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Question:
Sex has become close to non-existent due to my wife's chronic pain associated with fibromyalgia. What suggestions do you have for us?

Answer:
by Mitchell Tepper:
(05/16/2004)
Many people with chronic pain complain of decreased interest in sexual interactions, since pain takes a toll on sexual desire and can even make one feel asexual. And if pain is aggravated by sexual activity, itıs easy to come to fear and avoid it. Worse, having sex despite pain out of guilt or a sense of duty to a partner can have a deleterious effect on a relationship. Maintaining a good sex life in the face of chronic pain requires flexibility and ingenuity. Dr. Naomi McCormick, author of When Pleasure Causes Pain: Living with Interstitial Cystitis, makes the following suggestions that have application for anyone experiencing pain: Schedule sexual activities when your symptoms are least problematic; take pain-controlling or antispasmodic medications prior to sexual activity; experiment with sexual positions and activities that minimize painful intercourse; have your partner stimulate your genitals orally; tell your partner exactly what feels good and what is painful; and spend time engaged in other sexual, erotic and intimate activities that do not involve intercourse or orgasm. Hot tubs, saunas, steam rooms and even tanning beds can ease stiff, sore muscles and loosen up joints. Try one of these options prior to engaging in sexual activities. If floating in warm water relieves your wife's pain, you can rent a hot tub and experiment in the privacy of your home. If overheating is a concern--it often is for people with multiple sclerosis or are subject to autonomic dysreflexia--consult with your physician first. Alternatively, try relaxing your wife with a whole body massage using warm oil. Incorporate gentle manual stimulation to her breasts, nipples, labia and clitoris. Focus on making her feel good, not bringing her to orgasm. Let your wife be your guide. At another time, your wife can focus on pleasuring you in a way that doesn't aggravate her pain. With regard to intercourse, take time to find positions that are comfortable for both of you and do not put too much pressure on any one part of her body. If she becomes uncomfortable, switch positions. And talk. Communication is critical when pain is involved, especially for women who have been taught to be sexually passive. McCormick urges women to tell their partners when they want sex, when they don't want it, and how they want it. Reducing painful sexual activities and increasing pleasurable ones should help to revitalize your sexual life. --Mitch Tepper

Reviewed by Sexual Health Editorial Team

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