All serious disease impacts sexual function adversely, and this is especially true in the elderly. In contemporary culture, sexual function is considered to be the province of the young. This cultural attitude denies the geriatric patient the right to sexual self-expression. When illness or infirmity interferes, the spouse may not be able to cope with a partner’s disease and the change in sexual behavior caused by the condition. After surgery, there may be a direct relationship between the development of sexual problems and lack of discussion about sexuality prior to discharge from the hospital. Finally, fear of death during intercourse may lead a couple to sleep apart. A lack of communication about sexual concerns is common between physician and patient when both are concerned about the primary disease. In Western culture, both patient and physician are generally inhibited from speaking about sexual function.