sex, relationships, and chronic pain
question:
I was diagnosed with multiple sclerosis two years ago, right when I was starting to get deeper into learning about reclaiming my sexuality and pleasure. It affected physical intimacy with my ex-partner and led to us ending things. It’s also impacted my confidence and has been frustrating to deal with just in general. Not sure how familiar you are on the topic, but my doctors don’t address this at all (and I’ve brought up the sexual limitations I have!). I would love to know any tips around sex and chronic pain you have.
answer:
Hello love,
Thank you so much for this question. The struggles around chronic pain and sexual intimacy are real and so rarely discussed. Or when it is, too many people complain that their doctors minimized their experience or suggested that it wasn’t as important as their other medical concerns (as if they had to choose between discussing pain management or sexual education and pleasure!).
Living with chronic pain or illness does not mean your sex life becomes non-existent or less important. And experiencing painful penetration doesn’t have to last a lifetime for many people. So we’re going to dive into understanding the sexual barriers related to experiencing chronic pain and tips for increasing intimacy and pleasure.
how chronic pain affects sex and relationships
For many people, sex and intimacy are important parts of life and experiencing chronic pain can have a significant effect on sex lives. Nearly 70% of questionnaire respondents living with chronic pain reported that pain negatively affected their sexual activity. Here are a few ways that chronic pain can affect intimacy and relationships:
Increased irritability and other mood changes, such as depression
Frustration that body will not move or engage in a desired way
Low endurance or tolerance for physical activity
Fear of rejection by current or partner(s)
Decreased ability to enjoy sexual experiences
Increased anxiety that sex will cause or increase current pain/injury
Troubles with being vulnerable about pain and limitations
Embarrassment or shame about body function and needs
Decreased sexual desire and interest
Difficulty becoming aroused and/or reaching orgasm
Engaging in less physical touch in fear that partner(s) may want to have sex
It also doesn’t help that not all pain management and medical professionals acknowledge that people with chronic pain and illness have questions about their body, desire more sex education, or that their clients are struggling with sexual problems at all. But, your sexual health should be an ongoing topic in your treatment, especially if you identify as a sexual person and are experiencing sexual problems.
And sometimes pain management and other medications decrease sexual arousal and interest, vaginal wetness and erections, responsiveness to touch, cause fatigue and loss of coordination, and more.
Pain can be so consistent and overwhelming that you can’t think of anything but the pain and suffering. That being so, it’s common for conversations with your partner to turn into talking about your pain and discomfort. Some clients with chronic pain acknowledged that their partners would feel less important and unprioritized as a result.
But whether pain is related to a back injury, multiple sclerosis, fibromyalgia, arthritis, irritable bowel, vaginismus, vulvodynia, cancer treatment, or anything else, know that you are seen and deserve to be treated wholly.
Sexual pleasure has also been shown to minimize pain due to the secretion of endorphins, which help relieve pain and reduce stress. Endorphins are hormones that are released during activities you find pleasurable and research has found that orgasms can block or decrease pain. And, we also know that a healthy sex life has health benefits, such as increasing self-esteem, decreasing stress, improving sleep, promoting immune health, and more.
tips for more pleasurable sex
In spite of your chronic pain, satisfying sex and relationships are possible. There are ways to have sex that decrease pain and pressure, prioritize sensual intimacy and closeness, and do not include penetration. In some ways, chronic pain just might be the reason you have better sex in the future!
Acknowledge your emotions
Chronic pain and illness comes with many physical and emotional changes that can impact your sex life. For example, if you are feeling less sexually attractive, having negative thoughts about your pain getting better, frustrated with your medical care and treatment, it would make sense that you feel less sexual arousal and desire. So working to address the emotions you are experiencing will be helpful as you learn new ways of being in relationship to your body and managing your pain.
This may include practices such as radical acceptance, mindfulness, and body neutrality. Those three practices can help you be present in the moment, accept your body for how it shows up in that moment, and discover the pleasure present as well. These are awesome tools to practice on a daily basis as well as during sexual activity.
Get curious about your body’s pleasure
As you create new narratives about your body and sexual health, you’ll have more capacity for becoming curious about your body and sexual pleasure. If after the onset of your chronic pain and illness you can’t imagine or figure out how to be sexual in the same way as before your pain, ask yourself, “Who says that I have to be sexual in the same ways?”
It’s time to not only get curious but to get creative as well.
Listening to your body when it comes to your pain and pleasure will open you up to exploring new positions, touch, and toys that promote your sexual pleasure and satisfaction. Exploring through masturbation, adding pillows and wedges to relieve pain and pressure, or using the Ohnut to ease the discomfort of penetrative sex can all be the result of prioritizing sexual curiosity.
Pleasure mapping is another fun and insightful activity to try. It consists of exploring your relationship to sexual pleasure without intercourse and orgasm being the end goal. Make a note of everything that brings you pleasure from touch and scents to textures and taste. Doing this alone and with your partner can improve your understanding of your individual and partnered pleasure. It’s also an excellent time to be vocal about what feels good and what doesn’t.
Schedule intimate time
When living with chronic pain, planning your activities around medication, pain spikes, ebbs and flows of fatigue, or appointments becomes almost necessary. Though scheduling sex gets a bad rap, it can be extremely satisfying and scheduling quality time with your partner(s) feels affirming for all involved. But if it’s less of a boner (pun intended) to call it scheduling a date as opposed to marking sex on the calendar, then do that!
It’s also worthwhile to schedule date night and intimacy if your pain is predictable. This allows you to take pain medication ahead of time, limit activities before your date that may increase exhaustion, get enough sleep, and engage in other forms of self and health care.
Physical intimacy and masturbation
Usually people think of sex when the word intimacy is used but it isn’t a synonym. As you explore new ways to sexually connect, remember to also engage in other forms of physical intimacy. This may be cuddling, kisses, hugs, and massages. Prioritizing physical touch outside of sex and intercourse is a great way to maintain intimacy and connection.
You may also be interested in exploring mutual masturbation, which typically involves one person masturbating in front of their partner. This can be a great practice to add to your sexual repertoire for times when you aren’t able to sustain or tolerate positions involving someone else’s body. During solo sex, you can position your body in the ways that are most pleasurable and the least pain provoking for you, plus you get the regular benefits of masturbation! You can both masturbate together and you can spice it up a bit by putting on a masturbation show for one another.
Communicate with your partner(s)
Having pleasurable sexual experiences requires open and ongoing conversations. This can range from talking about limitations to fantasies, but communicating about them will make for a better relationship. Many partners without chronic pain or illness feel in the dark and would appreciate knowing their partner’s needs and that their partner is still sexually interested in them (even if they aren’t physically or emotionally up for it at the moment). Additionally, plan to get in the habit of talking during sex. No, not just for the hot and steamy dirty talk. But to let your partner know how you are feeling and if any adjustments of your body position are needed.
Consult with a professional
You may want to reach out to a professional for a variety of reasons. If your medications are causing sexual problems, need a pain medication adjustment, are feeling more depressed, relationship conflict is increasing, or are looking for more sexual education, there are professionals who can support you. You are deserving of holistic and affirming medical and sexual health care so be sure to ask current or potential providers how they feel talking about sexual concerns and if they have experience around your concerns. Ask for recommendations if they don’t feel competent in the area and solicit recommendations from your community.
We hope this has been insightful and informative. It’s important for you to know that you deserve pleasure – in your relationships, during sex, and even in your medical treatment. There are people to talk to and things to do to help as you navigate chronic pain and health.
With pleasure, peace, and power,
Dalychia & Rafaella