Sex advice for people with chronic pain

Sexual intercourse can cause discomfort for people living with long-term pain.

But living with chronic pain should not mean that the pleasures of sexual activity are beyond your reach.

Sexual activity, when comfortable, can provide a certain amount of temporary pain relief. The key is to return to some form of sex as soon as possible.

The longer you avoid it, the bigger the fear of resuming sex becomes, and a downward spiral can set in.

Also, a loss of intimacy can drive couples apart and harm their relationship in the long-term.

Plan ahead for sex

If you live with chronic pain, spontaneous sex is never going to be easy.

Planning and preparing for sex may not sound as romantic, but is a better way of achieving a satisfying sex life.

People often experience more pain at certain times of day. So it may help to have sex when your body is at its best, when your muscles are the least painful and your joints not so stiff and when you're least tired.

Many people are most intimate just before going to sleep at night, but for people with chronic pain this can be the worst time.

Instead, plan to spend time with your partner in the afternoon, or whichever time of day you feel the least pain.

Tips for more comfortable sex

If you take medication to control your pain, try to time sex for when your medicine's therapeutic effect is at its peak.

Experiment with different positions that lessen physical strain, such as lying side by side. Here are some suggestions from Arthritis Research UK.

It can help to warm the bed in advance with an electric blanket to ease muscle and joint discomfort.

Also, do some gentle stretches and use polyester or silk sheets to make it easier to turn and move in bed.

Alternatives to intercourse

If intercourse is not an option, there are alternatives such as:

• masturbating each other
• oral sex
• sex toys

Don't underestimate the pleasure and the feeling of intimacy you can get from:

• touching and being touched
• cuddling
• massaging
• kissing

For example, you could take a shower together or massage each other in turn if one of you has a bath.

Talk openly to your partner

Talk openly and honestly to your partner about how pain affects your enjoyment of sex and what you want from your relationship.

Pick the right moment to have this conversation. It may be better to talk about it over dinner or while out walking, for example, rather than while in bed or in an intimate situation.

When to get help

If your pain is so severe that it is affecting your ability to have a satisfying sex life, talk to your doctor.

You may need a different or stronger pain control plan.

Some types of medication have side effects which can affect your sex drive and your ability to have sex. Your doctor may be able to recommend an alternative or adjust your current medication.

If necessary, your doctor can refer you for professional sexual counselling.

Read 10 self-help tips to beat pain.