Can Sex and Chronic Pain Mix?

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Chronic pain impacts sex and intimacy within a marriage

Let’s Get Personal… Sex, Intimacy & Chronic Pain!

I received a lot of mostly positive feedback last week about my blog on how your partner’s chronic pain can impact your marriage.  One topic I didn’t talk much about was how it can impact intimacy within a marriage or more bluntly how it can impact sexual relations within a marriage.  But in following with my usual style of brutal honesty and disclosure, let’s dive in to this topic and talk candidly!

My husband and I have not always been on the same page when it comes to sex drive… he tends to be a ‘the more the merrier’ type of guy while I’m more the ‘chronically exhausted-already have two children who invade my personal space- take it or leave it’ kind of person. I wasn’t always so boring; I used to be more sexually exciting and ready to go… before two kids, a demanding career, an additional job as an optimally balanced coach (which I love!) and stressors in many areas of our lives. I used to be really carefree and fun! In addition to the usual life stressors that plague many of us, my husband’s chronic pain has also impacted our intimacy and sexual relationship. I’m going to differentiate intimacy from sexual relations throughout this blog because I do view them differently. Everyone knows what having sex is and the typical array of activities that fall under that umbrella. I look at intimacy as related but also separate.  To me, intimacy is the hugs, cuddles, flirtations, physical closeness but also emotional closeness. Intimacy is the warm and fuzziness that hopefully occurs on a daily basis even if sex is in the once a week (or less) category.

When my husband first got injured, back when our sex life was way more exciting, his pain impacted us a little but not substantially. I was also way more understanding toward his pain and his injuries and he also bounced back from his injuries faster. If his back pain prevented sexual activities, we still cuddled and watched movies or found ways to maintain intimacy. So if we couldn’t Netflix and Chill, we’d watch Netflix and actually chill.

As the years went by, his injuries and pain increased, as has their impact on our sex life. When he is in too much pain to do more than lay on an ice pack or heating pad, usually sex is not occurring.  When he required surgery and had a lengthy recovery, sex was obviously not occurring.  If his pain impacted his desire or his attempting to initiate sex over a period of time, even though I knew the reason, it would still have an impact on my psyche… does he still find me attractive?  Would he want to have sex with me if he could?  Mark usually has a very high sex drive so his not initiating or showing interest could cause insecurity and concern (even though I knew the reason! Emotions and how I process emotions are not always logical at the time!!). Now to be fair, our marriage and life together has had its own share of ups and downs completely unrelated to his pain, so I will not say that his pain was the only stressor that ever impacted our sex life.  But it is definitely an additional stressor.

Chronic pain impacting a couples’ sex life (or anyone’s sex life for that matter) is very common among those who suffer from chronic pain.  Often the person in pain has no interest in moving, being touched, even just putting in the effort to engage in sexual activity.  From my unofficial research, I would suggest women with chronic pain are more likely to shy away from sex then men in chronic pain, but there are many cultural and hormonal factors that probably influence that stereotypical observation.  Aside from the pain impacting desire, chronic pain (and the source of the pain) can obviously impact the physical ability to have sex. Many chronic pain sufferers have shared that a decrease in sexual activity stems more from the increase in pain rather than a direct decrease in libido.  In other words, they still want to have sex but it hurts too much! If you or your spouse have an injury that makes traditional sexual positions uncomfortable or impossible, I encourage you to communicate openly and honestly with each other. A little creative thinking or a brief google search can find many additional positions! My husband swears sex is pain relieving (possibly a manipulation lol) but some research actually backs this up.  Sex and intimacy release endorphins which can relieve pain, at least temporarily.  It also increases feeling of connectivity which helps with the emotional side of pain (ie loneliness).

What has been harder to handle as a spouse that the impact of chronic pain on our sex life, is the impact of his chronic pain on our intimacy.  When he is incredibly grumpy because his pain is so intense, we have less intimacy and often are prone to then getting into arguments. When he is constantly distracted because of his pain (or he is zoning out with dumb cell phone games to distract himself from his pain) we have less intimacy.  If he is on his cell phone, I’m more likely to pick up mine, and then we are two people lying in bed, not touching, both engaged in mindless cellphone games or Facebook.  When he needs to lay a certain way or stretch out a certain way (and therefore cannot cuddle) this can impact intimacy and the possibility of sex.  Others in chronic pain have shared with me a sensitivity to being touched. While some in pain adore a massage, others become so sensitive they don’t even want to hold hands.  This would certainly impact intimacy and sexual relations. While Mark and I have not encountered this, he certainly is less offering of massages or even just loving touches throughout the day when he is in pain.  Actually, now that I think about it, even during the normal course of day-to-day activities, when his pain is high, he is less affectionate, less considerate, and less communicative, which impacts our marriage because it in turn impacts how I interact with him.  I would love to tell you that when I notice my husband is being less considerate because he is in pain, I either give him space or cut him a break… but I promised not to lie to you. Even though I intellectually know a pain flare up is usually responsible for the change in his attitude, affection level, interaction level, etc. I do not always respond well.  I usually counter withdraw, become a little colder or a little abrasive. As I sit here writing this, I can easily point out and own my reactions and see how poorly I can react; however, in the moment, when I’m hurt that he is less engaged or I’m angry to be the one taking care of the kids all day Saturday while he lays in bed again, I do not always react with a clear head.

Now before you start feeling bad for my husband, don’t! He definitely still needs work on communicating what is going on with him!! I’m certainly more empathetic than I used to be and I’ve gained a greater understanding of what being in chronic pain really is like given I have thankfully not experienced severe chronic pain. I am finally wrapping my head around his reality… the reality of living with severe pain that can fluctuate in intensity. I think it is very hard for non-chronic pain spouses and relatives to really accept and understand what living with chronic pain is really like. It is hard to grasp the need to prioritize your daily activities because at any time pain can flare up or your back can lock up. It is hard to understand how one moment he seems fine and is playing with the kids or able to join me on errands but the next moment he is in bed “just laying flat” or can’t stand in line another minute.

So before I start on too many tangents, let me refocus on the topic at hand. Chronic pain is absolutely like a mistress in your marriage or relationship. If you are single, chronic pain is already your primary companion which makes it more difficult to date or socialize. And if your loved one has chronic pain, don’t give up and personalize the lack of intimacy/sex! Find ways to at least be intimate with each other even if sexual activities aren’t occurring. Talk without looking at your cell phones, watch tv together while at least holding hands or make a point to at least compliment each other once a day!  Communicate openly with each other about your needs and wants in ways that are not accusatory or confrontational. And finally, don’t be embarrassed by needing to seek professional help if you or your partner’s chronic pain is negatively impacting the relationship.  A healthy sex life and high amount of intimacy are definitely important factors in a relationship and it is worth putting in some work to improve your satisfaction in these areas if needed.  No relationship is perfect and if you are anything like me and Mark, then you too are probably a work in progress!

To follow up with Amanda or inquire more about living a healthier life, you can always reach out to Optimally Balanced.

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