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Nov 12
A graphic of a man showering with a thought bubble that say SEX, behind him are two carers

Disability, Sexual Expression and the Privilege of Privacy

By Disability, Undressing Disability

Let’s take a look at the realities many disabled people face around sexual expression and intimate relationships.

This article is written by Zoe Lloyd, a counsellor and disabled woman who has live-in PA’s. It is intended to provide insight for:

  • care home workers
  • carers and personal assistants
  • occupational therapists and physiotherapists
  • those working and supporting disabled people to enjoy every aspect of a fulfilling adult life.

Question

To give an insight, let’s start with a few questions to help set the scene.

  •  What do you do to prepare for a date or a naughty weekend away?
  •  Do you need help with intimate personal grooming such as hair removal or applying body lotion to make you feel and look your best?
  • Who do you tell when you’re planning to have sex?
  • Who helps you to open the packaging on your new sexy lingerie or sex toy?

Privacy

We’re guessing many of you get ready for a hot date in private and don’t have to tell anyone else what you’re up to. Some of us will not have that freedom of privacy and will rely on a carer/PA to help us get ready for some intimate fun.
This could be requiring help to shave ‘down there’ or packing sexy underwear and sex toys into a case…. someone knows what your plans are!
Many disabled people live their lives in this way, without the privilege of privacy.

a graphic of a male showering with two carers in the background and thought bubble that reads SEX coming from his head

Embarrassment and Anxiety

All of these scenarios where someone is left feeling quite exposed by their lack of privacy, can lead to a constant underlying hum of embarrassment and anxiety.

No matter how much you may laugh it off or pretend you’re confident, having no privacy affects you.

Other people don’t need to have someone involved in these processes unless they choose to share. That’s the key – our lack of choice. If we need to pack a case for a sexy weekend, and can’t physically do it ourselves, then someone else will always know what you’re taking and what you’re planning. Therefore, we either deal with that, or we would have to deny the sexual part of ourselves forever. All just to save some embarrassment. Disabled sexuality should not be a taboo topic, whether that be in residential care homes, in PA/client relationships, or wider society.

Disclosure to a PA/Carer

Another point to consider is which carer/PA would you feel comfortable involving in this intimate side of your life? Disabled people can have several carers all of whom come with their own personal set of beliefs and embarrassment levels which can cause more barriers.

Imagine planning your sex life around the days a specific carer –the most approachable one– is working? This is a perfect example of the lack of spontaneity many disabled people face. It’s great when you’ve created a relationship with your carer where you feel happy to disclose these details. However many people don’t get that luxury.

Plus there’s having the confidence in yourself to ‘own’ your sexuality and not be concerned about someone else knowing your private life. Finding this secure place within yourself can be a lengthy process. Yes, you’ll see Instagram influencers who appear very comfortable with their sexuality, naturally that’s why they’re in the public eye! They provide a voice for those without the confidence. Unfortunately many people feel trapped,  still too ashamed to share their sexual desires with their carer. Resulting in their carer not knowing how to help facilitate access to their wishes.

Starting the Conversation

How can carers and care giving professionals improve this situation?

  1. Tell your client know you are open to having this kind of conversation. Take the awkwardness away before it gets to that point. For example you could say, ‘I’m here to support you in whatever way I can. I’m happy to talk or help you with anything – even if it’s sex stuff! I know it can be embarrassing, so I’m letting you know you don’t have to feel embarrassed with me’.
  2. If it feels appropriate, share a story of your own, so they don’t feel there’s such an imbalance of having privacy exposed.
  3. Depending on your work environment, have literature or symbols (say Pride colours for example) visible. This way the client knows that the PA/Carer or organisation is a safe setting of acceptance. These items can be used as a prompt for a conversation starter.
  4. Judging each situation differently. You may be able to suggest, in a light-hearted manner, ‘oh are you going to take some sexy underwear?’, or ‘bet you’re going to get all spruced up – want me to help?’ This breaks the barrier for them and the client can then say yes or no more easily.

 

Sexual Expression Training

Enhance The UK runs two fantastic training courses on sexual expression, the first of their kind in the UK. The courses are designed to support residential care home workers and those working in the field to better understand disability sexuality and an individual’s right to sexual expression. Learn more via the links below or get in touch to enquire about available dates.

