Chronic pain can interfere with your quality of life and take a toll on your mind, body and spirit. And when it comes to sex and chronic pain, you may experience difficult emotions and physical challenges that affect how you connect sexually with a partner and yourself.
When you experience pain that lasts for more than three months, it's known as chronic pain, per the Cleveland Clinic. Some examples of chronic pain conditions include:
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Living with chronic pain can put a strain on your ability and desire to experience sexual pleasure — which is an important part of many people's overall wellbeing.
But if you desire an active sex life or intimacy with chronic pain, it's totally possible. Here, experts share tips on to improve your sex life if you have chronic pain.
Communicating with your partner, working with a professional and finding creative ways to connect can all help improve your sex life when you're living with chronic pain.
How Does Chronic Pain Affect Your Sex Life?
Chronic pain doesn't just get in the way of physically engaging in sex, it can affect your thoughts and feelings about sex, too.
"A person's sexuality is multifaceted and encompasses sensuality, sexual identity, sexual health and reproduction, sexualization and their values," licensed occupational therapist and sexologist Nicole Porter, OTR/L, tells LIVESTRONG.com.
"So, when they experience chronic pain, it is not just sex that gets potentially disrupted but all these other features that make up their sexual being," she adds.
Some of the sexuality-related challenges you may have to navigate with chronic pain, include:
- Distorted body image
- Feelings of inadequacy related to giving and receiving sexual pleasure
- Physical discomfort during sex
- Internal and external shame about having chronic pain
- Difficulty navigating sexual intimacy
You may also experience fear and a loss of confidence related to being sexually intimate with a partner.
"Lack of ability to engage in activities that we enjoy can lead to depressed feelings and loss of confidence, which can have an extremely negative impact on our ability to be intimate with our partners," Yili Huang, DO, licensed pain management anesthesiologist and director of the Pain Management Center at Phelps Hospital, Northwell Health, tells LIVESTRONG.com.
"Further, if an individual has experienced pain while being intimate with their partner, they are often afraid of having a similar experience again," he adds.
While having sex with chronic pain can be tricky sometimes, good sex may help. A January 2015 study in The Clinical Journal of Pain found that sexual functioning lessened the association between pain intensity and depressive symptoms experienced by sexually active people with chronic lower back pain.
Endorphins are released during touch and sex, per the Mayo Clinic. These hormones that travel throughout the nervous system aid in natural pain relief. Together with the sense of closeness that can accompany sex, endorphins may help you better cope with your chronic pain.
How to Improve Your Sex Life When You Have Chronic Pain
Trying to have an active and pleasurable sex life with chronic pain can bring up a ton of tough emotions for both you and your partner, particularly when one person has chronic pain and the other doesn't.
But it's not all bad — and in some cases, chronic pain can help you reimagine sex and connection.
"I am learning that others lean into their chronic pain and use it to enhance their connection and understanding of their own body," Porter says. "With this as a goal, people then find pleasure in engaging with sexual partners in new ways that are pain-free or that help to reduce pain."
If your chronic pain has negatively affected your sex life, there are several ways to make sex feasible (and fun) again. Here are some tips that may help you reignite your sexual and emotional intimacy.
Communication is a hallmark of all healthy intimate relationships, but especially those where one partner has chronic pain. "Your partner(s) cannot read minds or know what you're feeling if you don't say something," Porter says. "You have to be open and honest about your wants, needs and desires — and that type of communication takes time, trust and effort for all involved."
Talking to your partner about how you feel about sex, both emotionally and physically — and hearing them out — can help you reclaim your sexual pleasure.
Having regular and vulnerable conversations about sex gives you the chance to address your fears, desires and any pain or discomfort.
Using "I" statements and talking in a neutral, non-bedroom setting like the kitchen or living room can help bring ease to the conversation, per the Mayo Clinic.
2. Work With Your Pain
Doing things that help to accommodate instead of aggravate your chronic pain can help make sex more comfortable.
Using assistive devices that help to make certain positions feel better for your body or that help introduce new types of stimulation can help you find more comfort and enjoyment during sex.
