**12.2 Medical illness and sexuality**

Looking at sexuality from the biological perspective, neurological, vascular and endocrine systems contribute significantly for normal sexual functioning. Neurological disorders like stroke, epilepsy, multiple sclerosis, traumatic brain injury and spinal cord disorders lead to sexual problems. Endocrine disorders like androgen deficiency, hyperprolactinemia, diabetes mellitus can produce sexual dysfunctions. Vascular disorders like hypertension and atherosclerosis, prostatic illness, carcinomas all can lead to sexual dysfunctions. Prevalence of sexual dysfunctions among these psychosomatic disorders is around 20–70%. Sex and intimacy are likely to be powerful providers of salutogenesis in both the chronically and critically ill patients. Sexual encounters can serve as a refuge in an otherwise chaotic and turbulent situation, and intimate relations might constitute engines of meaningfulness and coherence in a context of meaninglessness and incoherence that so often dominate the everyday life of patients with chronic illnesses [38].