Disability and Sexual Expression Training

Sexuality, Sexual Expression and Relationships Training for Care Providers

 

 

Sep 29
The words 'Breaking News' written in a tv news format against a yellow background

News: Enhance The UK launch Ground Breaking Disability And Sexual Expression Training

By Disability, Undressing Disability

In what is believed to be a first for the UK, disability awareness charity Enhance The UK has developed a new training programme on the topic of Disability and Sexual Expression.

Aimed at professionals working in caregiving roles such as occupational therapists, care home staff and physiotherapists the course tackles the subject of disability and sexual expression.

Jennie Williams, CEO of Enhance The UK (ETUK) said “Our training programme is for occupational therapists, physios, sex educators, teachers and anyone who works with disabled people. It is designed to build confidence and develop communication skills so that the current barriers around sex and disability can be removed and open conversations about sexual expression can take place with a person in their care.”

Jennie wears a patterned swirly dress, has long blonde hair and dark framed glasses with pink lipstick
ETUK highlight that the training is necessary because sex and disability is still a taboo subject, and even in a medical environment there are barriers due to a professional’s personal level of embarrassment or awkwardness around the topic.

The following scenario puts this in context. A man in his 30s has been in a traffic accident and has acquired a spinal cord injury. His life has changed dramatically and whilst he’s receiving support for his physical and mental health, he’s unsure who to ask about his sex life. A lack of intimacy is causing issues in his marriage and impacting his self esteem.

CEO Jennie Williams explains “Everyone has a right to sexual expression and it’s wrong to assume that disabled people aren’t sexual beings with the same need for intimacy, exploration and expression. Yet in a professional capacity it can be a tricky subject to approach when your employer has no policy in place, or you feel uncomfortable or embarrassed chatting about sexual wellbeing with a patient. Our training course will build confidence and develop communication skills thus enabling open conversations which support the needs of both patients and caregivers. ”

Jennie adds “We have delivered this unique training course to an NHS Trust and to care home staff and the feedback is extremely positive. It’s obvious there is a need for this course for professionals. Our goal as a charity is to change the way society views disability and to raise standards in sexual health and sexual awareness for disabled people. We are delighted to be able to support both professionals and the disabled community with our work.”

Learn more about our Disability and Sexual Expression training by contacting us directly. You can also watch this video and learn the details of the 3.5hours course.

 

Sep 10
A group of young people, at the front are a young couple holding hands one of whom is a wheelchair user

Disability Inclusive Sex Education

By Sex & disability, Undressing Disability

Tips for teachers to create disability inclusive sex education.

When delivering sex education, it is important that everyone can access the session equally and feel that the content speaks to them personally. All sessions should be inclusive, regardless of whether it is known that there is a disabled person or child partaking in the lesson. Here are a few factors to consider to ensure lessons are as inclusive as possible.

Representation

It is crucial that each student feels represented by the content. Often, resources show diversity in terms of race, age, weight, and gender but disabled children can often feel left out. They do not see anyone that is like them included in the sex education material. This feeds into the stigma around sex and disability. With a subtle change of focus in education, showing a disabled person in the images for example, the recognition that disabled people want and indeed do have sex and intimate relationships can become the standard view in our society.

This representation can be valuable for both sides:

• the disabled person to no longer feel that sex and relationship probably aren’t for them, as it’s not talked about with their situation being characterised.
• Other pupils seeing inclusive sex education can help stop perpetuating the notion that they couldn’t or shouldn’t have a relationship with a disabled person.

Accessible Resources

Not everyone will be able to access the lesson material in the same way. When planning your sessions ensure you have differentiated resources. There are some examples of adjustments you can implement:
• Ensure all videos are subtitled. This is useful practice at any time and for anyone, not just if you know of a deaf/hard of hearing pupil.
• Interactive games/exercises – think about whether these are accessible. Sometimes a small adjustment like a large dice or putting people in groups so they can work together and support each other can make a big difference.
• Providing large print worksheets
These should all be offered as standard, in any lesson.

Be Pupil-Led

You will have worked hard on your lesson plan, but you’ll be writing from your frame of reference. It is useful to be open to suggestions or concerns from pupils. Allow space for them to offer their thoughts and raise points that are meaningful for them. Then listen and respond to those points. It may not fit the direction of your lesson plan, but it could be what is needed by them and where the real learning could happen.

