Living with a chronic illness means having to weigh up the positive versus negative impact of day to day activities you want or need to undertake. This could be going to a social event that you know will tire you out completely, or having sex with someone. This not only affects you directly, but your partner too as you both recognise that having sex has physical and perhaps financial repercussions too.
When googling issues of sex and chronic illness, the functionality issues always come up. Often the advice is targeted towards erectile dysfunction, inability to reach orgasm, or fertility problems. But what about the psychological, physical and societal implications?
Chronic illness is often associated with anxiety, depression, poor self-esteem, and grief. A new diagnosis can present feelings of loss and fear, or an injury or surgery might have dramatically changed someone’s appearance and function. This can have a detrimental impact on an individual’s perception of their own desirability and bring a lack of self-worth, and can impact your desire to want to have sex.
But let’s also discuss how pain and fatigue can be a huge factor in sex and chronic illness.
How might pain and fatigue impact our sex lives?
So, you might really want sex tonight, but you just know that this will cause pain, not only at the time but for days to come.
Common worries and decision processing may be:
- Does having sex mean you can’t fulfil work obligations properly for the next few days?
- Will you have to take time off and suffer loss of earnings as a result?
- Will you be unable to do activities with your children for 2 days or have to cancel social events in the days after?
- Will I have to increase my medication or take antibiotics?
What effects might my condition have on my partner?
Your partner may worry that any sexual activity will be harmful and avoid sexual intimacy because of this. This may play into your feelings of undesirability when in fact your partner is not wanting to cause you pain. The result is both partners feel frustrated, or undesirable. So, as always, this is where communication plays a huge part.
Being open and honest with each other rather than making assumptions will help the relationship.
Trying to understand each other’s reasons for not initiating sex may allay any negative self-esteem.
It also gives you the opportunity to say what you can cope with today. Maybe you don’t have enough energy for a full-on session but are craving intimacy and touch.
You can both be clear about what is manageable and set those limits and expectations for the evening.
Touch and physical intimacy are extremely important. Not everything has to be about penetration and different parts of the body may be more sensitive after an injury or neurological illness.
The emphasis can be directed towards intimacy and pleasure rather than the goal of orgasm and performance. Exploring this with each other and discovering different ways to be intimate can be exciting. Chronic illness doesn’t mean you can’t enjoy sex anymore, or that your partner will be bored and frustrated.
What can I do to help myself and my partner?
You, and your partner’s life can consist of so many changes, limitations and adaptations when living with a chronic illness, so having a satisfying sex life can feel like one area where you feel healthy and normal. Yes, it might be different but if you’re both satisfied with it, then all is good. Knowing that having sex will cost you physically, take a look at these tips and see what may help.
Honesty
Find a way to effectively communicate with your partner, letting them know how much energy you have in the tank right now. Say 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 and toys
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!
Preparation
Taking painkillers 30—60 minutes before you’re going to get down to it, may relieve some stiffness and pain. Take painkillers again the next day 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
This can be done 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.
Timings
You will know your own body. 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, time out for romance – candles, putting down the phones and actually looking at each other sharing feelings and stories. 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!
We’ve spoken to partners of people with chronic illness, and they’ve shared that whilst some things are limited, you can get other gems from the relationship; more enjoyment and awareness of the moment, more intimacy and closeness, and always making the best of any situation. Perhaps recognising that things can’t be taken for granted and to enjoy what is in the present, as nothing is ever guaranteed.
Learn more:
Follow Undressing Disability on Instagram, X (aka. Twitter) and LinkedIn, and check out our website for more support. Our resource on Disability, Bondage and Sexual Pleasure compliments this topic and may be helpful.
You’ll also find lots of articles in the Love Lounge sections of our website about accessible sex toys and accessible sex positions. We’re biased of course but our Undressing Disability Podcast is well worth a listen too, also available on Spotify.