day before a sexual encounter) while you’re on a walk or having a glass of wine together. Avoid any blaming, and be clear that you’re simply making sexual requests so that the experience is more comfortable and pleasurable.

In addition to what you learn by talking to your doctor and your partner, consider these specific steps to get your sex life back on track if you are affected by…


Take a man with low-back pain and have him engage in intercourse the way 70% of Americans do—with the man on top of his partner performing short, rapid thrusts—and you’ve got a perfect recipe for uncomfortable sex.

A better approach: The man with the bad back can invite his partner to go on top, and they can try a circular, thrusting motion. If a woman has back pain, the couple might try the side rear-entry position and long, slow thrusts. If your partner also has back problems, take lovemaking to the shower, where the warm water can loosen sore muscles.

Also helpful: If you’re in chronic pain, such as that caused by arthritis, your doctor can refer you to a physical therapist, who can give you additional positioning tips.

Taking your favorite over-the-counter pain-reliever or using a heating pad about 30 minutes before sex also helps. This approach often reduces back and joint pain for an hour or more.

Even if your pain is not entirely eliminated, you may get enough relief to enjoy yourself. And after orgasm, your pain will likely be less intense for a period of time.


Cancer treatment, such as surgery, radiation and medication, can create pain, fatigue and all kinds of psychological and physical fallout.

With breast cancer, it’s common for a woman to worry about her partner’s reaction to her altered body and how her breasts will respond to touch, particularly if she has had reconstructive surgery, which reduces sensitivity.

What helps: When talking about these issues, don’t be afraid to get specific. Some women will not want to be touched on the affected breast or breasts, at least for a while. Others will crave that touch. Some might feel uncomfortable about nipple stimulation but fine about touching on the underside of the breast.

Cancers that affect other parts of the body, such as cervical or testicular malignancies or even mouth cancer, can also interfere with intimacy. If a man has been treated for prostate cancer, for example, he may want to focus more on pleasure-oriented sexuality rather than the traditional approach of intercourse and orgasm. Whatever the situation, talk about these vulnerable feelings and enlist your partner’s help as a sexual ally.


Too much body weight can get in the way—both psychologically and physically.

It’s common for a person who is overweight to think: I don’t feel sexy now, but I will when I lose some weight. While weight loss is a healthy idea, putting your sexuality on ice until you reach some ideal state is not. Learn to love and care for the body you have.

What helps in bed: Think beyond the missionary position, which can get pretty awkward and uncomfortable if one or both parties carry a lot of weight around the middle. Try lying on your sides instead. Or try a sitting and kneeling combination—a woman might sit on the edge of a sofa, supported by pillows behind her back, while her partner kneels before her.


The fatigue often associated with heart and lung disease can douse your sexual flames. But a bigger issue is often the fear that a bit of sexually induced heavy breathing will prove dangerous or even fatal.

If this is a concern, ask your doctor whether you are healthy enough for sex. A good rule of thumb is to see if you can comfortably climb two flights of stairs. If the answer is yes, then almost certainly you’re healthy enough to have sex.

What helps: If you still feel nervous, you can gain some reassurance by pleasuring yourself. A bout of masturbation produces the same physiological arousal as partnered sex. And it gives you a no-pressure chance to see how that arousal affects your breathing and heart rate.


People with frequent tremors, muscle spasms and other conditions in which a loss of control over the body occurs can still enjoy sex.

What helps: When talking to your partner about sex, decide between the two of you, in advance, on what you will say if, during lovemaking, your body becomes too uncooperative. It might be just a single word—“spasm,” for instance—that tells your partner you need to pause.

Then agree on a “trust position” you will assume as you take a break to see if you want to return to sexual activity. For example, some people will cuddle or lie side by side.