Range of Learning Styles

Ensure each session is delivered in a range of learning styles, so that each pupil gets a chance to learn in the way that works best for them.
Think about Visual, aural, verbal (reading/writing) and kinesthetic ways of learning and share the material in:
• Videos/Images
• Group Discussion
• Activities
If an activity is tricky for someone to do, then ask if there’s a way they think they may like to try it, or check if they’re ok watching someone else do it. For example, someone with poor dexterity may struggle with putting a condom on the demonstrator. They can still learn the right way by watching a peer do it. Also, this could develop into a discussion point for how people would overcome feeling awkward doing this for the first time with a partner if someone struggled.
There is always learning to be had from every situation if the session allows the freedom for discussion.
If every lesson is delivered catering for the different learning styles, then you are already halfway there to being fully inclusive!

Learn More

Keen to make your sex and relationships education lessons inclusive? Then check out our Disability and Sexual Expression training

Contact us directly or you can also follow our Undressing Disability campaign on Instagram and twitter.  #UndressingDisability

 

Sep 08
blurry gold sparkles

Sex and Bodily Fluids

By Sex & disability, The Love Lounge

The Question

Dear Love Lounge,

I’ve got a question about sex and bodily fluids. I’m in a new relationship with a wonderful woman who uses a catheter and a stoma bag. She has a spinal injury. We haven’t yet had sex but have had very small discussions about it.  She says everything will be ok, and she’ll handle it.  But it’s something I’ve never come across before and would like to know more about it before we do the deed. I feel quite nervous about sex and bodily fluids.

Can you help as I don’t want to ask my girlfriend the little details as she doesn’t seem that keen to talk in depth about it – she says it makes her feel unsexy.

Thanks,

Luke

 

The Answer

Hi Luke,

I can totally understand your trepidation around the area.  As it’s a new relationship your girlfriend may not want to risk losing the ‘spark’ by bombarding you with medical details.  Hopefully once you decide to become more intimate, and she sees you’re not put off by it, the pathways of detailed communication will open up.

And it will probably need to, so that you’re aware of what it’s like for her and to be aware of what might happen.  Sex and bodily fluids, when using a catheter and stoma bag can be a concern if you’re new to it.  I have asked for some advice from our friends at the Spinal Injuries Association to let you know what to expect.

 

Catheters

Your girlfriend will have either a suprapubic catheter (a catheter inserted through the abdomen into the bladder) or a urethral catheter. With a suprapubic, it can be taped to the abdomen to prevent it getting in the way.  It can be drained beforehand and then a spigot or catheter valve can be attached to reduce the amount of tubing. This means you can do away with the drainage bag, so it’s more discreet whilst you’re being intimate.

With a urethral catheter, it can be carefully taped away from the genitals, on the leg or abdomen, allowing some slack to avoid causing trauma.  You’ll need to be mindful of your movement in having sex with a urethral catheter; but it should all be ok if taped securely.  It could be dislodged if accidentally pulled, so be careful!  As the urethra is so close to the vagina, both of you may be aware of the catheter rubbing against your skin.  Again, this shouldn’t be a problem but just something to be aware of.

 

Stomas

With a stoma, the bag collects the waste and this can happen at any time during the day or night.  Your partner may want to empty her bowel before you get down to business.  This can be done with suppositories or an irrigation system (water is flushed through the bowel via the rectum, and it flushes out the stool, to clear the lower part of the bowel).  Then, a cap is placed over the stoma so that the bag is not needed while you have sex.   For peace of mind about any leakages with sex and bodily fluids, it may be wise to use a mattress protector anyway.

Hopefully this information will ease your worries, now you know what to expect.  Perhaps opening the dialogue with your partner, with your new-found understanding, will allay her fears of the situation not seeming sexy.  Showing her you’re at ease with it and want to make her feel as comfortable as possible too, should lead to you both having an enjoyable, happy sex life.

Have fun!

Zoe x

Contact Us

Everyone who writes into our Love Lounge receives an email with a private answer to their question. We then anonymise the Q&A and share them here on our website to help others who may be struggling with the same concern.  Get in touch if you’d like some advice.

Keep up to date with all our Love Lounge articles by following us on Instagram @UndressingDisability or on twitter @ETUKUndressing.

#UndressingDisability

 

Next question
Sep 03
A woman holds and red and white megaphone and shouts into it. She has pinned up blonde hair and wears a checked short sleeved blouse

Calling All Occupational Therapists – It’s Time To Talk About Sexual Expression!

