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Key points
- The majority of men and women living with chronic pain report a negative effect on their sex life, survey data shows.
- But regular sexual activity, in addition to bolstering quality of life, can be an effective tool in the fight against chronic pain.
- Couples living with chronic pain are advised to experiment with different positions, types of sexual and non-sexual contact, and solo sex to find activities that work.
- Frequent communication and planning can help couples stay emotionally close and sexually satisfied, even on days when sex isn't possible due to pain.
For many, sex and intimacy are critically important aspects of life, functioning, and happiness. But for those with chronic pain, sex often becomes something that is complicated by fears related to performance, rejection, and how to engage in sexual acts without increasing pain.
A 2015 survey of patients with low back pain, for example, indicated that 72 percent had sex less frequently following the onset of back pain, 70 percent found sex less satisfying, and 61 percent said their pain made their relationship more difficult. Sadly, sexual functioning is rarely discussed or addressed likely due to discomfort by both patient and providers.
Why Sex Matters for Chronic Pain Sufferers
Sexual activity plays an important role in the quality of life and can be helpful for those with pain. Endorphins, the body’s naturally produced "painkillers," are released during sexual touching and intimacy. In fact, research using fMRI suggests that orgasm actually blocks or lowers pain levels in women and decreases headache pain. Scientists have also found that sex mediates the relationship between depressive symptoms and back pain. In addition, sexual activity can create other health benefits that are especially useful for those with pain, such as improving sleep and decreasing stress.
One of the keys to being intimate that is often overlooked is communicating with your partner. Living with chronic pain can lead to lowered self-esteem and confidence due to decreased functioning in a variety of areas. Talk about your feelings around sex, which may include concerns about inadequacy and performance fears.
If your sexual activity has decreased due to pain, but you still have interest, be sure to let your partner know that they are still desirable and desired. They may not be aware of your obstacles and instead feel that they are the problem, leading to emotional hurt and distancing. It is also important to remember that sexual dysfunction can stem from commonly used pain medications such as opioids and certain antidepressants, so ask your doctor how medications may be impacting you.
How People with Chronic Pain Can Better Enjoy Sex
A healthy sex life is possible. Here are 5 tips to help with intimacy:
- Get Creative: Touching, a long kissing session, massaging, and cuddling can all increase intimacy and be arousing. There are many ways to be close outside of intercourse.
- Experiment with Details: Explore positions to find what is best for you and consider things like side-by-side and other low-impact options. Research even suggests that certain positions are actually better for men and women with back pain. In addition, try out different times of day to see what is preferable.
- Solo, Together: To minimize the amount of movement, consider self-stimulation manually or with the use of a vibrator which can be done alongside a partner or alone.
- Plan for Pleasure: While spontaneity has its upsides, deciding on a "date" and setting aside time for sexual activity is helpful for those with pain. Take any medication in advance that can lessen discomfort and stay positive.
- Keep Talking: Communicate during sex so that your partner is aware of your feelings and feedback, and keep talking outside of the bedroom about how to keep the flames ignited.
Although disruptions in one’s sex life are common in persons with chronic pain and can significantly impact the quality of life, they are an overlooked and undertreated aspect of clinical care. Do not be embarrassed to talk to your partner or provider about your sexual concerns. For more information, find a sex therapist or psychologist with expertise to help provide additional guidance; to find someone near you, visit the Psychology Today Therapy Directory. A healthy sex life can be part of a life with chronic pain.
References
Eidelson SG. SpineUniverse.com. Chronic back pain in America 2015: survey results. http://www.spineuniverse.com/resource-center/bpa2015/low-back-pain-fact…. Accessed March 23, 2021.
Pakpour AH, Nikoobakht M, Campbell P. Association of pain and depression in those with chronic low back pain: the mediation effect of patient sexual functioning. Clin J Pain. 2015;31(1):44-51.’
Hambach A, Evers S, Summ O, Husstedt IW, Frese A. The impact of sexual activity on idiopathic headaches: an observational study. Cephalalgia. 2013;33(6):384-389. doi:10.1177/0333102413476374
Sidorkewicz N, McGill SM. Male spine motion during coitus: implications for the low back pain patient. Spine (Phila Pa 1976). 2014;39(20):1633-1639.
Sidorkewicz N, McGill SM. Documenting female spine motion during coitus with a commentary on the implications for the low back pain patient. Eur Spine J. 2015;24(3):513-520.
Wise NJ, Frangos E, Komisaruk BR. Brain Activity Unique to Orgasm in Women: An fMRI Analysis. J Sex Med. 2017;14(11):1380-1391. doi:10.1016/j.jsxm.2017.08.014
