How to deal with sexual problems

Many people with chronic pain and their partners have sexual problems. Sometimes problems begin because of the pain (for example, when the person doesn’t seem interested in sex, or because the partner is fearful of causing pain or being hurt). Sometimes pain makes existing problems worse.

If these issues are dealt with, sex can help maintain closeness and relax both of you. It can also reduce stress and relieve pain. Pain does not make you asexual. The drive is still there – it may be even stronger. Being in pain does not mean you do not have all the parts in working order! One way of dealing with problems is to avoid sex altogether. However this can be upsetting and can add to a couple’s problems, especially if they find it difficult to talk it over.

Avoiding sexual activity can also lead to avoidance of all physical closeness. For Jim and Ann, this was distressing for both of them, especially at a time when Ann needed to feel much closer to Jim. So not dealing with the problem can leave sex as an area of tension and anxiety. This tension and worry may increase pain. Feelings of failure, frustration and guilt can become reasons for avoiding sexual activity. People often worry about their partner’s sexual needs and whether not having sex is likely to cause problems in the relationship.

Many couples have full and contented lives without sexual intercourse. However, if you want to make changes, it will take understanding, time and commitment to deal with it, rather than avoid the problem. Firstly, both partners need to talk, perhaps several times. It is important to remember that it is a shared problem. Your partner needs to know your thoughts and feelings, so that you both understand exactly what is going on for each other.

For example, your partner may not understand that, even though it is difficult at the moment, you may want to make love in the future, in another few weeks.

Case history: Steve and Nicole

As Steve spent more time sleeping in the spare room, often six nights a week, Nicole thought he was no longer interested in their sex life. She already felt upset about a great many changes so trying to talk about the loss of making love seemed a real challenge. She did try to share her views and feelings when Steve was having a better day with less pain. He was a bit irritable about it as they talked it over. But he began to see what was concerning Nicole and they shared their feelings and thoughts slowly. Nicole discovered that Steve still found her very attractive and she realized the stress of making love was making Steve very anxious on top of more pain. Steve was keen to see if they could pace just being close together, touching and hugging more often and maybe sleep together more, two extra nights a week. Steve would also do some gentle stretches for his legs and back before cuddling Nicole in bed. Nicole was willing to try, and happier that they had started to share their feelings and thoughts.

Acknowledging both partners’ feelings is an important part of keeping the connection strong between you.