By Sex & disability, Undressing Disability

This blog has been written by Katherine Sellors for her fellow Occupational Therapists. The aim is to help break down communication barriers and enable conversations about sex and sexual expression with patients in your care.

Sexual Expression

Occupation is what is meaningful, and it can be argued that nothing is quite as individually meaningful as sexual expression.

Sexual expression is the individual expression of sexual self and interpersonal interactions (emotional and/or physical). It’s a very objective concept but that’s what makes it so great.

It includes:

  • what makes you feel attractive and good about yourself
  • your sexual behaviours and desires
  • incorporates sexual orientation, gender identity and gender expression

Unique to each person it can be such a core part of our identity that it is a protected right under the Human Rights Act. Despite working in a variety of sectors as a profession, OT’s should always be working holistically, meaning we may need to discuss sexual expression no matter where we are working.

a dark haired woman in a red dress holds up a sign that reads Occupational Therapists

Appropriate Practice

Your employer may have policies and procedures in place telling you exactly how to manage these situations when they arise which is great! Unfortunately, if you don’t have these in place, it can muddy the waters on what would be considered appropriate practice. The second place we would look would be our professional standards but unfortunately guidance here is also limited. Fortunately, there is other guidance out there we can use.
One of my favourites is the PLISSIT model or the more recently expanded, or Ex-PLISSIT, model.

PLISSIT / Ex-PLISSIT Model

The premise of this model is that is an acronym of various stages of treatment. First we must give our patients Permission to talk about sexual expression, then we must provide Limited Information meaning we only give them an overview of information that often helps support sexual expression, following this are Specific Suggestions, information for their circumstances and finally Intensive Therapy which is referral to specialist services. Some patients may not need to go through the full cycle and may find their difficulties are resolved after the initial steps, others may need to complete the cycle multiple times for a variety of different needs.

The difference between PLISSIT and Ex-PLISSIT is the concept of permission being expanded through all the stages. So, remember Permission, Limited information, specific suggestions, and intensive therapy.

Recognition Model

A different model is the Recognition Model, the premise of this being we need to recognise our patients as sexual beings and once we have done this, we will be able to feed that recognition into our treatment.

In principle this would be like recognising any occupations our patients may wish to pursue from washing and dressing to writing a novel. We would help them engage in sexual expression using the same clinical reasoning we would to support any engagement. It has been suggested, to do this, we can add the concept of supporting sexual expression to our explanation of OT and what we can help support and then allow the patient to lead from there.

There are other models and guidance for discussing sexual expression in academic journals relating to specific areas of practice such as learning disability, nursing homes and rehab that may be of individual benefit.

This does beg the question “what if I don’t feel comfortable”. It is important we recognise our own comfort levels and areas of knowledge to ensure we give the best care to our patients.

If you truly feel you are not the best person to address this with someone that is ok as the information doesn’t have to come from you. It is important we don’t make our patients feel uncomfortable for raising their issues, so take down whatever information you feel comfortable with and signpost to a more appropriate information source or professional.

It is important to note that this article is not advocating working outside of comfort zones or appropriate practice but to highlight an area of practice that we can be involved in. If you are unsure or want clarification before acting then speak with HCPC, RCOT or your workplace for their clarification.You can also enquire about Enhance the UK’s Sexual Expression Training.

Useful Links

Enhance The UK –
The expert team are experienced trainers, enquire about their Disability and Sexual Expression training.
https://enhancetheuk.org/disability-and-sexual-expression-training/

The Health and Care Professionals Council
https://www.hcpc-uk.org/

Royal College of Occupational Therapists
https://www.rcot.co.uk/

The Undressing Disability Hub

Sign up for free to access free resources and network with others working or interested in the field of sex and disability.
https://undressing.enhancetheuk.org/signup

Aug 12
graphic of a male and female in different sex positions using a liberator wedge

Adaptive Tools for Sex Toys

By The Love Lounge

The Question:

Dear Love Lounge,

I heard about you from some of the sex educators on Instagram. I want to know if there are any adaptive tools for sex toys and accessories that can make lube more accessible.

Cheers,

T.

 

Our Answer

Hi T,

You’re in luck! Yes, there are some great adaptive tools for sex toys and accessories that can make lube more accessible.

