Sex is important. It puts a smile on your face, gives you a bit of a cardio workout, creates a connection between you and your partner, improves your self-esteem and can even make your skin healthy! Chronic pain can be a significant barrier to expressing yourself sexually, causing a drought akin to the Sahara. How do you maintain a healthy sex life with chronic pain?
Note: this article contains a frank discussion of sexuality and includes links to resources that are fairly explicit. It is intended for adults only. You should probably read this at home instead of work and out of the sight of small children).
Ready? Let's talk about sex!
Before you start turning up the heat, assess which parts of you need some extra TLC. No, not erogenous zones, I'm talking about the parts of your body that hurt. Talk to your doctor about being safe while you have sex so your joints are protected. RA can affect the top joint of your neck and, in some cases, make that joint unstable. Ask your doctor to check out whether your neck is affected by RA and ask how careful you have to be. If your neck hurts try not to fling your head about in the throes of ecstasy. Thinking is normally not high on the agenda during intense arousal and orgasm, but learning to be careful in those moments is possible.
Being prepared can also include taking pain killers before sex. This might compromise you and your partner's ability to be spontaneous, but will make sex much more comfortable. Keep in mind, though, that you are on painkillers, so don't get too acrobatic or you might inadvertently strain parts of your body that you shouldn't. Sex itself can also bring wonderful pain relief - the endorphins released during orgasm are your body's own opiates. The combination of your painkiller and the endorphins can pack a wonderful double punch in terms of pain control.
The fear of making the pain worse is one of the biggest hurdles to living your life as normally as possible. It can be paralyzing, preventing us from going out, playing with our kids, making a yummy dinner or having sex. Learning to work around and with the pain starts with having effective pain management, but it also depends upon realizing that pain isn't the worst thing that can happen. Not living your life is far worse. Eventually, you learn ways of preventing pain when you can, deal with pain when it's there and the fear subsides.
This ability to live with the pain ripples into every part of your life and you learn to give it a go, even if you don't feel perfectly well. That includes your sex life. As Sherrie Piburn recommended in my interview with her and her husband Gregg, "if you feel even the slightest urge, go for it, even if it turns out that you can't follow through in the end." Keep the lines of communication open with your partner so they can begin to learn the difference in what to do when you're feeling good and when you're in pain. Sometimes, starting slow with soft, gentle caresses can lead to slow, gentle sex that can be very intense. And sometimes, it stays with just soft, gentle caresses and that can be wonderful, too.
What is Sex?
Often, sex is defined only as intercourse. When you have chronic pain, sticking to this narrow view can mean a very unsatisfactory sex life. However, redefining what is sexual can open up a whole new world for you and your partner, one that will make both of you feel tingly, sexy and loved. Almost anything can be sexual. Making out on the couch like teenagers, caressing an arm with the lightest touch, watching the trail of goosebumps follow your finger or feeding your partner a piece of sinful chocolate cake. It can be a gentle scalp massage or reading a sexy story to each other. And it can be masturbation, both mutual and one person doing it themselves, while the person who is hurting maintains eye contact and offers caresses and encouraging words. You get the idea. Sexy and sexual isn't just intercourse. In fact, sometimes knowing intercourse is off the table can need to a more sensual and intimate experience.
Positions, Furniture and Toys
There are a number of ways you can make sex more comfortable. One is to get more creative with the positions you and your partner use to avoid stress on parts of your body that are hurting or weak. There are a number of different positions that can make sex easier for people with RA, as well as for those who have back pain.
Using pillows to support various parts of your body during sex is an option, but pillows tend to squish and move. Depending on your level of pain and mobility problems, you may want to look into sex furniture. The company Liberator offers not just sex toys, books and DVDs, lingerie and other sexy items, but also sex furniture that can provide support for different positions. The Canadian company Love Bumper specializes in sex furniture and has the added benefit of having considered the needs of a wide range of disabilities right from the design stage.
Sex toys can also be a terrific help for people who live with pain and mobility issues. Various forms of vibrators can help enhance stimulation when hands and jaws hurt too much to really get into the action. Both Liberator and Love Bumper mentioned above sell toys, but there are many other websites (including Amazon) that offer quality products and allow you to browse in the privacy of your home. Google "sex toys" and have fun
checking out the options! You can also do a search for "adult store" in your geographical area to find a place where you can see the products before you buy and get help from a clerk about the best product for you.
Sex is important, but intimacy is even more vital to your relationship. Finding small moments of intimacy throughout the day will help nurture the connection between you, especially during times where you may not be able to have sex. Intimacy can be any moment that makes it feel as if there's just the two of you there, together. It can be spooning in bed, holding hands while cuddled on the couch, doing the dishes together or gazing into each other's eyes while the house is in chaos around you.
Helping your partner can make each of you feel cherished and supported and nurtures the spark between you. Your partner can take over some of the tasks that are hard for you to do and you can find ways of taking care of your partner, even though you're in pain. That can include leaving a cute love note in their wallet, taking over the household administrative tasks (such as paying the bills) or picking up a small treat while you were out.
Having a satisfying sex life when you have chronic pain is more than possible. Thinking creatively and remembering that there's no such thing as "normal" can be a big help in finding your way to adding new and interesting things to do with your partner.
Throughout February, writers from many HealthCentral communities have been writing about Sex, Romance and Other Relationships and how they interact with your condition. Click on the link above to check out our special Valentine's Day area for a full list of all the posts that were part of this project.
Lene is the author of the award-winning blog The Seated View.