Do you (or someone you love) have a chronic illness that is affecting sexual health? Sexual health is a key component of overall well-being and life satisfaction. Nothing magnifies one’s sense of sexual health (or lack thereof) more than chronic illness. Sex remains an important value in patients with chronic illness and their partners. Although the primary goal is obviously to stay alive and achieve a reasonable quality of life, much energy gets used up trying to maintain (or salvage) one’s sexual function and satisfaction. Or even worse, some people close the door on their sexuality for good. There are many hormonal, surgical, pharmacological, medical, and psychological interventions available to improve sexual function. Chronic illness and sexual health can live side by side.

Society is uncomfortable with the notion that people who are ill or disabled might still want, or have, sex. While sexual activity may be placed on hold as other aspects of living with chronic illness intervene, sex remains an important part of life for men and women with chronic illness.

Illness Causes Sexual Worry

Most of my clients with medically-induced sexual dysfunction are keenly aware that their partners’ sexual needs are not being met. They worry that their partner may be unfaithful, no longer find them physically attractive, be afraid of hurting them, be afraid of “catching” their illness, or “write them off” as a sexual partner. If they do not already have a partner, they worry they will never find one.

Illness Affects our Sexual Self Esteem

A client of mine with cancer told me she feels “contaminated and toxic” and does not want her husband to be exposed to her “poison.” A male client told me he had not had sex since his heart attack 17 years earlier! Yes, I said 17 years! He said he was afraid he would have a heart attack and die if he did. He had occasionally masturbated during the 17 years, but, was afraid that the physical exertion of sex would kill him.

As it turned out, there was much more going on than just his fear of death during sex. Once we began discussing all aspects of his sexual history and marital history, it became clear that dynamics with his wife were perpetuating his avoidance of sex. After 7 sessions, he and his wife were having intercourse again.

Another client with Fibromyalgia and Rheumatoid Arthritis told me that her range of movement is so limited that she can’t find a single sexual position that is comfortable. Even missionary style sex is difficult for her to endure. She “takes one for the team” about once every 4 or 6 weeks, but she gets no pleasure out of it. She is preoccupied with the fear that her husband will cheat on her with someone who can be “fun in bed.” She longs for the days when she was game for anything and enjoyed having sex anywhere, anytime. Just because chronically ill patients may need to accommodate for changes in function, mobility, and response; it doesn’t mean they can’t celebrate their sexuality.

Clients Blame Themselves for Sexual Problems

Clients with chronic illness sometimes feel silly or embarrassed to bring up sex with their partners. They feel like they should be focusing on getting well. Because they feel betrayed by their bodies, sometimes clients feel they don’t “deserve” sex. “Sex is for healthy people,” one of my clients told me. “I have Diabetes, high blood pressure, high cholesterol—and I’m morbidly obese. I can barely walk. My penis doesn’t work and it’s my own damn fault!”

One of my clients needed surgery for prostate cancer. As a result of his surgery, he lost some penile length and could no longer provide adequate stimulation for his wife during intercourse. When he ejaculated, his semen was mixed with urine. He was extremely self conscious about this and said “I’m not going to pee inside my wife.” Even with a condom on, he was unwilling to have sex. Over time, he came to appreciate that the Cancer hadn’t killed him. Eventually, he and his wife resumed sexual activity.

Will My Body Ever Work Again?

Some clients worry that their sexual function may never return. They worry they will never enjoy sex again. They worry they will lose mobility. They worry they will be infertile. They worry about a lot of things. Physically ill individuals are sexual beings. Their sexuality is certainly affected by their illness, but it is not rendered invisible. Humor, determination, and creativity go a long way toward reclaiming sexual health when dealing with a chronic illness.

Ignored by Doctors

Another problem for chronically ill clients is that sexual dysfunctions are under-detected and minimized in the doctor’s office. Physicians are not typically savvy when it comes to discussing sexual health concerns with patients, especially patients that are elderly, chronically ill or disabled. Patients must advocate for their sexual health needs and initiate conversations with their health care providers about sexual concerns. There are treatment options out there. If you have a chronic illness that is affecting your sexual health and satisfaction, please contact me. I can help you achieve your optimal sexual health and satisfaction.

Kimberly Resnick Anderson


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