Sex & long-term health conditions

Often, people with long-term health conditions experience difficulty with their sexual relationships.

This can be due to:

fear of injury or pain
worry about being unable to perform because of difficulty getting an erection or vaginal dryness
concern about causing a health emergency such as a stroke or heart attack
fear of increasing symptoms such as shortness of breath, coughing or wheezing or fatigue
negative feelings or thoughts about one's body or self.

Long-term health conditions do not need to end sex. Through good communication and planning, you can have satisfying sex. By being creative and willing to experiment, both the sex and the relationship can get better.

Guidelines for improving your sex life

Communication with your partner is most important.
- Confront your fears and worries by talking about them and problem solving together. You might find the list of practical solutions below good to talk through. Learning new positions and ways to increase sensuality are not going to be enough without talking with each other.
- Talk about what kinds of physical stimulation you prefer, and which positions you find most comfortable.
- Share your fantasies.
Spend more time on sensuality, fantasy or foreplay and less time on intercourse.
Make your intimate time last longer or be more pleasurable by concentrating on ways to arouse your partner and give pleasure while in a comfortable position.
Practice and patience are key to learning new skills.
If some of the self-management techniques suggested below aren't enough, talk to your general practice team, a therapist or a counsellor.
If you decide that sexual activity isn't that important to you, it's important you talk about this with your partner.

Practical tips

Exercise

Exercise can help your sex life. Walking, swimming and biking can help to reduce shortness of breath, fatigue and pain and improve your activity tolerance. Do some warm-up exercises before sex.

Fantasy

Use fantasy that you can share with your partner in bed. Become an expert at fantasy by learning some sexual fantasies and practising them several times a week. Then you can call up your fantasy and concentrate on this during sex to distract you from pain, other symptoms or negative thoughts during sex.

Medication

Take your medication so that its peak effectiveness is when you're ready to have sex. Some medication can cause sexual difficulties, so talk to your general practice team or pharmacist about timing or alternative medication if this may be a problem.

Mental health

If mental health issues interfere with your sexual function and desire, talk to your general practice team. Individual or couples counselling may help with non-medication related personal relationship, intimacy and sexual problems.

Plan

Fatigue can really get in the way of sexual desire. Plan your sexual activities around your fatigue, when you're less tired. This may mean mornings are better than evenings.

Lubricants can help with sensitive or dry genital areas.

Vibrators can be helpful for people with neuropathy (nerve damage), and concentrating on the most sensual parts of the body for stimulation can help make sex pleasurable.

Positioning

Finding a comfortable position can minimise symptoms during sex.
Experimentation is the best way to find the right position for you and your partner. Experiment with different positions before you and your partner are too aroused, and try using placement of pillows or using a seated position in a chair.
Change positions regularly so you do not get sore or stiff.

Sensuality

Connect with your partner through sensual sex – making love not only with your eyes, but with your nose, ears, mouth and hands.
Sensual touch is especially important because our skin is the largest sensual organ in the body, rich with sensory nerves.
You can enhance sexual stimulation with the use of oils, flavoured lotions, scents, feathers, fur gloves – whatever the imagination desires.
Experiment with different types of touch: firm, light, with different body parts or even sex toys.

Slow down

Just as in any other physical activity, pace yourself. Stopping to rest is okay. Take it slow and easy, relax and enjoy extended foreplay.

HealthInfo recommends the following pages

Healthify He Puna Wairoa – Sex and cancer
A page about how having cancer can affect physical intimacy.

Written by a private occupational therapist, Canterbury. Adapted by HealthInfo clinical advisers. Page created May 2023.

Sources

Page reference: 1144254

Review key: HISLT-1144254