Sexuality in chronic illness.

Three parameters are involoved in sexual functioning-psychological, organic performance, and organic enjoyment spheres. In evaluating an individual with chronic illness who has sexual complaints one must obtain a normative data base with the general history of the present illness, pertinent past history, a complete sexual history, a psychosocial history with special concern of present factors leading one to pertinent physical findings, and laboratory data (see Table 2). Frequently, it is helpful to interview the sexual partner. Finally, the subjective and objective data must be assessed and a plan with psychiatric or organic treatment, or both, must be made. Often it only can be with prolonged follow-up that we can adequately delineate the exact etiology of the sexual disorder in an individual with chronic medical illness. Even if treatment is difficult, the physician's continued support and interest can mitigate problems in this important aspect of life.