There are a number of medical conditions doctors habitually treat with drugs that tend to diminish sexual desire or otherwise affect sexual functioning. The necessity for any drug should always be discussed with one's doctor before treatment begins, for sometimes there are alternate choices. And sometimes a change in lifestyle may bring about the same benefit as the drug.
In any event, it is helpful to know if what appears to be a lack of desire or an inability to come to orgasm has been brought on by medicines or psychological, environmental or relationship factors that might be changed.
Perhaps the most common medical problem for which doctors prescribe drugs known to have sexual side effects is high blood pressure. In recent years, such a wide variety of drugs has been introduced to lower blood pressure that the odds are some may impede normal sexual activity. For those who notice any such change, it would be wise to discuss the problem with a physician who can undoubtedly suggest alternatives.

What are the options for a person needing life-protecting medications? Some doctors find that by switching antihypertensive medications, some of the sexually negative effects can be lessened. Sometimes it is feasible to lower the dosage or to lower salt intake. Exercise and weight reduction can contribute positively to lowering the need for antihypertensive drugs. One man I know tells me that he took off 14 pounds in a month simply by eating a bran muffin before each meal to cut down his appetite, plus he took a 15-minute walk each day.
No one who is using hypertensive drugs prescribed by his physician should stop using them without a prior consultation with that doctor. Life itself may depend on their use, so a person cannot afford to take that chance without careful professional collaboration.
Nevertheless, a study of nutritional therapy has shown that over one-third of people who previously needed drug treatment for high blood pressure had their blood pressure adequately controlled with nutritional therapy alone.

Drugs prescribed for arthritis can also have sexual side effects. For example, the corticosteroids may cause temporary impotence. Analgesics prescribed for pain may affect male sexual capacity, while aspirin, taken over a long period of time, may reduce fertility.
Among older persons, of course, this may not be a critical issue. However, a number of men over 50 still want to father children. More often than not, these older citizens make wonderful fathers and should not be denied the chance.
The most common form of arthritis is osteoarthritis, a degenerative joint disease many older people are prone to. The discomfort of osteoarthritis can often be controlled by weight loss and gentle exercise that maintains range of motion in the joints. Swimming and walking can be very helpful. If pain in hip joints becomes too acute, there is always the possibility of surgical relief by a total hip replacement. It is said that the happiest people in a hospital are mothers of new babies and older folks with new hips.

Glaucoma is a slowly progressing disorder of the eyes in which the pressure inside the eye gradually increases. It is a very familiar problem of the elderly, resulting eventually in blindness if left untreated. But some of the prescribed eye drops for keeping it under control contain beta-blockers that have side effects of lessening sexual desire. This does not mean that they should not be used, but it does mean that an elderly person using them might recognize that they do have some effect on sexual functioning.
If a person is experiencing impaired arousal or orgasm difficulty, he or she should question whether any of the following drugs are being prescribed: antihistamines, barbiturates, chlordiazopoxide, librium, chlorpromazine, cimetidine, clofibrite, or clonidine.
Positive sexual functioning is important to anyone's sense of the quality of life. So it behooves us to question our physicians seriously whenever a drug is prescribed.

About the author: Dr. Hamilton, a retired psychologist and sex therapist, is the author of five books and a recipient of the American Library Association award. Her television appearances include "The Phil Donahue Show," "The Merv Griffin Show," and "The Tonight Show."