Liberator Bonbon

One option is to use a sex toy mount like the Liberator Bonbon, pictured below.

adaptive sex toys - a red wedge shaped piece of furniture with a vibrator on the curved side

The Bonbon is a piece of Bedroom furniture that can help someone who has poor dexterity. The toy is placed in the mount and the user can then mount the toy.  Liberator also make other sex toy mounts including the Axis and the Wanda, 2 different styles of Magic wand mounts which give options of how they are used.

On A Mission

Penis owners are not left out when it comes to adaptive tools for sex toys.  Liberator also make Fleshlight mounts such as the ‘On a Mission’ which give the user the chance of a hands free experience. There’s also the Keon by Kiroo which is an automated Masturbator.

Sportsheets Thigh Strap

Another way of using sex toys is to use mounts and harnesses. The Sportsheets Thigh Strap can be used to attach a dildo to the thigh of a seated person. It’s a popular choice for wheelchair users.

Some people prefer sex toys with a suction base so they can stick the item to a smooth surface. This enables them to mount it, giving a hands free experience.

LaPalma

Another adaptive tool for sexy toys that can be used to help someone hold a vibrator is the LaPalma mount from Spareparts. (Pictured below)

LaPalma - looks like a black fingerless glove which has space for a vibrator

The user can attach a dildo to the O mount on the palm. The Lapalma also has 2 pouches that you can insert a Vibrating bullet into to make the dildo vibrate.  It is a useful product for those who suffer with arthritis and other dexterity issues.

Lube

There are a couple of ways to make using lube more accessible.

  1. Choose a brand that uses pump bottles such überlube. This is because some lube bottles are made of thick plastic and are hard to squeeze.
  2. Use an automatic lube dispenser such as the Pulse which also warms the lube. The pulse is not cheap but a lower cost alternative is to use an automatic soap dispenser. Be aware that some dispensers may struggle if you use a really thick lube.

Liberator Fascinator

red throw / fabric sheet

Cleaning up after sex can be an issue for some people. One way to make this a bit easier can be to use a throw such as the Liberator Fascinator which comes in a range of sizes.  They are fluid proof and can be thrown in the washing machine afterwards.

If you want something a bit more permanent on the bed you can get fluid proof sheets made from PVC or Polyurethane which protect your bed and are easy to clean up.

 

Learn More

Follow our Undressing Disability campaign on twitter and Instagram to keep in the loop on all the topics and questions we cover from our Love Lounge. If you have a question you’d like answered then get in touch. We answer each questions privately via email, and then make it anonymous and share it on our website to help others who may be too shy to ask.

#UndressingDisability

 

Next question
Jul 14
the hashtag Disability Pride Month written in white on a pink background

Disability Pride Month 2021

By Sex & disability, Undressing Disability

A guest blog post by Damian, from the Undressing Disability Team. Damian shares his personal experience of learning to accept and love himself as a disabled person and why he now celebrates Disability Pride Month.

Damian wears a pink tshirt and leans against a brick wall. He is white with short brown hair and dark rimmed glasses and a light beard

When I was diagnosed with Ehlers Danlos Syndrome (EDS) at 14 years old, I found it hard to come to terms with. I wondered what it would mean for my life. It took me a very long time to “own” my disability and not be afraid or ashamed to show it.

I think it was hard when I was first diagnosed as I had to give up a lot of the things that I enjoyed doing, like running and playing football. There was nothing in the way of support or guidance back then.  Looking back now, I think I was affected more than I realise by the fact that I did not get to finish my last year at school. The school decided it wasn’t safe for me to be on the premises after I slipped down a couple of stairs on my crutches. They had no interest in making things more accessible for me so I had to leave and was only allowed to sit a few of my exams. To be honest it was hard getting people to accept that I had a disability. Back then, hardly anyone had heard of Ehlers Danlos Syndrome so the fact I had to leave school and was seeing my friends less made it really hard. I missed out on a lot of the experiences teenagers usually get to enjoy.

“I tried to hide my disability”

Some people thought I was making my condition up as there was nothing to see. That’s possibly one of the main reasons I began to hide my disability as much as I could. I would only tell a small amount of people and that was usually if I absolutely needed to.

I wear support braces on most of my joints and always used to wear clothes that covered them up. If people could see my wrist brace, for example, I would just say that I’d sprained my wrist instead of explaining about my condition.  I would only ever wear shorts on holiday as I did not like people seeing my knee braces. But I was still worried about what strangers would think about seeing me like that.

It took nearly 20 years for me to be more confident about myself and my disability.

