Older patients have many assaults on their sexuality. Our culture often discourages sexual interest in older persons. Changes in sexual physiology and the effects of chronic illness and medications can further contribute to negative expectations and can impair sexual performance. The emotional and relational stresses of aging can lead to depression, thus further compounding sexual slowdown. Failure to appreciate psychological factors can result in inappropriate treatment by the physician and actually add to the patient's distress. This report considers the mind/body relationship in sexual performance and offers guidance to the physician in the diagnosis of physical and emotional factors affecting the older person's sexual life.