Your doctor solemnly announces that you have diabetes, lupus, heart disease, rheumatoid arthritis or some other chronic condition, and inquires, “Any questions?” You ask quite a few, but can’t quite manage, “What about sex?” Every chronic condition is different. But coping sexually doesn’t depend much on the condition. To enjoy the best sex possible despite your chronic condition, follow these six steps:

1. Be Flexible

If you define “sex” as just vaginal intercourse, and can no longer do that, you might think that sex is over for you. But if your definition of sex is more flexible, then bidding farewell to intercourse is like passing up one dish at a huge buffet. Even if you can’t have intercourse, there are many ways to enjoy physical intimacy, fulfilling lovemaking, and orgasm. Men don’t need erections to climax. Satisfying sex is based on leisurely, playful whole-body massage. Even those with severe disabilities can often kiss, cuddle, use sex toys, receive massage and oral sex, and perhaps provide it. Focus not on your disabilities, but on your abilities. Where there’s a will, there’s always a way.

2. Find Information and Support

Ask your doctor about the sexual implications of your condition and the sexual effects of your medications. Then ask your pharmacist. Next, search the Internet: sexual effects of—then list your medications. You may get different answers. But you’ll come away with a useful overview.

Join the organization devoted to your condition. It’s a rare chronic condition that doesn’t have a national organization. To find the organization, search the Internet, or visit the American Self-Help Group Clearinghouse. Then ask the organization for information on coping sexually, and possibly, for a referral to an expert on your condition’s sexual implications.

Finally, most chronic-condition organizations sponsor support groups. Consider joining and asking group members how they cope sexually.

3. Stay As Healthy As Possible

“How can I be healthy?” you ask, “I have this damn disease.” Yes, you do. But you'll feel better, have an easier time managing your condition, and retain more sexual interest and ability if your lifestyle is as healthy as possible:

• If you smoke, quit.

• Don’t drink more than two alcoholic drinks per day.

• Eat at least five servings of fruits and vegetables a day.

• Within your abilities, strive for regular moderate exercise, ideally, at least 30 minutes a day.

• Get at least seven hours of sleep a night.

4. Look For New Opportunities

Having a chronic condition means grieving the loss of things you can no longer do, among them, how you had sex. But if you stop there, you wind up depressed—and depression kills libido and erotic enjoyment. As time passes, look for new opportunities for fun and personal growth—including new approaches to making love.

5. Try Lubricants and Toys

Diabetes and other conditions may decrease genital sensitivity. Lubricants often help. They’re inexpensive and available over the counter. In addition, vibrators might help women and vibrating penis sleeves might help men. Depending on your situation, other sex toys might also enhance your lovemaking. Try a few.

6. Consider Sex Therapy

Sex therapists are psychotherapists with advanced training in sex problems. They never have sex with clients, and they don’t watch you have sex. They discuss your situation, suggest ways you can enjoy sex, and assign erotic “homework.” The process typically takes a few months of weekly appointments, and studies show that two-thirds of people who consult sex therapists report significant benefit. To find a sex therapist near you, visit the American Association of Sex Educators, Counselors, and Therapists, the Society for Sex Therapy and Research, or the American Board of Sexology.

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