Sex and intimacy are an important and integral part of any marriage.  It helps fulfill a vital human need for connection. It’s a natural and healthy part of living.  But what happens when one of the partners rarely wants to connect in this way because of chronic pain, illness and/or fatigue?

When someone has chronic pain, the pleasures of sexuality often disappear. There’s a complex relationship where the pain itself may interfere or other factors may complicate matters; mood disorders, decreased sex drive, medications, side effects of those medications, fatigue, and stress.  So how can you reconnect with your sexuality and with your spouse in spite of the chronic pain or illness. 

Talk to Your Doctor

Sometimes pain is the direct cause of sexual problems.  You simply hurt too much to consider having sex.  Sometimes it’s the act of sex itself that makes pain worse.  If your pain is so severe that sex seems out of the question on a regular bases, talk to your doctor.   You may need to adjust your pain medications.   You may need to take a different medication or a stronger dosage or you may just need to adjust the timing of your medication.

Alternatively, certain medications may actually cause sexual problems.   They can diminish your libido or change your nervous system which impacts sexual function.   Certain medications can also affect blood flow and hormones, which are really important in the sexual response.

If your sex life isn’t what you want it to be, make sure you discuss all of this with your doctor and they may be able to recommend some alternatives. Sometimes, it might seem embarrassing to talk about these things. It may seem silly or inconsequential based on what is going on for you medically. But as I said before, your sex life is an important component of your overall joy and happiness as well as your relationship. It is worth talking to your doctor about.

Examine Your Emotions

To have a satisfying sex life, you need to feel good about yourself.   If pain or illness has changed you physically, if you are unable to work or contribute as much as you would like to in your home, your self-esteem may be low, which can definitely affect how you show up in the bedroom. Understanding what your partner might be dealing with also might be difficult and add to your anxiety, fear, guilt and resentment.   Your condition and stress in your relationship can also worsen things.    

If sex exacerbates your pain, sometimes it’s the anticipation or fear of that pain that keeps you from participating sexually with your spouse. And it makes sense, but it’s also hard on the relationship. 

Make sure you are working with a coach or therapist to help you work through the complex emotions you may be experiencing and strengthening your relationship with yourself as well as your spouse. It is also important that your spouse has someone to discuss their emotions with as well.

Talk to Your Partner

As well as a coach or therapist, make sure you are talking to your partner about your feelings and how your pain is affecting you.   Make sure you are also talking to them about your intimacy and your sexuality.   Doing this in a neutral setting, not in the bedroom, is usually helpful.   Make sure you are communicating your own thoughts and feelings and not blaming your partner for how you are thinking and feeling.   Communicate your wants and needs and allow your partner to do the same without taking responsibility for their thoughts and feelings. Focus on what you want instead of what your partner isn’t doing.   For example, instead of saying “you don’t’ touch me anymore,” say “I love it when you hold me close.”

It’s important for both partners to be able to talk about their fears and desires. When we don’t hear what our partner is actually thinking and feeling it is our tendency as humans to tell ourselves a story that makes sense, but may not be true.  You may think that your partner has stopped touching you because they no longer find you attractive or desirable, but the actual reason might be because they are afraid of causing you more pain or discomfort.   With both partners being able to express how they think and feel, it can bring the two of you closer together instead of tearing you further apart.

Find a New Normal

When one partner has chronic pain or an illness, things may not look like they used to or the way you imagined.   It’s important to find a new normal.   Spend time getting to know each other at this new phase and find things that work for you both now.   Find things that you can do together that you both find enjoyable.   Maybe it’s taking a bath, going for a walk, or watching a movie.   Working on your emotional intimacy will help make it easier to move into reconnecting physically when possible.

Expand your Definition of Sex

Sexual Intercourse is just one way to satisfy your need for connection.   But intimacy and sex is so much more than intercourse.

Focus on touch.   Try to find places on the body that do feel good to be touched.   This can be as simple as holding hands, cuddling, massaging, and kissing.   Touch in any form increases feelings of intimacy.

Self-stimulation is a normal and healthy way to fulfill your sexual needs. If one partner is not able to do the stimulating, you can self-stimulate and the other partner can be there to support or touch you in different ways.   Vibrators and lubricants can aid you in this without any physical exertion.

Different positions can often help alleviate pain or help partners be more sexual and intimate with each other.   Oral sex can often be a great alternative or supplement to traditional intercourse.

Plan Ahead

Sex and intimacy can be more satisfying if you plan for it in advance.   Look for patterns with your pain and see if you can find days or times that seem to be better and try to plan for those times to connect with your spouse. Give yourself time to try new things.   Stay relaxed.   Keep a sense of humor.   Expect setbacks.   Try not to get discouraged and focus on the negative.   Stay positive and keep trying.

It’s Worth the Effort

Sex and intimacy, can actually make you feel better.   The body’s natural painkillers, endorphins, are released during touch and sex.   The closeness that you feel during sex can actually help you feel better and stronger in the long run as you strengthen your relationship with your spouse, which makes it easier for you to cope with your chronic pain. Decide if and when the pain might be worth it for you to connect and bring the two of you closer together.

For the Spouse

Just like the partner experiencing the pain, things have probably changed a lot for you too.   You are living a life that you weren’t expecting.   It might be a life where you have a lot more expectations and responsibility placed on you than you thought you would experience.   It’s important that you grieve the life that you thought you would have.   Grief is a normal part of the process.   But beware of resentment.   Believing that your life and your spouse should be different than they are is the number one reason for resentment.   While it may not have been what you were expecting, your life was always going to be this way.   Take the time to be sad and grieve, and then it’s time to decide what it is you want for yourself and move forward.    

You get to decide how you want to move forward from here.   While it may look different than you thought it would, you can still choose what you want your life and your sexual relationship to look like, based on a different set of circumstances.   Using the suggestions I mentioned previously, you can create a truly beautiful, intimate relationship that you can still love and enjoy.

An intimate relationship is all about connection and seeing your partner for who they are and where they are in their life.   This can be a great opportunity for the two of you to connect in ways that you may never have been able to had they not been experiencing this pain.   In what ways could this actually be a blessing for the two of you?

Make sure you are taking the time for your own self-care and understanding your own thoughts and emotions around your partner’s chronic pain and your intimate relationship.   Learn to communicate well and don’t make up stories of what you *think* might be happening instead of learning what truly is.

If you can learn to accept what is and move forward with the expectation that you want to show up in love and compassion and make things work, you can still have a successful marriage and sexual relationship despite the challenges that may have come up. Be sure to reach out to a qualified coach or therapist if you need help.