Sex & chronic pain

When you’re in pain for any reason—whether the result of a chronic condition, or an injury—chances are, having sex isn’t at the top of your list. But while that’s 1000% natural and valid, you might wish you could. Perhaps unsurprisingly, people nursing physical hurt often find themselves dealing with fear of sexual pain and an accompanying aversion to sex, along with depression, anxiety, and, big surprise, a strained relationship. 

Food for thought: an active sex life not only promotes a healthy relationship, it can also decrease pain. Achieving orgasm can boost pain thresholds by more than 100%, and self-stimulation can increase pain thresholds by 75%. This is probably why some people use sex/masturbation as a tool to help manage pain.

If you’re not open to sex right now, more power to you, but if you're partnered, do make sure you find other ways to foster intimacy. If you are very open to sex, but have been lamenting its loss—or panicking at its loss—this one’s especially for you.

Different ways to share sexual intimacy with a partner

No matter what anyone says, and regardless of Hollywood’s out-of-touch portrayals of sex and passion, penetrative sex is not the be-all and end-all. Sex is an inherently creative act, and what it looks like is highly personal to you and your partner. The only certainty is that it should feel good—whatever that means to your unique body, your unique pain, and your unique pleasure.

Consider the following creative ways to share sexual intimacy with your partner when pain is part of the equation:

Sex without penetration 

There are many reasons penetrative sex may hurt, including lack of lubrication, yeast infections, endometriosis, vaginismus, and vulvodynia—to name just a few. If intercourse itself is undesirable, there are other ways to have amazing sex and share arousal/intimacy with a partner. Also, let’s not forget that it’s very common not to orgasm strictly through penetration, so there really is a whole world of other (more) potentially orgasmic types of sex that deserve your attention.

You might, for instance, explore each other's bodies through touch. Think, erogenous zones. This could mean cuddling, fondling, stroking, massaging, and kissing or making out—and/or simply being naked together. You might also explore outercourse, which can entail any of the aforementioned acts, along with oral sex, frottage, vibrators, manual stimulation—or really, anything not involving a penis or toy entering a vagina! Oh, and if anal sex works for you, great. If not, don't sweat it. You might be surprised what mind-blowing sex you can have once you let go of the sex you “should” be having.

Self-pleasure

Masturbation is a potential solution to so many problems. And it’s all yours. You control the beat, the tenor, the motion, the position, the tool, the pace, the story. Whether you have a partner or not, exploring self-pleasure can really help to reacquaint you with what feels good (or amazing), and what doesn’t. Knowledge is power, babe. Consider a tantric masturbation approach where you go slow, put zero pressure on yourself, and nurture a healthy sense of wonder at your body’s capacity for sensory pleasure.

Try different times of day…or month

Work with your body, never against it: if you have more pain in the evening, having sex earlier in the day might help. If you have more pain in the lead up to your period, or during ovulation, try having sex at another stage in your cycle. The link between hormone imbalances and the prevalence of chronic pain deserves further exploration, but there is some research out there.

Try different positions

Fact: the positions that worked for you before you dealt with chronic pain may not work now. Try different positions—some may feel better than others. If you have severe back pain or neck pain, try a side-to-side position to alleviate back or neck pressure, using pillows for support if needed. If you’ve had knee or hip surgery, you might try missionary, a standing position, or laying on your side with the affected leg on top. Really, there are optimal positions for a range of different injuries, so ask your doctor or practitioner to be sure. Finally, always be sure to take time to find a comfortable height and move slowly in and out of positions.

Warm up

Relax, breathe, and stretch beforehand. Why? Because stretching before sex (as with any other exercise) can improve flexibility, strength, and can help prepare your body for activity. Don’t push it, though. Be gentle and kind to yourself.

Use lube 

There are many good reasons to use lube. If chronic dryness is a symptom associated with your pain, that’s a good reason. Chances are you’ll want to use a good water-based lubricant, because it’s nice and slippery and easy to clean up with just water. But it may need to be reapplied periodically. Silicone-based lube is very slick and can be used in water, if that’s what you’re up to. They’re also less likely to require multiple applications.

Don’t rush

Take your sweet time. Rather than jumping into sex, start with a little mind sex: read each other erotica, massage each other, let something other than pain be the focus. Consider exploring mindful or tantric sex and let go of the need to get from point A to point B altogether—you never know where you may end up!

Don’t force it

It should go without saying that you should never just push through your pain, and/or deny its existence, but then again, we’re all wired differently. You don't want to cause yourself further pain, or re-injure yourself, so do respect your limits, and/or your healing process.

Bottom line: whether your pain is short or longterm, know this: you can have a healthy and satisfying relationship. Although it may sound trite, intimacy really does begin with honest communication. You and your partner might both try sharing your feelings and desires—intentionally and regularly. Sometimes, amping up communication can bring you closer to your partner than ever before, strengthening your relationship. If sex continue to be a real issue, consider speaking with a qualified counselor or sex therapist. 

No matter what, know that you got this, and that your pain doesn’t define you. One love. <3