Men who are living with osteoarthritis, rheumatoid arthritis, or other forms characterized by sore, stiff joints and pain can find ways to work around these symptoms if they have a willing partner. For example:
- Massage can be used both as foreplay and to relieve sore joints and muscles.
- You may need to plan your sexual activities for times of the day you feel your best.
- Use pillows and other soft support for affected joints.
- Experiment with new positions.
- Soak in a hot tub or sauna before having sex.
- Take your pain medication 30 minutes before sexual activity.
Involuntary urine leakage is usually associated with women, but among men, especially those who have undergone some type of treatment for a prostate problem, it is common as well. Fortunately, in most cases it is temporary, but temporary can still mean months or even years, and it can be embarrassing and cause men to avoid intimacy. In addition to talking to your doctor about possible treatments, men with urinary incontinence should always empty their bladder before sex, try different sexual positions that minimize pressure on the bladder, and keep the lines of communication on the topic open with their partner.
PTSD (Posttraumatic Stress Disorder)
Posttraumatic stress disorder (PTSD) can happen to anyone, but it has become especially prevalent among men (and women) who have been in combat. Recent research has shown that when compared with the general population, male veterans with PTSD were significantly more likely to have sexual problems, including erectile dysfunction, than their civilian peers. The recommended approach for men who are experiencing PTSD and sexual challenges is to seek help from knowledgeable therapists and to include their partners in therapy so they can both work through the situation together.
Parkinson’s disease is a progressive neurodegenerative condition that affects movement. Although the American Parkinson Disease Association states that “diminished sexual function is practically inevitable,” there are ways to reduce the impact of the disease and share sexuality with your partner. It’s important to discuss the side effects of medications prescribed for Parkinson’s, as many are associated with sexual side effects including, in rare cases, hypersexuality. Men who have Parkinson’s disease should talk to their doctor about adjusting medications as needed. In addition, couples may want to try different positions and find other ways to share intimacy.
Multiple Sclerosis (MS)
Multiple sclerosis affects the nervous system, which means damage to the nerves can have an impact on muscle movement and cause spasms. If the nerves that run down the spine are affected, they may affect sexual arousal and orgasm, as well as cause fatigue and weakness. A variety of natural and conventional treatments are available to treat MS, but be sure to tell your doctor about any sexual difficulties you are experiencing, as they are often overlooked by physicians.
Low testosterone (low T) is often blamed for lack of sexual desire among men, but often it is not the true cause. However, this has not stopped marketing and pharmaceutical companies from pushing testosterone replacement therapy (TRT) on men who are experiencing a decline in sexual desire and activity, among other symptoms. Often these men are given TRT without ever having their T levels measured.
A small percentage of men do have a medical condition known as hypogonadism, or very low T levels, which can be treated with TRT. In the majority of cases, however, lifestyle changes and addressing other health issues associated with low sex drive, such as diabetes and heart disease, are the best treatment. All men who believe they have low testosterone should have their levels checked.
The presence of chronic pain can make it difficult to even think about engaging in sexual activities. At the same time, use of some medications to treat chronic pain have sexual side effects. If you experience chronic pain and it is having an impact on your sex life, talk to your doctor about your pain management plan. If your medication is not working, can you try something else? Is it possible your current medication is contributing to low libido? These are two questions you need to ask to start the conversation with your doctor.
Approximately 30 million people in the United States alone have diabetes, and many of them may be dealing with the consequences of this common disease. One is the harm that high blood sugar has on blood vessels and nerves. In men, this damage can result in erectile dysfunction and ejaculation problems. To help avoid these sexual hurdles, be sure to control diabetes by staying active, eating a nutritious diet, maintaining a healthy weight, and monitoring your blood sugar regularly.
HIV and AIDS
Having HIV or AIDS can hamper your sex life in several ways. HIV affects hormone production, including testosterone, which can lower desire. Commonly used anti-HIV drugs, called protease inhibitors, have a negative impact on sexual function and can cause erectile dysfunction. Other side effects of HIV and AIDS medications include nausea, vomiting, fatigue, depression, diabetes, and heart disease. You should talk to a counselor or your doctor about treatment options.
A number of cardiovascular diseases, especially hypertension and peripheral vascular disease, cause damage to the small blood vessels that supply blood to areas away from the heart, including the penis. Compromised circulation to the penis can result in erectile dysfunction and lack of libido. In addition, use of medication for high blood pressure can cause lack of sex drive, ejaculation problems, and ED. Men who have had a heart attack may avoid sexual activity because they are afraid they may have a repeat episode.
Similar to diabetes, men can improve their sex lives by making lifestyle changes: improved diet, weight management, regular exercise, and stress management. Also talk to your doctor about any medications you are taking for your heart condition, as many (in addition to those for high BP) have an adverse impact on sexual health.
Regardless of the type of cancer one has, the disease can put a hamper on sexual activity. Some cancer treatments, such as chemotherapy, make sexual activity a real challenge. Fatigue, emotional stress, pain, surgery, and fluctuating hormone levels all can take their toll. You can still be intimate with your partner in other ways until you are both ready to return to sexual activity.
It’s often said that much of sex takes place between your ears, and this is certainly true when it comes to depression. One common symptom of depression is a decline or lack of sexual desire that can become chronic if it is not addressed. Fortunately, depression can be treated successfully if you make the effort. Consider talking with a professional therapist or doctor to uncover the cause of your depression and then take steps to alleviate it. Both lifestyle changes and talk therapy can be effective. Be aware that many antidepressants can cause or contribute to sexual problems, including low libido and erectile dysfunction.
Inflammatory Bowel Disease (IBD)
The pain, fatigue, fecal incontinence, and need to go to the bathroom frequently associated with colitis and Crohn’s disease are real hurdles to sexual activity. Inflammatory bowel disease also may affect a person’s physical appearance due to surgical scars, ostomy placement, or fistulae. Embarrassment and anxiety over not having total control over bowel activity also are concerns.
It is critical to establish and maintain safe communication between partners. Men and their partners who are dealing with IBD may find significant help from support groups and therapy. Help for men with IBD who are struggling with sexual issues is available.
Crohn’s and Colitis UK. Sexual relations and IBD.
Rosenblatt E, Kane S. Sex-specific issues in inflammatory bowel disease. Gastroenterology & Hepatology 2015 Sep; 11(9): 592-601
Tran JK et al. Sexual dysfunction in veterans with post-traumatic stress disorder. Journal of Sexual Medicine 2015 Apr; 12(4): 847-55