Pain and Intimacy

This comes from older blog.

Chronic Pain & Intimacy

Today’s topic is one that is on the taboo side and not talked about that often even with people that do not have Chronic Pain.  So put the kids to bed and get a pencil for some notes!

People need physical and emotional intimacy almost as much as they need food and shelter. Sexuality helps fulfill the vital need for human connection. It’s a natural and healthy part of living, as well as an important aspect of your identity as a person. But when chronic pain invades your life, the pleasures of sexuality often disappear. Here’s help on how to reconnect with your sexuality in spite of the chronic pain.

Sometimes pain is the direct cause of sexual problems. You may simply hurt too much for sex. Adjusting your pain medication may be the solution. If your pain is so severe that sex seems out of the question, talk to your doctor. You may need to adjust the timing of your medication or create a different or stronger pain control plan.

Chronic pain can lead to fatigue, insomnia, and symptoms of depression. Pain medicines may reduce libido. And for some people, intercourse itself can cause pain, says Meeru Sathi-Welsch, MD, an anesthesiologist and pain specialist with Long Island Neuroscience Specialists.

“Chronic pain infuses every aspect of a person’s life,” agrees Daniel Kantor, MD, president-elect of the Florida Society of Neurology (FSN) and Medical Director of Neurologique, an organization dedicated to patient care, research and education. “You don’t see yourself as a romantic, sexual being, because you’re so defined by the pain.”

To have good sex, you need to feel good about yourself. So start by examining your own emotions. If pain has left you physically scarred, unemployed or unable to contribute to housework, your self-esteem could be so battered that you feel you are unattractive and undesirable to your partner. Awareness that your physical and emotional distance is hurting your partner may add to your anxiety, fear, guilt and resentment.

Stress can also exacerbate underlying difficulties in your relationship. Even strong relationships can be challenged by medical problems or chronic pain. Being aware of emotional conflict and what’s causing it is an important first step in strengthening your relationship with your partner. Counseling may help.

The next step in reclaiming your sexuality is to talk with your partner about your feelings. At first, this may be best accomplished by talking to each other fully clothed, at the kitchen table or in another neutral setting. Sex can be difficult to talk about. Begin your sentences with, “I,” not with “you.” For example, “I feel loved and cared about when you hold me close,” is more likely to invite dialogue than, “You never touch me anymore.”

This is the time for both of you to talk about your fears and desires. You may think that your partner has stopped touching you because he or she has lost interest, or finds you undesirable. Instead, your partner may be fearful of causing you more physical pain.

Spend time just getting to know each other again. Each of you might do little things that will make the other feel loved. Restoring your emotional intimacy will make it easier to move to the next step — physical intimacy.

Start reconnecting physically with an exploration of each other’s bodies that avoids the genitals entirely (sensate focusing). The goal is not orgasm. Instead, you’re learning more about what feels good to you and to your partner.

Don’t think of sex in the same way you always did. The positions that worked for you before you began your struggle with chronic pain may not work for you now. You may need to think of new ways to initiate intimacy and different ways to be intimate.

  • Change positions. Especially if you have severe back pain or neck pain, being on the bottom — or the top — could be painful. Try a side-to-side position to alleviate back or neck pressure; use pillows for support.
  • Take your time. Instead of just initiating sex, sit quietly by the fireplace with your partner and read a romantic or sexy book to each other. “This is time for you as a couple, not focused on pain,” Kantor says. “Hold each other’s feet and give your partner a foot massage. Don’t be in a rush. After a while, it becomes not about the pain and not about forcing yourself.
  • Oral sex. It can be an alternative or supplement to traditional intercourse.

Intimacy can be more satisfying if you plan for it in advance. Make a date with your partner, picking a time of day when you have the most energy and the least pain.

Take your pain medication well in advance so that its effectiveness will peak when you need it. Limit the amount of alcohol you drink and avoid using tobacco in any form. Alcohol and tobacco can impair sexual function.

Give yourself plenty of time to try new things. Try to stay relaxed and keep your sense of humor. Focus on the journey, not the destination. If you encounter setbacks, try not to become discouraged or focus on the negative — keep trying.

Intimacy can actually make you feel better. The body’s natural painkillers, called endorphins, are released during touch and sex. And the closeness you feel during lovemaking can help you feel stronger and better able to cope with your chronic pain.

When you’re coping with chronic pain it can be tempting to just write off the sexual part of your life. But that puts your relationship at risk. “If you’re not at least willing to explore intimacy with your partner, you’re going to be in trouble,” Sisk says. “Your partner has to learn what your illness means to you, how it affects your sexuality, and try new things to make it better. And you have to understand that sex is important to your partner. You can’t say, ‘That part of our life is over now.’

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