anonymous on September 12, 2011

My wife’s fibromyalgia means we never have sex. What can we do to solve this problem?

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

answered by Mitchell Tepper, PhD, MPH on September 12, 2011

I’m glad you asked this question because it’s relevant to anyone who has to manage chronic pain in themselves or a loved one. I’m happy to offer you some ideas to hopefully help decrease our wife’s pain during sex...but I would also encourage her to see her doctor to make sure she’s managing her fibromyalgia in the healthiest way.

First, you’re not alone. It’s quite common for people with chronic pain to shy away from sexual activity.Sometimes the pain itself – or anxiety about making the pain worse – are understandably enough to want to avoid sex. In other situations, medications (like anti-depressants) can also take a toll on sex drive, or libido.

But there’s good news…partners who willingly and patiently experiment together have a good chance of discovering new ways to experience intimacy and sexual satisfaction.

For starters, if you haven’t had sex in a long time, it’s important to find ways to re-establish your feelings for each other, as well as a sense of trust and closeness between you.

One way to do this is to touch each other intimately without the goal of having sex or experiencing orgasm. For example, perhaps your wife would enjoy a whole body massage from you with warm massage oil. Incorporate gentle manual stimulation to her breasts, nipples, labia and clitoris. Focus on making her feel good, not bringing her to orgasm.

Or, perhaps taking a warm bath together would help ease some of her pain ⎼ for some people, moist heat from a bath, shower or hot tub can help ease the discomfort of fibromyalgia.The important thing is to create an atmosphere where your wife knows she won’t be pushed to do something that causes her pain.

When you’re both ready, work together to experiment with sexual positions. Many people with fibromyalgia have specific points on their bodies that cause the most pain. Get creative with new positions that take pressure off those points so your wife feels comfortable. Using pillows, chairs or other props may also help her get comfortable. Ideally, there won’t be too much pressure on any one point of her body...and if she becomes uncomfortable, switch positions.

You can also work together to decrease and/or manage stress. Day-to-day stress can aggravate fibromyalgia working together to decrease stress, or learning ways to manage stress better might also help ease your wife’s pain, and possibly make her more receptive to sexual activity.

Communication is critical, too…especially when chronic pain is involved. Make sure to give your wife the opportunity to tell you what’s comfortable and satisfying for her, and be responsive when she suggests that you change positions.

Thanks again for writing, and I wish you both the best of luck in rediscovering your sexuality in new ways.

Related info:

Mitchell Tepper, PhD, MPH

Dr. Tepper directs sexual health education at An AASECT-certified sexuality educator and counselor, his areas of expertise include sexual dysfunctions, sexuality following disability or illness, pleasure and orgasm, relationships, and military and veteran couples' counseling. Dr. Tepper was educated at the University of Pennsylvania and Yale University.

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