Let’s Talk About Sex: How to Deal with Intimacy Issues with Chronic Illness

  • By Jennifer Mulder
  • 15 February 2021
  • 9 minute read
Let's Talk About Sex: How to Deal with Intimacy Issues with Chronic Illness | The Health Sessions

It’s not something most people easily talk about: the intimacy issues they face as a result of chronic illness.

By nature, sex is a deeply personal and vulnerable act. Baring your body and soul to someone else is intimate in itself, let alone when you look, feel and experience sex differently than what we believe to be ‘normal’.

But sex also plays an important role in the quality of your life and relationships, even if you’re sick or disabled. That’s why it’s important we normalize talking about sex with chronic illness.

Intimacy Issues with Chronic Illness

When you’re chronically ill, your body doesn’t function the way it used to, causing you painful symptoms and limiting your activities. That can make sex challenging in several ways.

Maybe you struggle to get in the mood, due to fatigue or nausea. You could also experience low libido as a side-effect of your medications. If you do have sex, it’s painful or you don’t have enough energy for intercourse. Neurological problems associated with diabetes and MS can even impair sexual function.

And that’s just the physical side of sex. When you don’t feel comfortable in your own skin or you worry about what your lover may think about your scars or ostomy bag, it’s hard to open up and enjoy each other’s bodies. Not to mention what a turn-off it is if you’re legitimately scared of having a heart attack during sex.

Many people with chronic illness feel too anxious, depressed and stressed to even think about sex, especially when you’re newly diagnosed. But after a while, you might start to miss that part of yourself, or your partner longs to connect with you physically again. How do you deal with these intimacy issues when you’re chronically ill?

Let's Talk About Sex: How to Deal with Intimacy Issues with Chronic Illness | The Health Sessions

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How to Deal with Intimacy Issues with Chronic Illness

There’s no one-size fits all approach to handling intimacy issues with chronic illness. So much depends on your specific condition, the sexual problems you encounter, whether you’re newly dating or married for decades, your self-confidence and preferences. But here are some general ideas to get you started.

1. Talk to your doctor

Just the thought of talking about your sex life with a stranger probably feels awkward. Chances are, it doesn’t even cross your mind during doctor’s visits, with all the symptoms and medications you want to discuss in such a short time. But with millions of people around the world suffering from chronic illness, it’s time we start normalizing discussing sexual problems with medical professionals.

Because a large number of prescription drugs can affect your sexual functioning. Common medication like statins, blood pressure meds, antidepressants and tranquilizers could lower your sex drive and cause vaginal dryness or erectile dysfunction. If that’s the case for you, you should never discontinue drugs without your doctor’s permission, but discuss other treatment options instead.

What’s more, taking your pain relief medication, using your inhaler or checking blood sugar levels before intercourse could all improve your sexual experience. Your doctor can give you more information on how to best time your medications around sex for your specific situation. And don’t be afraid to ask your general practitioner for assurance on whether it’s safe to get physical with heart disease or other life-threatening conditions.

A physical therapist could also help you to increase your range of motion or manage your energy levels. More so, pelvic floor therapy can be used to treat pain during sex, incontinence and erectile problems.

For more information about how to create a sex life that works for you, check out The Ultimate Guide to Sex and Disability. Finally, you could consider couples counseling or a sexual therapist if intimacy issues cause serious problems in your romantic relationship.

2. Communicate openly with your partner

Trust and intimacy go hand in hand. To feel secure, emotionally and physically, you need to be able to talk openly with your lover. Now that you’re ill, your likes and dislikes may have changed. However, your partner can’t read your mind, so make room for pillow talk. Share what hurts, what still feels good, what you can and cannot do.

Also let your lover in on your insecurities, worries and fears around sex. Maybe not right before or during sex, but in a neutral place when you have the time and privacy for deep conversations. And don’t forget that your bed parter probably also struggles with the changes in your (sex) life. It may be hard to hear, but don’t take it personally when he or she shares their own problems too. If you struggle with (re)building trust and intimacy, dr. Sue Johnson’s best-selling book Hold Me Tight contains valuable advice on reestablishing that emotional connection and physical bonding.

And finally, try to maintain a sense of humor and lightheartedness around the subject of sex. Your ability to laugh together when things don’t go as hoped, will make it so much easier to pick up where you left off.