Now I am very much of the thinking that if I have to wear braces and supports, I want people to see them.  I quite often wear ones that stand out so it’s not unusual to see me wearing pink wrist supports. It makes me more confident about my disability and I guess it helps others to be more aware of me. Hopefully they can give me more space and not bump into me.

My brightly coloured accessories become quite a conversation starter at times and I am now happy to talk about my disability. It is something I will not hide ever again. It plays a big part in who I am. I wanted to write about this for Disability Pride Month as I know that whilst some people are posting on social media about all the things they are proud of, others will be lacking the confidence to do that. I hope in sharing this it helps in some way. To see what others are sharing search the hashtags #DisabilityPrideMonth or #DisabilityPride. 

I now speak passionately about being disabled and I’m very proud of who I am.  Part of my role here at Enhance The UK is to answer questions for the Love Lounge and by helping to run the Undressing Disability campaign. Joining the team at Enhance the UK has given me both confidence and a platform to talk about my disability and experiences in the hope of helping others realise they do not have to hide their disabilities.

Throughout the month of July we’re sharing posts on our Instagram Stories that relate to #DisabilityPrideMonth with the aim of bringing together the disabled community so we can celebrate, and learn from each other’s experiences. Follow us @UndressingDisability.

 

Stay Connected

Keep up to date with all our latest news, insights and resources by joining us on twitter @ETUKUndressing and Instagram @UndressingDisability.

The Love Lounge is a free service offering advice on questions relating to disability, sex, dating and relationships. Get in touch.

Jun 16
condoms against a blue background

I hate condoms

By The Love Lounge

The Question

Dear Love Lounge,

I’m 23 and in a new relationship. I had cancer aged 12 and lost my right leg from the knee down. I’m comfortable in my own skin and after a few pints I’m confident enough to chat up girls and get laid. I’ve been dating someone I really like but she insists on using condoms, and I really hate condoms. I still have check-ups, but the specialist is God fearing and ages with my Grandad, so asking questions about sex feels weird. I reckon with all the chemo I had my tadpoles will not be champion swimmers. How can I find that out so we can ditch the condoms?

Cheers,

Joe.

Our Answer

Hi, thanks so much for writing in!

Honestly? You’re probably not going to like my response but, until your relationship is more established, I think your partner has a very good point. Condoms don’t just prevent pregnancy, they prevent STI’s too. As well as having sex, a new relationship is about gaining trust. And regardless of how many check-ups you have, your girlfriend probably just wants to keep herself safe – and good for her!

What do you hate condoms? If it’s the fit or feel, there are loads of different sizes and textures on the market. Try and be playful about it, seeing which ones feel the best for both of you. Find out where you can get free condoms via this NHS link. 

three condoms in blue, red and silver wrappers

Then, we’d suggest attending your next check up with your girlfriend. Ask to see a different specialist if possible to talk about the impact chemotherapy may or may not have had on your fertility. Or just drop in at your local sexual health clinic, where you can both chat about your worries, concerns, and explore all types of contraception. Only condoms protect against STIs though, so that part really is a trust thing! Build on that, and the rest might just follow. If you sign up to our Undressing Disability Hub for free, you can access our free resource on all types of contraception.

Love Lounge Team x

Learn More & Join Our Hub

We get lots of questions to our Love Lounge. We answer each individual one privately, then make them anonymous and publish here to help more people. Use the search box on our website to look for a specific topic e.g. disclosing disability, or accessible sex positions. If we can help you, then email us. 

Join us on twitter @ETUKUndressing or Instagram @UndressingDisability. You can also join our Undressing Disability Hub for free.

 

Next question
Jun 02
A brown haired woman presses her hands over her eyes exhausted with her glasses resting on her head. Her shoulders are visible and she wears a multicoloured top

Sex, Chronic Pain and Fatigue

By Disability, The Love Lounge

The Question

Dear Love Lounge,

I want to ask about sex, chronic pain and fatigue. I really want sex with my partner, but I might need antibiotics and a few days in bed to recover. I get so frustrated that I have to wonder if the price of doing it is worth it? I feel like I should always be able to offer sex, but I know that it will cause me pain for days. I worry about how this impacts my relationship with the man I love. I’m writing in to ask for any tips you may have!

Thanks,
Belle

 

Our Answer

Hi Belle,

Thanks for writing to us, we get a lot of questions about sex, chronic pain and fatigue.

