A healthy sexual relationship can positively affect all aspects of your life. However, chronic pain issues can interfere with healthy sexuality.

When chronic pain is present, you may not feel like sharing your thoughts and feelings or having close contact with another person. You also may not be interested in more intimate physical contact, including sexual intercourse.

Why might people with chronic pain fear intimacy?

For people with chronic pain, fear issues may be part of the reason sexuality is avoided. These issues include:

  • Fear of rejection by a partner. It is common for people with chronic pain to feel that a partner is no longer interested. You might wonder if a partner is less attracted because you are in pain. Talk about your partner’s feelings and fears, and share your own.
  • Fear of pain associated with sex. It is natural to worry that sexual intercourse will cause you physical pain. You can address this concern by experimenting with different positions that are more comfortable. Also, relaxation exercises can help reduce fears and manage pain.
  • Fear of failure to perform. Pain, depression, alcohol, and medicines are among the factors that might affect sexual functioning, or the ability to get aroused or have an orgasm. Sometimes, failure to perform is due to stress and anxiety. In many cases, patience and understanding can help in overcoming performance problems. Many medicines can reduce your sexual ability and/or cause erectile difficulties. If you suspect a medicine may be affecting your sexual performance, don't stop taking the drug without first consulting your doctor. You can also speak to your physician about medication to improve erectile functioning.

What are some alternate ways of expressing sexual intimacy?

Intercourse is not the only form of sexual intimacy. You and/or your partner might want to try some of the following:

  • Touching. Explore your partner’s body through touch. This might include cuddling, fondling, stroking, massaging, and kissing. Touch increases feelings of intimacy.
  • Self-stimulation. Masturbation is a normal and healthy way to fulfill your sexual needs.
  • Oral sex. This form of contact might be an alternative or supplement to traditional intercourse.
  • Sex toys or vibrators. Many couples enjoy variety. Mutual use of toys with your partner can add variety to your sexual repertoire and reduce pressure to perform.

You may also want to experiment with having sex at different times of the day or in different positions, e.g., in the shower, whirlpool, or hot tub. If you have more pain in the evening, having sex earlier in the day may help. Different positions may help in easing pain that occurs. Books may be a helpful resource to learn about different positions.

You may want to use glycerin-based lubricants, such as Astroglide®, when there is a lack of natural lubrication. Lubricant use may ease or prevent pain associated with sexual contact.

What are some non-sexual forms of intimacy?

Sexuality is only one form of intimacy. Non-sexual ways you can be intimate with your partner may include:

  • Sharing feelings. Discussing your feelings with a partner may bring the two of you closer together. Talking and listening can help you and your partner better understand one another. Open dialogue with your partner about each other’s needs and concerns helps to overcome barriers to a healthy relationship.
  • Participating in common interests. Hobbies, sporting activities, or volunteer activities can bring couples closer together when they share interests.
  • Making time to be alone together. Couples can do such things as taking a bath together, sharing a candlelight dinner that you prepare together, taking a walk, or just holding each other in bed.

There are many additional ways of creating non-sexual intimacy. Explore various things that you and your partner can do together to bring you closer.

You can have a healthy and satisfying relationship in spite of chronic pain. Remember that intimacy begins with honest communication. In your efforts to become more intimate, you may discover something about your partner that you did not know previously. Your relationship may be better than it was before you faced the issue of chronic pain.

You and your partner need to talk about how you feel, what you miss, and what you want or need from your relationship. In any relationship, an effort must be made to maintain what is good and change what needs improvement.

What if sexual problems persist despite these efforts?

If sexual problems continue, consider speaking with a counselor or sex therapist.


© Copyright 1995-2015 The Cleveland Clinic Foundation. All rights reserved.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/2/2015...index#12080