Sexuality & Illness

Erectile dysfunction is defined as the inability of individuals with a penis to achieve or maintain an erection sufficient for sex over a longer period of time. Occasional erection problems are completely normal and occur in almost all individuals. Erectile dysfunction is only diagnosed when the difficulties occur more frequently and are perceived as bothersome.

The causes can range widely. There are often physical reasons, such as circulatory disorders, diabetes, hormonal changes, or side effects of medication. Psychological factors also play an important role. Often, physical and psychological factors have a combined effect.

Erectile problems can put a strain on self-esteem, relationships, and the way people deal with intimacy and sexuality. Many of those affected feel ashamed and do not talk about it, even though erectile dysfunction is widespread and has nothing to do with personal failure.

Vaginismus refers to a sexual dysfunction in which the pelvic floor muscles of people with vulvas involuntarily tense as soon as something is inserted into the vagina, for example during penetrative sex, when inserting tampons, or during gynecological examinations. This tensing is not intentional and can make penetration painful or even impossible.

The causes of vaginismus are many and varied. Psychological factors often play a role, such as negative or stressful sexual experiences, insecurity, shame, or a strong feeling of pressure to perform. Physical causes such as pain or gynecological conditions can also trigger or exacerbate vaginismus. Often, several factors work together.

Vaginismus can be very stressful for those affected and can affect self-esteem, sexuality, and relationships. Some sufferers feel misunderstood or ashamed to talk about it.

Vaginismus is readily treatable. Depending on the situation, education, counseling, sexual or psychotherapeutic support, pelvic floor training, and a taking a sensitive approach to one's own body can help. Involving partners can also be beneficial.

Anyone who experiences difficulties or pain during penetration should seek support. Talking openly about it and accepting help is an important step on the path to a sex life that is self-determined and pleasurable.

Sex is healthy for the heart and circulation. However, people with cardiovascular disease are often unsure how much sex is okay for them. In general, sex stimulates the circulation. Your pulse and blood pressure rise and a whole bunch of hormones are released. For most people, though, their pulse doesn't go up as high as you might think, only to about 90 to 130 beats per minute.    Oliva-Lozano, J. M., Alacid, F., López-Miñarro, P. A., & Muyor, J. M. (2022). What Are the Physical Demands of Sexual Intercourse? A Systematic Review of the Literature. Archives of Sexual Behavior, 51(3), 1397–1417. doi.org. That's comparable to the strain of climbing stairs.

People with cardiovascular disease or who have had a heart attack should discuss their exertion limits with their doctor. It is also important to check whether potency-enhancing drugs (e.g., Viagra) can be taken together with other medications. You can find out how best to talk about sexuality in the section “Sexuality & Language."

Some chronic physical and neurological conditions, such as rheumatism, multiple sclerosis, or Parkinson's disease, are associated with pain or stiffness in the joints. Fortunately, there are ways to make sex enjoyable despite these issues. It is important to talk openly with your partner about any problems or concerns you may have. Together, you can try out new positions and reduce feelings of embarrassment or anxiety. In the section “Sexuality & Language," you can find more information on how to talk about sexuality. It may be worthwhile to bring up the topic of sex with your doctor, for example, to discuss adjusting your pain medication and when to take it.

Intestinal disorders such as Crohn's disease or ulcerative colitis can affect sexuality through pain, psychological stress, or stoma (artificial intestinal opening) issues. Here, too, open and honest discussions with partners and doctors are crucial. It is also particularly important that contraceptive methods are appropriately adapted. For example, the pill is no longer reliable if you have diarrhea. Solutions can often be found to ensure that sexuality can still be fulfilling even with intestinal disease. You can find out how best to talk about sexuality in the section “Sexuality & Language.”