Let's Talk About Sex: How to Deal with Intimacy Issues with Chronic Illness | The Health Sessions

3. Set the mood

When you have to time your meds intake or empty your ileostomy bag beforehand, sex probably feels a lot less frivolous and spontaneous than you were used to. Although that may be a hard change at first, you could also try to see that ‘prep time’ as a form of extended foreplay.

Especially when you’re stressed or in pain, take time to relax your body and mind. Engage your senses: put some music on, light a candle or change into something you feel comfortable in. A steamy sex scene in a novel or movie could help take your mind off your problems and get you in the mood. You could even have a warm bath or shower to relax, relieve pain and ease stiff joints before sex. As a bonus, add a drop of jasmine, rose oil or vanilla to your tub or massage oil – three popular scents proven to be aphrodisiacs.

4. Try new sexual positions

Depending on the kind of intimacy issues you experience, there are several ways to make sex with chronic illness more pleasurable.

First of all, try to time your sexual activities when you’re most likely to feel energetic and pain-free. Of course that’s not always possible, but get creative with lazy morning sex or a quickie just before dinner if that’s when you’re on the top of your game.

If you have aching muscles and joints, you can support yourself with rolled-up towels or a pillow under your hips to ease pain and increase mobility. Keep a snack or your inhaler by your bedside if you have diabetes or lung problems. Also avoid weight on your chest if you easily get out of breath. What’s more, choose sexual positions that need less energy to maintain. These disability-inclusive sex positions on The Mighty could give you some ideas.

Finally, using lubrication is an easy way to make sex more comfortable, flexible and longer-lasting.

Let's Talk About Sex: How to Deal with Intimacy Issues with Chronic Illness | The Health Sessions

5. Find other, comfortable ways to express your love and desire.

Do you feel too exhausted or in pain to have intercourse, but you’re still craving some loving? Explore different ways to be intimate with your partner. Have an old-school make-out session, focusing just on passionate kissing. Run your fingers over each other’s bodies, give a gentle massage or share your fantasies. Wrap your arms around each other and just cuddle without an agenda. Just make sure you and your partner have the same expectations.

Touch means more than sex. Physical contact is vital to our wellbeing: it calms your heart rate and breathing, and even increases your natural killer cells. Touch strengthens your relationships and helps to keep that romantic spark alive. So focus on pleasure instead of performance.

In order to meet each others need to feel loved, it’s also really interesting to learn how you and your partner express and experience affection. Because when you expect roses and compliments, you may overlook little gestures of love like doing extra chores around the house or that kiss goodnight. Find out what your primary love language is in the New York Times bestseller The 5 Love Languages by Gary Chapman.

6. Experiment with solo sex

Even if you have a partner, it can be helpful (and pleasurable) to explore on your own what works for you now that you’re ill. How do you get into the mood, even if you don’t feel that great? What kind of touch and pressure do you like, which positions are comfortable enough?

Whether you’re solo or not, The Mighty has listed a round-up of accessible sex toys that can help you enjoy sex when you’re disabled or in pain.

Let's Talk About Sex: How to Deal with Intimacy Issues with Chronic Illness | The Health Sessions

7. Get in the right mindset

Having a chronic illness means you have to rediscover how your body works – as does your partner. Inevitably, you’ll get frustrated and disappointed about all the things you can no longer do, in the bedroom and in general. But after you’ve taken the time to grief your losses, hopefully you can start to see it as a way to get to know each other all over again.

Sex with chronic illness will be an exploration, with both highs and lows. Not everything you and your lover try, will turn into a happy ending. But with an open communication and playful attitude, you’ll find new ways to connect physically.

When it comes to getting in the right mindset, you should also address symptoms of depression and anxiety. Because it’s hard to get aroused when you feel down, stressed and overwhelmed. What’s more, worrying about having embarrassing symptoms during sex can also stop you from being intimate with your partner. Talking about your mood problems and concerns with someone you trust – a psychologist, fellow spoonie or your best friend – could make it easier to overcome these emotional obstacles.

And last but not least, remember the benefits of having sex – your pleasure, expressing your love, the feel-good hormones – when you’re – rightfully! – concerned about the downsides you’ll face. Knowing your symptoms will worsen during or after sex, would put a damper on anyone. By including physical intimacy in your pacing routine, you could reduce the post-exertion malaise or flare-ups afterwards.


Intimacy issues due to chronic illness can stir up the best relationships, and make you feel vulnerable. But connecting physically in anyway you wish, can also be a great way to strengthen your bond with your partner. And sometimes, love is all you need to get you through the toughest times.

What helps you and your partner most to deal with intimacy issues with chronic illness? 

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