When you are in pain, the last thing you probably want to do is be intimate with your partner. But, it is important to remain close to your loved one. A healthy intimate relationship can positively affect all aspects of your life.

Many people living with pain often have fears about sexuality, including:

• Fear of rejection by a partner: It is common for people with chronic pain to feel that a partner is no longer interested. You may wonder if a partner is less attracted to you because you are in pain. Share your feelings and fears with your partner and listen to your partner's concerns.
• Fear of pain associated with sex: It is natural to worry that sexual intercourse will cause you physical pain. You can address this concern by experimenting with different positions that are more comfortable.
• Fear of failure to perform: Pain, depression, alcohol and medications all may affect sexual performance or the ability to get aroused or have an orgasm. Sometimes, failure to perform is due to stress and anxiety. In many cases, patience and understanding can help in overcoming performance problems. Many medications can reduce your sexual ability and/or cause impotence. If you suspect a medication may be affecting your sexual performance, don't stop taking the drug without first consulting your doctor.

If intercourse is undesirable, there are other ways to remain close, including:

• Touching: Explore your partner's body through touch. This may include cuddling, fondling, stroking, massaging and kissing. Touch increases feelings of intimacy.
• Self-stimulation: Masturbation is a normal and healthy way to fulfill your sexual needs.
• Oral sex: This form of contact may be an alternative or supplement to traditional intercourse.

You may also want to experiment with having sex at different times of the day or in different positions. If you have more pain in the evening, having sex earlier in the day might help. Try different positions as some may feel better than others. You may also want to use lubricants when there is a lack of natural lubrication. Lubricants may ease or prevent pain associated with sexual contact.

Intimacy Without Sex

Sexuality is only one form of intimacy. Non-sexual ways you can be intimate with your partner include:

• Sharing feelings: Discuss your feelings with your partner. Talking and listening can help you both better understand each other and may bring you closer.
• Participating in common interests: Couples that play together often stay together, so the saying goes. Hobbies, sporting activities, or volunteer activities can bring couples closer together when they share interests.
• Making time to be alone together: Try taking a bath together, sharing a candlelight dinner, taking a walk, or just holding each other in bed.

There are many additional ways of creating non-sexual intimacy. Explore various things that you and your partner can do together to bring you closer.

Intimacy Is Possible

You can have a healthy and satisfying relationship in spite of chronic pain. Remember that intimacy begins with honest communication. You and your partner need to talk about how you feel, what you miss, and what you want or need from your relationship. In any relationship, an effort must be made to maintain what is good and change what needs improvement. In your efforts to become more intimate, you may discover something about your partner that you did not know before. Your relationship may become stronger than it was before you faced the issue of chronic pain.

If sexual problems continue to be an issue, consider speaking with a counselor or sex therapist.

Reviewed by the doctors at The Cleveland Clinic Center Department of Psychiatry and Psychology.

Edited by Cynthia Haines, MD, WebMD, March 2006.

SOURCE: The National Chronic Pain Society.

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