There can be many reasons for these problems. It can be a disease such as diabetes, substance abuse, medications, or even a psychological problem that causes sexual dysfunction. I have had and experience with a man who suffered from erectile dysfunction. (Impotence) Not only was diabetes its cause, but the fear of not being able to perform also contributed to the problem. Women also experience sexual dysfunction. Menopause can contribute to sexual dysfunction in women. Many women are forced to resort to lubricants because their bodies do not produce adequate lubrication for intercourse. The book states that people with spinal cord injuries can have a sex life. I was actually surprised by this. I couldn't imagine wanting to be sexually active if I were in a wheelchair. I think I would feel useless if that were the case and would have little desire to do anything. However, I've never been faced with a situation like this, so I'm not sure how I would do it