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"Will sex make my pain worse?" I get this question all the time.
I rarely tell my clients with chronic illness to discontinue sexual activity, because I feel the benefits can outweigh the negatives. The sexual intimacy achieved with your partner; the release of stress masturbation can achieve; and the overall endorphin rush sex produces have all the benefit that can help you with continuous pain.
Depending on the illness and the pain that comes with it, it is important to seek medical attention for pain prior to resuming sexual activity. When treating chronic illness, some people feel “broken." If you think about it, it is a loss of identity because so often people connect their bodies with sexual functioning and with their sexual identity.
So, what are the common strategies to help you feel unbroken? If you feel that your relationship is going to fail because of the sexual challenges associated with your pain, keep in mind that all relationships are going to have stumbling blocks. What you are going through is one of the many challenges that can happen in relationships. All human beings will experience challenges with their sexual functioning, whether this is a result of aging, other health concerns, or daily life stressors. This is not to diminish what you are personally dealing with, but a way to help you feel less isolated, hopeless, and alone. The goal is to find what brings you pleasure in the “new normal” that you are now living.
When I work with most people, I focus on what is more painful, and most of the time, it is penetrative sex. Often, people continue to think that to have great sex, they must have penetration. People also feel pressured in achieving orgasm.
A critical intervention that I use in my work is helping people focus on pleasure-based sex versus performance-based sex. This is critical when you are adjusting your life due to illness. Performance-based sex includes penetration being the main act, sex ending with ejaculation or orgasm, rigid expectations of your partner’s or own body, feeling like sex is a routine, tolerating pain or discomfort, limited communication, and the attention of being stuck in your head.
Pleasure-based sex includes multiple activities. Some of these activities are agreements of what sex includes, regular check-ins, the use of all body parts, arousal being allowed to come before desire, no expectations on how one should perform, focusing on physical sensations, orgasm being a bonus, but not a requirement, and sex ending when a person wants it to end.
Sex is about options and it is not an action or process of carrying out a task; rather it is about fun, pleasure, and being intimate with your partner. For example, a vibrator on the clitoris, oral sex, and mutual masturbation are just some of the exciting activities a couple can engage in to receive sexual pleasure.
When people are experiencing sexual challenges due to chronic illness, I have suggested they get creative with their sex. This may include going to a sex shop and picking out something they like and experimenting with it. People tend to enjoy this and they think of it as a new sexual adventure. It is critical to know that sexual pleasure helps lay the foundation of body acceptance and it is the antidote to pain, both emotional and physical. Sexual expression is part of personal identity, and to strip sexuality of its significance or to silence it is to damage the very notion of being human. Best wishes on your new sexual adventure!
