What Are The Barriers To Sex?

Paul Karoly
Aaron Taylor, and I conducted a study of over 2,000 people with different forms of chronic pain from across the United States and found that 63%reported that pain interfered with sexual functioning. Other researchers have found similar results; some studies show that people with pain may simply give up sex altogether. I have listed some of the barriers to sex among people with chronic pain.  Do any of them apply to you?

  • sexual activity sometimes increases pain
  • the person with pain may fear that sex will increase pain or cause injury
  • the partner may fear hurting the person with pain
  • the person with pain may not have enough energy for sex
  • pain may reduce the desire for sex
  • the person with pain may feel unattractive, old, or weak – and not sexy
  • the person with pain may be able to do certain kinds of sexual activities, but not others, and may not know how to talk about this with his/her partner

Sexual problems are most easily resolved when the couple can talk openly about issues, concerns, needs, preferences, and emotions. This is sometimes difficult. Sex is such a sensitive topic for most people that it may be hard to even bring up the topic. It can be difficult to talk about sex because of fears of being criticized or rejected, embarrassment, worries that you aren’t “normal”, feelings of anger or anxiety, worries about who is to blame, or insecurity. If this sounds familiar, you and your partner may benefit from taking a closer look at your sex life – at what is working and what isn’t.

The first step: approach your partner with a request to talk about your sex life.Your request should be straightforward. Try something like this: “I feel that my pain problem may be interfering with our sex life. I would like to talk with you about it. How about tonight after the kids go to bed or tomorrow afternoon while the kids are at soccer?”

Another approach is to print out a copy of this blog and two copies of our Talking About Sex Form – one for you and one for your partner. Give your partner the copy of the blog and the form. The form will help you both to organize your thoughts before you talk. Some people find it helpful to begin the conversation by talking about why it is difficult to talk about sex.

If you are comfortable talking with your partner about sexual issues, you may move right into discussing barriers and possible solutions. Remember that this first conversation is a just a beginning. Keep it short, positive, and focused on making the future better.

Many couples find that opening the door for discussion leads to improvement and greater sexual satisfaction for both; and a closer relationship makes coping with pain easier too.  However, your discussions about sex may lead you to the conclusion that you would benefit by seeing a sex therapist.  You can search for certified sex therapists in your area through the American Board of Sexology or the American Association of Sexuality Educators, Counselors, and Therapists.


About the Author. Dr. Linda Ruehlman is a social/health psychologist and researcher, co-founder of Goalistics, and director of the Chronic Pain Management Program, an interactive site that helps people with chronic pain to manage their pain and live richer, more effective lives as well as Think Clearly about Depression, a self-management program for depression.

DISCLAIMER: This blog is provided as an educational and informational resource only. It is not intended nor implied to be a substitute for professional psychological or medical advice.

PainPathways Magazine

PainPathways Magazine

PainPathways is the first, only and ultimate pain magazine. First published in spring 2008, PainPathways is the culmination of the vision of Richard L. Rauck, MD, to provide a shared resource for people living with and caring for others in pain. This quarterly resource not only provides in-depth information on current treatments, therapies and research studies but also connects people who live with pain, both personally and professionally.

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