Chronic Pain and Sexuality By: Kathy Church, MSW
Sexual intimacy fulfills the need for human connection and affection and is an important part of a healthy relationship. Chronic pain can cause problems in the sexual lives of sufferers. Sometimes pain medications can interfere with sexual functioning. Sometimes the person in pain no longer feels attractive or desirable. Sometimes it just hurts too much for sexual intercourse. Sometimes one or both partners fear increased pain with sex. Whatever the reason or reasons, almost 80% of patients living with chronic pain and/or disability and their partners report a significant reduction or loss of their sexual functioning.
Many of these issues can be overcome with thoughtful planning and communication. The first step is to be open and honest with your partner. Having a frank conversation – while fully clothed – about your worries and concerns can help improve your sex life. Talk about your worries and ask your partner about his or her concerns. Don’t assume you know everything that’s happening in your partner’s head before you have an honest discussion. You may think your partner no longer finds you attractive, but your partner may be afraid of causing you more pain. You may be surprised to discover what your partner is thinking.
When talking with your partner, try to use “I” statements instead of “you” statements. For example, instead of saying, “You never touch me anymore,” say, “I miss your hugs and caresses.” Using “I” statements often prevents a defensive reaction from your partner and allows both partners to express their feelings in a supportive manner.
A common assumption about sex is that it must be spontaneous, but living with chronic pain often inhibits spontaneous sexual intercourse. Just as many couples experience arousal at different times of the day, couples coping with chronic pain often have to manage other barriers to spontaneity, such as separate beds or demanding medication and therapy schedules. To compensate for a lack of spontaneity, couples should plan ahead for a date. Know which times of the day you feel your best and plan your interludes around them. If you are prescribed pain medication, schedule the rendezvous for when your medication is at its peak.
If your favorite position for lovemaking is now too painful, don’t be shy about experimenting with new ones. Depending on your pain condition, “spooning” (or side-to-side sex) can be a less painful option. Try to remain upbeat and turn these challenges into adventures! And remember, sexuality is much more than the act of sexual intercourse. Other options include mutual masturbation/self-stimulation or oral sex. Even touching and caressing can enhance your relationship and lead to increased feelings of intimacy and affection.
Sex and chronic pain are not natural bedfellows. However the extra effort is worth it – sex can increase your quality of life and the quality of your relationship and can even decrease your feelings of pain. In fact, studies have shown that during orgasm the body releases endorphins that can act as natural pain suppressors, often lasting up to a few hours afterwards, leading to less pain during and after sex. In addition, all of us crave intimacy. Achieving sexual closeness with your partner can help you feel stronger and better able cope with your chronic pain.
If you continue to have sexual difficulties and would like to seek counseling, it is important to find a counselor who is qualified in the area of sexuality. One source you may find helpful is the Sexuality Information and Education Council of the United States.
Kassan, Stuart S., Charles J. Vierck, and Elizabeth Vierck. Chronic Pain for Dummies: A Reference for the Rest of Us. Hoboken: Wiley Publishing, Inc, 2008. Mayo Clinic Staff. “Sexuality and Chronic Pain .” The Mayo Clinic. December 15, 2006. http://www.mayoclinic.com/health/chronic-pain/PN00009 (accessed December 8, 2008). Silver, Julie K. Chronic Pain and the Family. Cambridge: Harvard University Press, 2004. Sipski, M.L., and C.J. Alexander. Sexual Function in People with Disability and Chronic Illness. Gaithersburg: Aspen Publishers, 1997.