Persistent Pain and Sex
Is a good sex life possible when living with Persistent Pain?
Many of our clients say it is, but it may require a bit of preparation, planning and a willingness to try something a bit different.
Why might sex be affected by persistent pain?
Exacerbation of pain during or after sex
Fear of pain - both partners
Fatigue
Out of the habit
Feeling less sexual/sexy
Loss of libido
Difficulty with positions/movement
So what can help?
Talk about it: if you are in a relationship, probably the most important thing you can do is talk with your partner. This can be quite difficult or embarrassing but it can also be very helpful.
Talking can help deal with some of our presumptions about what is going on in our partner’s head: we are generally not good at mind reading (although we think we are!). People often end up guessing what the other person is thinking.
For example: You might be worried that your partner wants sex when you don’t (but perhaps you do want sex sometimes). Alternatively, your partner might be worried that you don’t want sex at all or that you don’t find them attractive anymore.
You might be worried that having sex will be painful.
Your partner might also be worried that sex might be painful for you or might do you harm and therefore doesn’t want to try.
You might be worried that your partner doesn’t find you attractive anymore.
Your partner still finds you attractive but doesn’t know how to express it.
Talking honestly with each other can often significantly help you deal with these concerns together.
Design a graded activity programme: Take the pressure off and agree not to have full intercourse (if that is the goal). Practise being more intimate, hold hands, have a kiss and cuddle, move on to more intimate touch. Agree on exactly what each stage is and ensure each person is comfortable before moving on to the next stage.
Think about how you’re feeling about yourself: People with persistent pain often report that they just feel less sexy and attractive, perhaps because their body shape has changed, or they feel they have lost confidence overall. This is very common in the general population too. Talking about this with your partner can help, as often partners do still feel attracted to you but it has become more difficult to communicate this.
Although it might seem a bit simplistic, some people have found it helpful to deliberately get back into the habit of doing things they have previously in their lives; e.g. wearing make-up, buying clothes that they feel more attractive in, as well as clothes they feel sexy in.
Other people have said that as their confidence has improved more broadly in themselves (e.g. via other pain management strategies and changes in their lives), their confidence in themselves physically and sexually grows or returns too.
Trying different positions/ways of having sex: It may be that your pain makes it impossible for you to have sex in the ways that you used to or want to. There are, however, various sexual positions which might be more comfortable for you. Just trying out different positions can be helpful.
Planning/making time and space: Sometimes putting some planning into when you have sex can help. Planned sex does not have to be unromantic. For example:
Choosing a time when you are feeling at your best can help. Convention means that most people have sex just before bedtime. But for many people with long-term pain or fatigue, this can be the worst time. Perhaps planning to have sex in the middle of the day might be more advantageous.
Choosing where you have sex can help. The bed might be the worst place for some people. Elsewhere may be better.
Having a hot bath beforehand can help loosen up stiff joints.
Turn up the central heating.
Having a nice meal as spending some time together beforehand can help create a relaxed mood.
Generally being stressed or anxious doesn’t help. Using relaxation exercises or telling yourself you will worry about other things later can be useful. (Sex can obviously also be a very good distraction in itself).
Try to cut out interruptions. Perhaps turn off your phone, move the clock and lock the door.
Some people have said that planning and talking about sex beforehand can actually increase the sense of anticipation and enjoyment. You are also, by definition, making a priority for sex by doing this, rather than just waiting for the ‘right’ moment.
Getting fitter/more flexible: Being fitter can help. Small changes in how flexible or strong you are can make sex more comfortable.
Remember that it is about choice. If you are not having sex and you are happy with this do not feel this is something you should focus on. However, if sex or the lack of it does worry you, hopefully you will find suggestions in this article helpful