How People in Pain Can Revive Their Sex Lives

Communication is the key to rekindling
People with chronic pain—and those who love them—don't need to resign themselves to a lifetime of celibacy. The subject can be broached from several angles, but the main lesson from doctors and couples is this: Communicate.

First, don't be embarrassed to talk to your doctor. "If the physician doesn't bring it up, the patient should," says Dr. Sitzman. "They should get validation that this is a common consequence of chronic pain and its therapy—and they should expect treatment."

Dr. Gevirtz recommends emailing questions beforehand so they can be discussed during the session. He also suggests keeping a pain diary at home so you can remember the details: For example, at what point during intimacy pain occurred or what the circumstances were surrounding an instance where your pain subsided.

Help is a doctor's visit away
Once your doctor has a clear picture, he or she can help. "The main thing is to validate that this is an anticipated side effect that can be treated, and that sexual activity is a normal part of intimacy that chronic pain patients shouldn't be denied," says Dr. Sitzman. Then, patient and doctor can work together to devise a pain management protocol for alleviating pain during sexual activity.

Addressing the emotional component
Couples can also seek out a sex therapist or couples counselor to relearn the building blocks of intimacy. "A lot of times couples are avoiding even basic levels of contact, not holding hands, not kissing, not even talking," says Datz. Part of her therapy with couples includes helping them reestablish physical contact and teaching them relaxation techniques: "Because there is often a lot of anxiety about sexual activity when you have pain," she explains, "it's helpful to learn to relax mentally and physically."

When a loss of self-esteem is keeping a patient from being comfortable with their partner, "we have specific ways of treating that in therapy," says Datz, including "normalizing" a person's symptoms so they don't feel quite so alone and alienated.

The payoff in pain reduction and relaxation
Reigniting intimacy can actually help pain, at least temporarily: "As doctors, we prescribe external opiates, but the best opiates around are the natural ones that the brain produces," says Dr. Gevirtz. "If you can give someone an orgasm, they will have a flood of endorphins and their overall pain numbers will go down."