Introduction
Sexual difficulties are not always linked to psychological issues or relationship challenges. In fact, a significant proportion are caused or worsened by medical conditions and medications. If you’re experiencing changes in desire, arousal, or satisfaction, your body—or something you’re taking for your health—could be the hidden factor.
The good news? Recognising medical causes is the first step towards solutions. You’re not failing, you’re not alone, and often, a few adjustments bring relief.
This article shines a light on the medical roots of sexual dysfunction, offers real-life solutions, and encourages collaboration between clients, therapists, and GPs for holistic well-being.
How Common Are Medical Causes?
- According to NHS data (2023), up to 30% of cases of sexual dysfunction seen in clinics are linked directly to chronic conditions or side effects from medication.
- Natsal-3 research identified diabetes, cardiovascular disease, depression, and hormonal disorders as the most frequent culprits (Mitchell et al., 2013).
- Many clients are unaware that sexual side effects are not “just part of getting older” or “in their head,” but treatable and addressable concerns.
Major Medical Causes of Sexual Dysfunction
1. Cardiovascular Disease
- Reduced blood flow due to high blood pressure, atherosclerosis, or heart disease can cause erectile dysfunction in men and arousal/lubrication issues in women (Yafi et al., 2016).
- ED is so tightly linked to heart health that it’s sometimes called the “canary in the coal mine” for vascular disease.
2. Diabetes
- Both Type 1 and Type 2 diabetes affect nerves and blood vessels, leading to problems with arousal, erectile function, orgasm, and lubrication.
- Estimates suggest over half of people with longstanding diabetes experience some sexual side effects (NHS, 2023).
3. Hormonal Disorders
- Low testosterone, menopause, thyroid issues, or polycystic ovary syndrome (PCOS) can all alter desire and enjoyment.
- Menopause may cause vaginal dryness and atrophy, impacting comfort.
4. Chronic Illness and Disability
- Multiple sclerosis, spinal injuries, severe arthritis, and chronic pain conditions can directly impact sensation and sexual function.
- Mental health struggles often follow, creating a complex web of physical and psychological challenges.
Medications Often Linked to Sexual Dysfunction
1. Antidepressants (SSRIs and SNRIs)
- 30–70% of users report changes in libido, arousal, or orgasm (Clayton et al., 2015).
- Delayed orgasm and reduced desire are common but can often be managed.
2. Blood Pressure Medications
- Some beta-blockers, diuretics, and other heart drugs can affect arousal or erection.
- Not all medications in these classes carry the same risk—alternatives may be available.
3. Hormonal Contraceptives
- Pills, injections, and implants may dampen libido for some women.
- Others experience no change, or even improvement, so individual response varies.
4. Other Medications
- Antipsychotics, some epilepsy drugs, cancer treatments, and opioid painkillers all have sexual side effects.
- Polypharmacy (taking several medications at once) increases risk.
Practical Steps: What You Can Do
- Track Symptoms and Medications:
Maintain a journal noting medication changes, health status, and any shifts in sexual experience.
Share patterns with your GP or therapist—details help identify causes.
- Open Conversations with Healthcare Providers:
Your GP is there to help, not judge. Use scripts for difficult topics: “I’ve noticed some changes in my sexual wellbeing since starting this medication. Is this common? Are there alternatives, or ways to help?”
Ask about all possible side effects—sometimes, they’re not listed front and centre.
- Do Not Stop Medications Abruptly:
Stopping heart, mental health, or hormone treatments suddenly can be dangerous.
Always consult your doctor before making changes.
- Consider Medical Check-Ups:
Routine blood pressure, blood sugar, hormone panels, and thyroid checks may reveal treatable factors.
For men: check testosterone, especially with low energy/libido.
For women: discuss menopause, contraception changes, and gynaecological health.
- Explore Physical Aids and Solutions:
Vaginal lubricants and moisturisers for dryness or discomfort.
Vacuum erection devices or oral medications for ED (discuss with a doctor).
Adjust timing and dosage of meds (sometimes taking them at a different time of day minimises side effects).
Therapy’s Role: Psychosexual and Supportive
- Normalisation: Understanding that sexual responses often change due to health or medication can reduce shame and isolation.
- Self-Advocacy: Therapy can help you develop language and confidence to speak up about needs and questions with your healthcare team.
- Adapting Sexual Scripts: Focus on pleasure, not just performance—trying new activities, positions, or forms of intimacy.
- Couple Counselling: Partners can learn to communicate effectively about changes, frustrations, and hopes.
When to Seek Specialist Help
- If sexual difficulties persist after medical checks.
- When distress or relationship tension grows.
- If pain is present (for example, dyspareunia, pain with arousal, or persistent discomfort).
Referral routes:
- NHS sexual health clinics
- Specialist psychosexual therapists (COSRT, BACP, or UKCP accredited)
- Endocrinologists or women’s/men’s health clinics for hormone management
Real Stories
Linda, 53:
After menopause and starting blood pressure medication, Linda experienced vaginal dryness and reduced interest in sex. With her GP, she explored hormonal and non-hormonal options and, in therapy, learned about the value of different forms of intimacy. Her wellbeing improved, and so did her relationship satisfaction.
Paul, 45:
After a heart attack, Paul was embarrassed by ED and afraid to ask for help. Therapy encouraged him to speak to his GP—who quickly adjusted his meds and referred him to a sexual health specialist. The result: increased confidence and a return to satisfying intimacy.
Resources and Further Reading
- NHS Sexual Problems: Causes and Solutions
- Diabetes UK: Sex and Relationships
- Menopause Matters
- Overcoming Sexual Problems by Vicki Ford and Michael Balint
Conclusion
Sexual wellbeing is connected to every part of your health, including your medical needs. Sexual difficulties are not your fault, and countless solutions exist—from medication adjustments to therapeutic support. Speak up, reach out, and take charge—your body and happiness matter.
References
- NHS. (2023). Sexual problems in men and women.
- Mitchell KR, Mercer CH, Ploubidis GB, et al. (2013). Sexual function in Britain: findings from Natsal-3. The Lancet, 382(9907), 1817–1829.
- Yafi FA et al. (2016). Erectile dysfunction. BJU International, 118(2), 226–239.
- Clayton AH, et al. (2015). Sexual dysfunction associated with depressive symptoms and medications. Current Psychiatry Reports, 17(3), 34.
- NICE. (2021). Sexual dysfunction: Diagnosis and management.
