SICK AND SEXY: Being intimate while chronically ill

Sexologists and psychologists agree that sex is an important contributor to the quality of life in many patients with chronic illness and their partners. Read on for an in-depth analysis and insight into how chronic diseases affects one’s sex life and how you can get your groove back.

According to the World Association for Sexual Health, sexuality is a basic human right and a fundamental part of a full and healthy life. For most healthy people, sexuality is central in their life and contributes heavily on their personal and relational quality of life. The same applies to individuals suffering from chronic diseases. And while issues of sexual function – foreplay, intercourse, and intimacy in general – may not be a priority during the time of diagnosis, or even during one’s initial management of their health issue, there’s a good chance it will eventually become one.

For a better understanding of the association between chronic diseases and sexuality, it is important to note that human sexuality is a complex phenomenon which can be affected by biological, psychological, relational and socio-cultural factors. Also note that chronic diseases are not only characterised by physical symptoms but also psychological and relational distress or psychosocial pressures

Disease activity, its complications and treatment may impact sexuality directly, indirectly and iatrogenically.

Direct impact of chronic diseases on sexuality

This happens when a chronic disease has a direct impact on the genital anatomy or central and peripheral sexual philosophy. Such diseases include vulva and penile cancer. Sometimes, chronic diseases may directly affect arteries, veins and nerve muscles which underlie sexual functioning.

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Indirect impact of chronic diseases on sexuality

Here, the chronic disease does not interfere with functions connected to sexuality, but they affect sexual functioning or sexual well-being indirectly. This indirect impact of chronic diseases is characterised by neurologic, vascular or hormonal complications. For example, the vascular impact of hypertension

Indirect impact may stem from more general consequences that co-occur together with the disease. For instance, chronic pain and fatigue.

Iatrogenic impacts of chronic diseases on sexuality

This type of impact refers to the preventive or curative surgical procedures that unintentionally induce sexual dysfunction. It also includes the side effects of prescribed medication or therapy that may inhibit or enhance sexual functioning. Take for examples treatments such as radiation therapy, chemotherapy, immunotherapy and a cocktail of medications, which can lead to low energy.

Beyond this, chronic pain, nausea, vomiting, appetite loss, and dehydration can leave you weak. And when you’re feeling done in by all of these illness and treatment-related symptoms, you generally don’t want or have the energy for sex.

In the cases of diabetes, rheumatoid arthritis, and lupus, medications are often prescribed that directly impact sexual function. As a result, patients can experience erectile dysfunction, decrease in orgasmic intensity, vaginal dryness, or even ulcers.

In order to accurately estimate the influence of a certain chronic disease on sexual functioning and sexual well-being, the progression of the disease must be taken into consideration. As it is, the life stage at which the chronic disease occurs determines the impact of one’s sexual well-being. Patients who are confronted with a chronic disease at an early stage in their life – before becoming sexually active – will tend to consider their disease as part of their sexual life and expectations.

However, patients confronted by the disease after becoming sexually active will have to consider the changes that come with the disease, its treatments and consequences on sexual functioning and sexual well-being.

Treatments and medications aside, a chronic disease may affect the psychological well-being of an individual in different ways. This may result in normal adaptive reactions, adaptive problems or disturbances that may in turn affect sexuality.

Chronic diseases and intimate relationships

A chronic disease may serve either as a source of relational growth or a source of stress for a couple, depending on their outlook of life. The healthy partner may, for instance, have the impression of being more of a caregiver than the partner that they are.

With the evolution in the medical sector, nowadays a major part of rehabilitation and recovery process takes place at home where the partner is the main caregiver. Also, caring for an ill partner generally means loss of personal time and freedom. This may bring up feelings of “limited life” to an individual, which can cause a drift between the couple and eventually cause serious relationship problems.

For couples where one partner has a chronic disease, they have to strive to strike a balance between togetherness and separateness. The latter is very crucial as it allows one to focus on personal activities other than caring for the sick partner.

The healthy partner may also feel connected to the patient to a point that they often believe it is better to hide feelings, emotions, desires and wishes in order to spare the sick partner. Due to this, the ill partner may end up feeling isolated, lonely and unsupported.

In addition, the fatigue that comes along with caring for the ill partner is so great that it leaves zero time to do anything as a couple. Most patients of chronic diseases admit that the diagnosis of the diseases negatively impact their sexual relationship. The diagnosis often results in cessation or reduction of sexual activities.

The increased emotional distance or decrease in trust after the diagnosis of a chronic disease can affect sexual functioning. For example, the couple may experience decreased sexual contacts caused by loss of interest in sex due to factors such as fear of causing more pain to the ill partner.

Some of these diseases end up interfering with the body image of an individual. For instance, breast cancer may lead to “mutilation” of a woman’s breast, which will tamper with her body image and consequently interfering with sexual intimacy. This “mutilation” threatens the woman’s sexual identity, making her question her attractiveness.

Diminished sexual desires in the ill partner may also be based from unfounded beliefs that having sex in such a status is dangerous because it can lead to pregnancies and cause pain.

Ways to get your groove back

Develop self-love:When our bodies or our physical abilities change because of chronic illness, it’s easy to assume we’re less attractive to romantic partners. Remember to love yourself even when you don’t feel like it amidst the pain and all.

Go with the change: Parts of your body that used to function seamlessly may not be working as well now. Don’t be afraid to switch your sex life so as to conform to the new normal. Embrace fun while at it.

Communicate, communicate and communicate some more: Don’t give in to the temptation of hiding your pain, struggles and feelings from your partner.

Talk with your doctor: If fatigue or sexual dysfunction is a major issue for you, your doctor may have a solution for that.

Remember,chronic illness can cause a lot of changes in our lives. It doesn’t mean you have to live without a fulfilling sex life.