I thought that title would be a nice attention grabber – and so it was. Why? Because patients living in chronic pain, and their partners, often accept diminished intimacy as a necessary evil. Moreover, it is a topic that likely is seldom discussed at office visits for many reasons including time, expertise, fear, embarrassment, or simply because it’s considered tabu by patients and conceivably by some non-behavior health clinicians. Perhaps its best addressed by a clinical psychologist, if one is available, because this is an issue that most often affects relationships, innermost feelings, mood, desire, euphoria, pleasure, and an entire alphabet of nouns that can ultimately affect wellbeing, health, and even exercise.
During this “Valentines Week”, the first showings of the best seller book(s) made movie, Shades of Grey, was the highest money-making movie of all time for a President’s Day debut. It netted almost 82 million dollars in 3 days. That begs the question; don’t you think a few chronic pain patients may have a vested interest in sexual activity?
This is the first of a two-part blog, the second of which will focus on pain medications by pharmacological class, how they affect various aspects of sexual function, and what you can do to mitigate that. But for today, I am thrilled to have our guest blogger Barby Ingle, a person who has endured chronic pain herself; she is an author, chronic pain educator, patient advocate, and President of the Power of Pain Foundation.
Please welcome these words in various shades of “gray” from Barby Ingle…
One of the most difficult things about chronic pain is the profound impact that it can have on your sex life. If you think you are the only chronic pain sufferer with intimacy issues, think again. Emotional, physical, and medication factors all play a role in chronic pain patients dealing with sexual dysfunction issues. Sexual dysfunction can come from habit as well. When people don’t feel well on a constant basis they can get into the habit of not having physical contact with their partner. After a while the person in pain can forget to even think about the needs of their partner and become consumed with their pain experience. As humans we need physical touch and companionship. If you are falling into a pattern of a sexless relationship make a conscious effort to change the situation.
Valentine’s should serve as a friendly reminder for how important loving physical touch is to a person in pain. Keep in mind the things done out of kindness are a way of showing affection. For those in pain these things can’t be overlooked or taken for granted. Let them know you are still interested and willing to have intimacy. This can put your partner at ease. It is easy to jump to conclusions as to why your partner has stopped touching you. The reason is usually not that they lost interest in sex or in you. It is usually a lack of communication and can be fixed. Maybe your partner is afraid of causing you physical pain. As a pain patient myself, I don’t feel sexy every minute of every day. I learned there are ways to have a sexual relationship that is romantic even through the pain I live with on a daily basis.
Many times rekindling the romance is successful with proper communication not just with your partner but also with your health providers. Talking to your provider about your sexual activities (or lack thereof) can be nerve wracking and a bit embarrassing for many. Unless we speak up about what we are experiencing we will not find a work-around for whatever is causing the dysfunction. More than likely it is something that can be overcome if we just communicate. Even if you are embarrassed or shy simply describe the changes you are having; lack of desire, difficulty with performance. Just like when a patient brings in a list of medications they are currently taking and the benefits or side effects they are experiencing, it is important to have this sexual function discussion.
Romance and intimacy is not all-or-nothing. Do not be shy about investing into your sexual relationship. These days it is very easy to be creative. There are many levels and creative ways to have a sexual experience. If you have vaginal pain, opt for other types of sex that is still satisfying to your partner and keeps you close. If you have erectile dysfunction, consider alternatives that can otherwise heighten arousal for each participant. There doesn’t have to be penetration every time or even most times, but it should be satisfying every time. Commit to the time it takes to have the sexual experience and mentally filter out the negative pain for a few minutes. Don’t reject your partner and positive experiences by insisting that any connection doesn’t count unless it is traditional sex.
Barby Ingle is the author of Real Love and Good Sex for Pain Patients and Their Partner http://barbyingle.com/books. She is a chronic pain educator, patient advocate, and President of the Power of Pain Foundation. Barby is also a motivational speaker and best-selling author on several pain topics. She has been a pain patient since developing endometriosis in 1997, and reflex sympathetic dystrophy in 2002.