"The use of wedges to assist in positioning helps to decrease muscle and joint pain," Porter says. "Introducing various sex toys into the space can decrease muscle fatigue and enhance pleasure by using various stimuli that your brain and body can focus on, which can override pain receptors."
You can also work with your pain by scheduling sex. "Other options include setting specific times and places to engage in sexual encounters, in order to give you time to prepare your environment," she notes.
Optimizing your mood and your environment might look like the following:
- Taking a hot bath or shower or getting a massage to decrease muscle stiffness
- Choosing sex toys
- Taking your pain medication
- Having sex on a soft or firm surface
Products That Help You Work With Your Pain
Porter recommends keeping the following criteria in mind when shopping for products that can help you have better sex with chronic pain:
- Size and shape: Does it fit your anatomy and your environment?
- Level of support: Does it support your body size, weight and areas of pain?
- Body-safe materials: Does it say body-safe on the packaging? Are you allergic to any of the materials?
- Budget: Does it work with your budget?
Here are our picks for a few products that may help you experience sexual pleasure with more ease:
3. Work With a Professional
You (and your partner) don't have to navigate your sexuality alone. Working with a professional who specializes in chronic pain can be beneficial.
Porter recommends seeking out the following professionals to help you reconnect with your sexuality, if you have chronic pain:
- Occupational therapists are great at modifying daily activities. They can provide information on how your specific condition can affect your sex life and suggest tools that can help.
- Physical therapists work to improve strength, balance and flexibility and problem-solve ways to move in a pain-free or reduced-pain range.
- Marriage and family therapists, social workers and other counseling professionals can assist in working through issues associated with chronic pain and/or effective communication techniques.
- Physicians can assist in pain medication management.
4. Get Creative
While your chronic pain might feel like (and be) a barrier to a fulfilling sex life at times, it can also make space for more creativity in your relationship. For example, if you haven't always had chronic pain and were used to sex looking a certain way, you can redefine what sex means to and for you.
"I think it is important for partners to establish what sex means for them," Porter says. "It could mean penile-vaginal intercourse, strap-on intercourse, oral sex, anal sex, sex toy use or different types of stimulation."
If certain types of sex don't feel good to your body, you can expand the ways that you have sex so that pleasure is still accessible to you and your partner, without making your pain worse.
You can do this by being intentional about trying new positions and sexual wellness aids. Porter suggests making a list with your partner, which is also another chance for connection.
She also encourages people to get creative in the following ways:
- Explore sexual fantasies without engaging in sexual intercourse
- Take a class or workshop
- Reconnect with your body via a new outfit or lingerie
5. Focus on Increasing Non-Sexual Intimacy
Sex can be an important form of intimacy in some relationships, but there may be times when your chronic pain inhibits your desire or capacity for intercourse. That's why nurturing non-sexual intimacy matters, too.
Porter recommends incorporating the following practices, to help you feel close to your partner without sex:
- Giving and receiving massages
- Spending time together via a new hobby or activity
- Connecting with other people who navigate chronic pain in their relationships
- Exploring kink practices. A 2019 paper in Disability Studies Quarterly describes the link between chronic pain and disability and found that BDSM (bondage and discipline, dominance and submission, sadism and masochism) was a useful tool for some people with disabilities to help control their pain. While the research on chronic pain and kink is limited and kinky practices aren't for everyone, the existing research shows that kink may help those with chronic pain reconfigure their pain and relate to it in more positive ways.
When to Talk to Your Doctor
When it comes to sex and chronic pain, you should talk to your doctor if you have pain so severe that it makes having sex feel impossible or medication side effects that impair your sexual function, per the Mayo Clinic.
- Cleveland Clinic: "Chronic Pain"
- The Clinical Journal of Pain: "Association of pain and depression in those with chronic low back pain: the mediation effect of patient sexual functioning"
- Mayo Clinic: "Chronic pain can interfere with sexuality"
- Disability Studies Quarterly: "Chronic Pain as Fluid, BDSM as Control"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.