You’ll have discovered that advice is often targeted towards erectile dysfunction, inability to reach orgasm, or fertility problems which won’t answer your question. On our Undressing Disability Hub, we have a more detailed resource on sex, chronic pain and fatigue (it’s free) for anyone who might want more insight. Here I’m going to focus on what you’ve asked for… some practical tips.

A brown haired woman presses her hands over her eyes exhausted with her glasses resting on her head. Her shoulders are visible and she wears a multicoloured top

Honesty

Find a way to effectively communicate with your partner, letting them know how much energy you have in the tank right now. What you are capable of doing, and whether you’re willing to go ahead and have a great time even if it means you pay for it the day after.  Don’t be too proud, you don’t have to power through all the time.  Revealing your vulnerabilities can often be very bonding for you and your partner.

Positions

If your body has changed because of a chronic condition or disability, then using toys or props might help. It may be easier for you to strategically position pillows for support or comfort. Try new positions that take pressure off certain joints or require less flexibility. Don’t feel you have to over perform to impress if it causes you pain. When you’re not relaxed and enjoying it, your partner will sense your pain and therefore not benefit from your gymnastics anyway!

If dexterity and pain is an issue, using toys on yourself or your partner may take the strain from you doing so much. Let the toy do some of the work! (This article on sex toys for those with dexterity issues may help.)

Preparation

Taking painkillers 30—60 minutes before you’re going to get down to it, may relieve some stiffness and pain.  The next day, take painkillers to manage the potential flare up after your activity.  Keep on top of it so your mind doesn’t always associate sex with pain.  This may help keep you relaxed for the future too. Pain might be inevitable but if you pre-empt it, or fear it, the tension will only make it worse.

Warm/hot showers

Shower solo or together to soothe the body’s aches and pains. Massage can relax those muscles, ease joint pain, enliven nerve endings and be bonding for both of you.  Even if you don’t take it any further.

a shower with water coming out - Sex, Chronic Pain and Fatigue

Timings

When are you most fatigued and most in pain? Try and plan your sexy time to optimise your experience, based on when is best for you.

Reassurance

Either from a clinician or yourself to your partner that they won’t make you worse (let’s say a heart condition where they fear sexual activity might be too much for you).

Don’t just focus on intercourse!

Find other ways to be intimate. Dance together, shower or bath together. Cuddle up, stroke each other or massage. Take time out for romance – candles, putting down your phones and actually looking at each other, sharing feelings and talking. This can all build intimacy and connection, without you paying the price for a having a bit of nookie and enduring pain for a few days.  If penetration is likely to cause horrid UTI’s, then these options are great for avoiding that, when you just can’t tolerate another course of antibiotics!

I hope that helps. Access the free resource on Sex, Chronic Pain and Fatigue via our Undressing Disability Hub. It’s free to join and free to download a wide range of valuable resources.

All the best,

Zoe x

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Join the online conversation by following us on twitter @ETUKUndressing and on Instagram @UndressingDisability 

 

 

Next question
May 26
CBD oil a plant and dropper

A Beginner’s Guide to CBD

By Disability, Undressing Disability

Could CBD help when it comes to disability, pain or mental health issues?

It seems like CBD is everywhere and in everything at the moment. But what is it, and what does it actually do? We’ve prepared your ultimate guide to all things CBD.

WHAT IS CBD?

CBD stands for cannabidiol. CBD is an active compound found in the cannabis plant. It can be extracted from the plant and made into oils, topicals, vape e-liquids or added to food or drink. It is non-intoxicating and it is thought to have potential health and wellness benefits.

HOW DOES IT WORK?

The endocannabinoid system is a biological system in our body. It impacts several major processes which include appetite, sleep, mood, and memory. It is thought that CBD interacts with the endocannabinoid system and binds to CB1 and CB2 receptors. CB1 receptors are found in the brain and body. CB2 are located mainly in the immune and gastrointestinal systems.

A jar of CBD oil with a plant leaf sitting on a wooden worktop

HOW COULD CBD HELP ME?

Inflammation

Inflammation is caused by your body’s white blood cells responding to infection, leading to redness, pain, and swelling. CBD could potentially function as an anti-inflammatory which would help to reduce swelling and inflammation. One of the ways that CBD is thought to reduce inflammation is by inhibiting an eicosanoid enzyme called COX2. One study in 2013 which explored the anti-inflammatory properties of CBD found that cannabinoid may protect against the harmful effects of inflammation in a mouse model of Multiple Sclerosis.

