Physical intimacy is often seen as one of the foundations towards a healthy relationship. But for those living with chronic pain, something as natural as sex can turn into a challenge – sometimes even leading to avoidance altogether. This in turn can lead to a negative impact on our relationships. In this article, we’ll explore how chronic pain impacts intimacy and relationships, and more importantly, how you can rediscover connection and pleasure.

What is Sexual Dysfunction?

Sexual dysfunction happens when something prevents you from wanting or enjoying sexual activity. It can affect any stage of your sexual response, such as:

• Lack of desire: Little to no interest in sex.
• Lack of arousal: Your body isn’t physically responding, even if you want to be intimate.
• Difficulty with orgasm: It may be delayed or absent.
• Pain during intercourse: Physical discomfort that makes sex unpleasant.

Sexual satisfaction is how you feel about your sex life. Although sexual dysfunction can lead to low sexual satisfaction, people without these issues can still have low satisfaction.

How Does Chronic Pain Affect Your Sex Life?

Living with chronic pain affects much more than just your physical health—it can also take a toll on your mental and emotional well-being. We will explore the two most common ways in which chronic pain can influence your intimacy and relationships.

1. Chronic Pain and Physical Health

A 2021 study review¹ showed a strong link between chronic pain and ‘increased sexual dysfunction AND lower sexual satisfaction’. Here are a few examples of how pain can interfere with your sex life:

• Spinal, hip, or pelvic pain can make certain body positions uncomfortable, increasing muscle tension.
• Mobility issues can also limit your movement, such as stiff joints from arthritis.
• Hypersensitivity is when the body reacts strongly to sensations such as touch or pressure. Conditions like fibromyalgia can make even a gentle touch feel painful.
• Nerve pain can enhance pain, and numbness can reduce physical sensations.
• Some painkillers or antidepressants have side effects that can contribute to sexual dysfunction.

2. Chronic Pain and Mental/Emotional Health

There is a higher incidence of anxiety and depression in those with chronic pain. The same study also found a correlation between those with anxiety and depression having more sexual difficulties. Poor emotional and mental health can lead to lower self-esteem, body image concerns, and reduced self-worth. This enhances the feeling of disconnect within yourself and your relationship. This then reduces sexual satisfaction and reinforces the lack of self-esteem, causing a negative cycle.

How to Improve Your Intimacy and Relationships

If chronic pain is affecting your sex life, you’re not alone. Please do not feel uneasy when talking about your sexual health. Sexual and intimate health are an important part of our lives and communicating your concerns will allow healthcare professionals to provide the best management possible for you. As chronic pain impacts physical, mental and emotional well-being, having a multi-angled approach can give you the best results.

• Osteopathy treatment can help reduce pain and improve your flexibility, which can help certain body positions feel more comfortable. Osteopaths can also teach relaxation techniques and breathing exercises to help your emotional well-being. They can also provide rehab, such as pelvic floor strengthening, if required. If this is something that is affecting you, you can contact us or book an appointment with JOsteopathy here.

• Talk to your GP. Certain health conditions, such as diabetes, heart conditions and kidney issues, can impact sexual function. Other factors that can influence sexual function include medications, such as anti-depressants, hormonal imbalances and menopause. If this could apply to you, it is worth contacting your GP for advice.

• Counselling – Some counsellors specialise in sexual health and relationships. This is particularly useful for:
  • Anxiety and depression
  • History of trauma or abuse
  • Issues with self-esteem
  • Relationship issues

Some can also teach you how to optimize your body’s sexual response and ways to enhance intimacy with your partner.

• Communication
  Open communication is key to maintaining intimacy, especially when dealing with chronic pain. Avoiding the conversation can lead to misunderstandings and frustration. Instead, talk with your partner about what’s comfortable for you and how they can support you. Discussing these things outside of intimate moments can ease the pressure and deepen your emotional connection. Be honest about your needs, boundaries, and what still brings you pleasure—this will help strengthen trust and understanding.

• Confidence
  Chronic pain can impact your confidence in intimacy, but focusing on what you can do, rather than what you can’t, is crucial. Simple acts like holding hands or kissing can help rebuild connection. Confidence grows when you explore new ways of being intimate and embrace the emotional aspects of your relationship. Remember, intimacy isn’t just about physical performance—it’s about connecting emotionally and finding pleasure in what works for you both.

In Summary:

Chronic pain can feel like it’s taking over every aspect of your life, including your intimate relationships, but it doesn’t have to. By seeking the right support, you can improve your sex life and reconnect with yourself and your partner on a deeper level.

I would highly recommend talking to and following Lorraine Crookes, who is a multi-award winning speaker, columnist, educator and healer, best known as the Sexual Empowerment Liberator. Lorraine has very kindly offered some FREE TRAINING to help you understand how you are feeling if your work life is reflected in your personal life. If you would like to take it a step further Lorraine also has a more in-depth course, which can be found here. She also has a blog and podcast, and is a very kind, genuine and open person to talk to about any intimacy or relationship issues.

Literature review:

1. Haydee Katz, Toby R O Newton-John, Alice Shires, Sexual Difficulties in the Population with Musculoskeletal Chronic Pain: A Systematic Review, Pain Medicine, Volume 22, Issue 9, September 2021, Pages 1982–1992, https://doi.org/10.1093/pm/pnaa451

Published 06/12/2024