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|Newsletters: Exploring Sexual Matters|
Exploring Sexual Matters
Audrey Kron, MA, CGP
I’m planning on getting married soon, and I’m concerned that my condition might affect my sexual life. Can someone with a chronic illness have a normal sex life? What kinds of sexual problems might I encounter? —B.L.
Congratulations on your upcoming marriage. I’m glad that you asked about the sexual implications of chronic illness. People find this is a difficult area to talk about, and there is often needless misunderstanding because of the lack of communication.
The simple answer to your question is that, usually, chronic illness does not prevent us from having a very satisfactory sex life. But, there are possible problem areas that could cause you or others some concern in the future:
The general symptoms of your illness:
Pain, fatigue, nausea, dizziness, poor motor control, diarrhea, incontinence, etc., can impede your sex life. However, often there are ways to get around these symptoms. First, talk to your doctor. Sometimes relieving symptoms may be as easy as changing medicines.
Then, communicate with your spouse or partner and together, find ways to modify your sexual activities to accommodate your illness. You may have to find different positions or different times. It might work out better if you could plan to use the time of the day when you are feeling best. Paul Pearsall in his book Super Marital Sex gives this practical advice, “If it hurts, check out why. If it can’t be helped, try something else.” As a last resort you might check with your doctor to see if you can take a pain pill or other medication that will enable you to participate more comfortably in sexual activities.
With good communication and some advance planning, many problems can be overcome. Some find that sex can divert attention away from the symptoms, but the way you handle these symptoms is also very important. Love, caring, and sexuality can be expressed in many ways besides intercourse. You know how. Sometimes, you just forget.
The psychological impact of the illness:
This can include depression, altered sense of identity, body image changes, loss of job, and role changes within the family and society. Certainly sexual relations are strained when you feel depressed or concerned about your body image, your role in the family, or your work. What happens in these areas will have impact in the bedroom. It’s important to involve your partner with your concerns because he or she, too, will have feelings about what’s going on. Spouses may be concerned that they are going to cause you to be sicker, or that they may harm you in some way. Others feel selfish that they have needs as well. Communication, again, is the key word. How you look, how you speak, how you act, and, most of all, how you care, can contribute to your sexual attractiveness.
The physical changes from the illness:
Some fear that they will be unattractive or rejected if they gain weight as a result of medication or experience other bodily changes. Others feel less attractive because of a catheter, tube, ostomy or even surgical scar. These fears may in turn accompany a fear of abandonment. Bodily changes need not interfere with sexual activity. I can’t repeat enough that a person who loves you won’t be bothered by physical changes. Why would you bother with a person who doesn’t love you? Other physical changes may make actual intercourse impossible in some cases. Here, again, is where your imagination can help you to find ways to satisfy your sexual needs. There are many parts of our bodies that can give sexual gratification. If you have questions about this, consider some reading. (A list of suggested books is included in Appendix Two of Meeting the Challenge: Living with Chronic Illness.)
The specific fears from chronic illness, tubes and ostomies:
Some fear that sexual activity will provoke symptoms, or that one’s sex life cannot be resumed. Some fear that sex will make the illness worse, or dislodge their catheter or tube. Some fear pregnancy. In all cases, it is important to get the proper information, and to discuss these concerns with your doctor. Also, consult your doctor about any prescribed medications that could affect your sex drive.
Another less serious, but more embarrassing problem, is the possibility of having a symptom flare up or a tube or ostomy leak during intercourse. True, this can be embarrassing, but one has to remember that your partner loves you and will be greatly influenced by your reaction. How you handle the situation makes a great deal of difference. You can get hysterical and hate your body and lower your self-image; or you can look at it as unfortunate, but something that happened. Your doctor may be able to prescribe medication or make some suggestions that can make you feel more secure during intimate times.
The specific fears about sex in general:
There are all kinds of concerns about sex, with or without illness. These concerns have to be dealt with as they normally would. You have to work on them, or, if you run into an impasse, you should seek professional help.
In all situations, it’s important to focus on the potential, not the limitations. Realize that sex is expressed in many ways. Think of the whole person rather than just the genitals. Flexibility, communication, education, understanding, and humor are all important. Above all, you should try to do what you can to improve any difficulties in your sexual relationship. Never abandon the idea that you can do something to enrich this important aspect of your life.Ask Audrey columns come from Ask Audrey: The Author’s Personal and Professional Experience with the Day-to Day Living with Inflammatory Bowel Disease and Meeting the Challenge: Living with Chronic Illness. Both books feature Audrey’s story of living many years with Inflammatory Bowel Disease and her expertise as a medical psychotherapist. To order copies of the books, call (248) 626-6960;,fax (248) 626-1379, e-mail shrinkA@aol.com, or 7466 Pebble Lane, West Bloomfield, MI 48322; or visit www.chronicillness.com. If you mention the Oley Foundation, we will receive a $2.00 rebate for each book you purchase.