ME/CFS, FM & Sex: Solutions to Common Problems

By Bruce Campbell

When ME/CFS or fibromyalgia enters a marriage, one casualty can be intimacy between the partners. Pain, reduced energy and reduced interest can all affect a couple's sex life, but, like other aspects of long-term illness, intimacy problems can be addressed as well.

In fact, difficulties around intimacy can provide the impetus for improved communication that can even strengthen a relationship. This article discusses strategies for responding to three common problems: fear, pain and reduced desire.

Confronting Fear

The experience of pain often leads to avoiding an activity, out of fear that pain will return or worsen. When the activity being avoided is sex, couples lose an important source of pleasure and intimacy, and may experience feelings like guilt, fear and resentment.

The person in pain may feel guilty about denying pleasure to their partner. The partner may be worried that he or she may do something to intensify pain, resentful at loss of intimacy, and guilty for feeling resentful. The solution is communication and problem solving.

For productive conversation about intimacy, think timing, setting and approach. Choose a good time of day for the person who is ill, when his or her energy is best and cognitive problems minimal.

Choose a place that minimizes distractions and interruptions. And bring an intent to find solutions that work for both partners and that strengthen the relationship. The idea is to discuss problems in a constructive rather than a confrontational way.

Problem solving starts with defining an issue in detail, for example intensification of pain from certain positions or pain that increases if one position is held too long. Second, think of several possible solutions to the problem, not evaluating any of them until your brainstorming is complete.

Often problems have more than one cause, so a combination of solutions may be appropriate. For the pain examples given above, you might consider timing the use of pain medications or switching positions frequently.

Then decide which ones are most promising and experiment with them. Some potential remedies may not work, but others may. The final solution may be a combination of several strategies.

In many cases, you will be able to solve your problems yourself, but at times you may want to get help, either in understanding the causes of your problem or in finding solutions. So it may help to ask what resources are available to you. For problems of intimacy, you might read books, ask other couples or consult a therapist.

Overcoming Pain

Some people find that pain interferes with their enjoyment of sex. Anticipation of pain can lead to avoidance of intimacy, which may create guilt for the spouse who is ill and resentment in the well spouse.

A number of strategies may help. If pain in intercourse is a major concern, you and your partner might focus on touching and cuddling. By focusing on giving mutual pleasure while in comfortable positions, you can make your intimate time together last longer and be very satisfying. Pain may be minimized if you concentrate on foreplay and sensuality rather than intercourse.

Another factor to consider is medication. One solution is for the person who is ill to time the taking of pain medication so that it will be at peak effectiveness when you plan to have sex. The type of pain medication is also important.

The person with pain may want to avoid narcotic pain medications and tranquilizers, which dull the senses as well as reducing pain. Other means of pain reduction include taking a bath before sex, stretching and massage.

Time of day is another consideration. Pain and other symptoms may be lower during certain hours of the day. By timing intimacy for those times, a couple may minimize discomfort and increase pleasure and enjoyment.

Pain can be reduced by using positions that are comfortable, by changing positions and by alternating activity and rest. Comfortable positions will differ from couple to couple and are best found through experimentation.

Changing positions periodically during sexual activity can also help control pain, especially for fibromyalgia patients, who are susceptible to greater pain when they stay in one position too long. Periodic rests may be especially useful for ME/CFS patients, for whom exercise is more successful if periods of activity are alternated with times of rest.

A final pain control approach is the combination of distraction and meditation. The common method of reducing pain by placing attention elsewhere can be applied in sex, by focusing on sensations, both those given and those received. Also, concentrating on mental images of making love keeps the mind focused on pleasure, distracting attention from pain.

Addressing Lack of Interest

Reduced interest in intimacy, often called low libido, can have a number of causes. One is fear of an increase in pain or other symptoms. For ideas on dealing with pain, see the previous section. Low libido can also be a side effect of medications. A change of medications or a lower dosage may help.

In Conclusion

ME/CFS or fibromyalgia do not have to mean the end of sex. Using flexibility, good communication and problem solving, couples can continue to enjoy sex and may be able to strengthen their relationship.

For more on this topic, see the article Illness & Sex: Six Strategies for Improving Intimacy.