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Normative changes occur in the sexual life of the individual. The onset of illness or chronic disease may have a significant impact on how and when a woman engages in sexual activity. Adolescence is a time of great physiological, emotional and psychological change. It is a time of exploration, emancipation, and a search for self-identity. For couples who want to continue sexual intimacy throughout pregnancy, the physician may recommend positional changes that are more comfortable for the woman and can accommodate the enlarging fetus. Pain, or the anticipation of experiencing pain, may have a negative effect on the woman's interest in sexual intimacy. Women in midlife, aged 40 to 65, can use guidance regarding the impact of chronic illness, hormonal changes, and medications on sexual functioning. Common sexual consequences of dementia include anhedonia, depression, impotence, incontinence, and anorgasmia.