Sexual Wellness Resource Center
For Adults over 50.

Chronic Illness and Sexuality

Chronic Illness and Sexuality
By Michael Bates, M.D.

People who live with chronic illnesses often have difficulties with sexual functioning. Sexuality can be altered by these illnesses and their treatments. Some people may become sexually inactive because of misconceptions about their ability to have sex or the safety of having sexual relations.

However, few, if any, chronic illnesses require complete restriction of sexual activity.

Why a Satisfying Sex Life Matters

Relationship and sexual satisfaction are important to the quality of life. This doesn’t change just because a person or their partner develops a chronic illness.

In a life restricted by illness, sex can be a powerful source of comfort, pleasure and intimacy. A satisfying sex life is one way of feeling normal in the context of chronic illness and the changes brought about by the illness and its treatment.

While issues of sexual function may not be a priority at the time of diagnosis—and sexual activity may be placed on hold during the initial management of the health issue—there is a good chance that it will become a priority again. You and your partner will likely want to connect again, and reclaim the things that have been put aside.

Relationship and Sexual Challenges During Chronic Illness

A chronic illness alters relationship dynamics—one partner often assumes the role of caregiver in addition to lover. It can also take away the spontaneity, ease and confidence from something that was once very spontaneous, natural and satisfying.

Partner communication is the key to meeting these challenges. Couples need to engage in open and honest conversations about feelings and expectations.   

It may also be necessary to think outside the box, to get creative. For example, couples who primarily relied on intercourse, and now find it difficult, might explore outercourse, visual stimulation, role play, and/or the use of sexual aids. This can open up a whole new world of sexual excitement and intimacy.

Chronic Illness and Sexual Dysfunction

Sexual dysfunction has many sources in those living with chronic illnesses:

  • Grief, anxiety and depression related to diagnosis of the illness can impair sexual response.
  • Sexual desire, arousal, and orgasm may be altered by hormonal, vascular, and neural changes to the genitals secondary to surgery or radiation.
  • Lowered self-esteem due to the illness or to body changes secondary to the illness and treatment.
  • Drugs used for treatment may contribute to the inability to get or maintain an erection, vaginal dryness, and/or decreased orgasmic intensity.
  • Fatigue and low energy

The Importance of Your Doctor

Your doctor must be involved in the process of reestablishing your sexuality. Sex may initially be impossible due to temporary surgical effects, or temporarily painful because of vaginal conditions caused by treatment. Drugs used in treatment may be modified by lowering the dose or by taking the medication at another time of day, or by substituting one medicine for another.

Another role of the physician is to give the patient and partner permission to explore and develop alternative means of sexual expression and intimate contact, in order to create a new normal.

So what is the take home message?

  • Touch and physical intimacy are extremely important for everyone, and maybe more so for those living with a chronic illness.
  • A satisfying sex life is one way of feeling normal when so much has changed.
  • Communicate, involve your physician, be creative and explore new avenues of physical intimacy.

References

Antori, Steph, How Chronic Illness can Affect Sexual Function, aasect, March, 2014

McInnes, MB BS, FACSHP. Sex Therapist, Chronic Illness and Sexuality, The Medical Journal of Australia, 2003; 199(5): 263-266 

Nusbaum, D.O., M.P.H., University of North Carolina at Chapel Hill School of Medicine, Hamilton, Carol, ED.D. P.A.-C. Emory University School of Medicine, Lenahan, Patricia, L.C.S.W., University of California, Irvien, College of Medicine, Chronis Illness and Sexual Functioning, Am Fam Physician. 2003 Jan 15;67(2): 347-354

 

About the Author

Michael Bates, M.D.

Dr Bates practiced obstetrics and gynecology for 34 years in Wichita, Kansas, until his retirement in 2011.

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