(Link to study : https://www.sciencedirect.com/science/article/pii/S0969996113001939)
(Link to statistics: https://edubirdie.com/blog/statistics-and-facts-about-mental-health-how-common-are-mental-health-problems)

Anxiety

Anxiety - a dark haired beared man holds his fingers to his temple and closes his eyes with scribbles to represent noise coming from his head

Struggling with your physical or mental health can lead to added anxiety. Mind.org estimated that 1 in 5 people have a mental health problem such as anxiety or depression. CBD may help to reduce anxiety. In a study, positive interaction between CBD and a crucial neuro-receptor linked to anxiety was noted. An evidence review published in the British Journal of Pharmacology found that full-spectrum CBD could have therapeutic benefits for both anxiety and pain.

(Link to study: https://bpspubs.onlinelibrary.wiley.com/doi/epdf/10.1111/j.1476-5381.2011.01238.x/)

Sleep

It can be difficult to get to sleep if you are suffering from physical discomfort or your mental health is causing you distress. A case study from 2019 revealed that CBD could potentially help while tackling anxiety.
It involved 72 participants with 47 of those experiencing anxiety and 25 suffering from poor sleep. They were given 25mg of CBD daily then recorded their feelings. The researchers noted that 79.2% recorded their anxiety felt lower and 66.7% said their sleep had improved after just the first month.

(Link to study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/)

WHAT’S THE DIFFERENCE BETWEEN MEDICAL CANNIBAS AND CBD?

CBD stands for cannabidiol and THC is tetrahydrocannabinol. Both could offer therapeutic benefits for a number of different conditions. In the UK, CBD is available over the counter legally but THC is not. You need a prescription for medical cannabis in the UK from a licensed clinic.

CBD could potentially help with nausea, migraines, sleep, anxiety, inflammation (skin conditions, arthritis), pain, epilepsy and seizures. THC is often associated with the treatment of glaucoma, insomnia, nausea caused by cancer treatments, appetite problems, pain and muscle spasticity, anxiety and multiple sclerosis.

Speaking to your doctor and doing research when it comes to starting CBD is important.

HOW DO I TAKE CBD?

There are a lot of different ways to take CBD. You may find that you prefer some more to others or some methods may suit different needs. It’s best to try different products and keep a journal so you can chart the benefits or differences you feel.

Here is a brief guide to the four most common ways to take CBD

Oils or Tinctures:

Tinctures or oils are an easier way to take CBD by simply popping a small amount under the tongue and allowing them to absorb before swallowing.
The molecules are absorbed through the lining of the wall of the mouth, which is particularly sensitive, and beneath the tongue. It is worth noting that there is alcohol in a tincture if you are trying to avoid it.

Edibles:

Edibles are foods and drinks that have been infused with CBD. Edibles range from gummy bears to brownies to bars of chocolate and bottles of water.
CBD is extracted from a plant using a solvent before forming a concentrated substance. This is then added to the food or drink. The big difference with edibles is that they take longer to work and some of the CBD is ultimately lost due to the metabolic process. This varies from person-to-person with variables such as height or weight.

Vape:

Vaping is a fast way to absorb cannabinoids into your bloodstream.
E-liquid vaporises at approximately 200°C, producing a vapour which is then inhaled. The CBD then enters the bloodstream through the lining of the mouth, throat and lungs, allowing for rapid uptake. Legal CBD e-liquids come in a variety of flavours but will not get you high as they do not contain Tetrahydrocannabinol (THC). THC is a Class B controlled drug in the UK and is illegal.

Topicals:

Topicals are great for relief from aching muscles and for treating skin conditions. The healing compounds are absorbed directly through the skin, allowing them to target a specific sore area for faster and more focused relief. Apply a balm, lotion or oil to the affected area of the skin after a hot shower and allow it to sink in.
Read more: https://cannavistmag.com/cbd101/ways-to-take-cbd/

WANT TO LEARN MORE?

The Cannavist Magazine is your essential guide to all things CBD and medical cannabis. It is available in-store at WHSmith, McColls and Easons. It can be found online at cannavistmag.com and Readly.com

Keep up to date with all of our latest podcasts, news and insights by connecting with @ETUKUndressing on twitter or follow @UndressingDisability on Instagram.

Sign up for free to our Undressing Disability Hub to access free resources on a host of topics relating to sex and disability.

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