Sex as you get older Dr Gill Jenkins Few medical conditions mean an end to your sex life, but some may require you to alter your pattern of sexual activity.

In this article

Cardiac and respiratory conditions Arthritis and joint problems

After the menopause Impotence

Sexual intercourse can be an aerobic activity. If you have angina or severe breathing difficulties, you may want to experiment with a more leisurely style or position. You'll know your limits.

You may need to take your medication before you start. This may mean sex loses some of its spontaneity, but you won't risk straining yourself.

Painful joints can stop you relaxing and enjoying sex

Painful joints can stop you relaxing and enjoying sex, so it's important to find positions that don't put pressure on them.

Take your painkillers before sex and don't be overambitious about how active you are unless you're happy to pay for it in the morning.

If you have back or disc problems, consider where and how you make love. Don't risk a prolapsed disc and getting stuck in a moment of passion.

The fall in female hormones (oestrogens) after the menopause means the lining of the vagina can become dry and less elastic. If sex becomes increasingly painful and sore, or if penetration is difficult, or you bleed afterwards, try a lubrication jelly or special vaginal moisturiser. You should also seek the advice of a doctor or menopause specialist.

Once the doctor has examined you and made sure there's no serious cause for your problem, they may suggest hormone replacement therapy (HRT). This contains the female hormone oestrogen, with or without progesterone. Alternatively, your doctor may prescribe a vaginal oestrogen cream to soften and moisten the vagina.

Erectile dysfunction, or impotence, occurs when a man is unable to get or sustain an erection. There are many physical causes that need to be excluded, but sometimes it can happen because of psychological causes.

Common reasons for erectile dysfunction include:

• Diabetes
• Vascular disease
• Prostate disease (and after prostate surgery)
• Stress
• Anxiety
• Depression

Many types of medication can also cause impotence, including high blood pressure treatments such as beta blockers.

Don't be embarrassed to see your doctor. Treatments are available for erectile dysfunction, including tablets, injections and local treatments, as well as mechanical aids.

Explore how to make the most of intimacy in later life with psychosexual therapist Paula Hall.

This article was last medically reviewed by Dr Rob Hicks in July 2007.
First published in March 2000.