Sex and Intimacy

Sexual feelings and attitudes differ amongst people, even when they do not have a physical illness.

Although changes in sex life are common after being diagnosed with a physical health condition, it does not mean everyone will experience this.  For some, a diagnosis may reduce any desire for sex, whereas for others, it may increase it. Remember that any changes in sexual relationships or intimacy may only be short term.

For those of you struggling with sexual relationships or intimacy as a result of your health, it may be helpful to know that the changes are normal. A physical health condition may impact upon your sex life both physically and emotionally. 

What is the physical impact of a physical health condition upon sex and relationships?

Living with a physical health condition may lead to a number of physical changes to your body, which may feel uncomfortable. For example:

  • Changes in sex hormone levels
  • Tiredness/Lack of energy
  • Pain
  • Sickness
  • Bladder problems
  • Changes in body image

Living with any condition and/or the side effects of treatment can be exhausting. For some people, this can result in little energy to do anything physical whether it be getting dressed, doing daily chores or having sex. It is common to lose interest in sexual activity, especially if you experience pain in your body.

Physical changes may also contribute towards the development of critical self-beliefs about your appearance and/or sexual relationship. Common beliefs may include:

“I am not attractive anymore”

“My partner won’t want to get close to me”

“I won’t be able to enjoy sex because of the pain I am experiencing”

What is the emotional impact of a physical health condition upon sex and relationships?

You may also be experiencing emotional changes and difficulties, including feelings of:

  • Sadness or hopelessness
  • Loss of sexual desire/arousal
  • Anger or frustration
  • Worry
  • Stress

Changes in emotions can vary in intensity and affect your intimate relationships. You may feel stressed, less confident or fearful which can stop you from engaging in sexual relationships with others. High levels of arousal may interrupt your body’s ability to respond – it may be that you want to have sex but unhelpful emotions get in the way. Additionally, frequent experiences of sadness and worry may spiral into depression or anxiety, which may impede upon your desire to want sex (or even think about it!).

Remember that problems with sex are very common, even for those who do not have a physical health condition. However, feeling anxious, sad or low as a result of your diagnosis may lead you to behave in ways which are not helpful in the long term, and this risks the development of a vicious cycle as shown by the example below:

Ryan was diagnosed with chronic kidney disease. He has had treatment and since then, has been struggling with engaging in intimacy. His partner often wanted to have sex with him, which triggered negative thoughts and feelings of anxiety for Ryan. He subsequently avoided spending time with his partner (both social and sexual activity), which put a strain upon his relationship and maintained feelings of sadness, and anxiety.


What can help?

Talking about the changes

It is normal to avoid communicating about sensitive and personal issues such as sex or even relationship difficulties. It is important to recognise that your partner may also be experiencing their own difficult emotions and concerns around the changes in your sexual relationship too. Talking openly about your feelings together can be highly beneficial if you feel comfortable to do so. Talking can be good for helping you to gain a sense of closeness as you both try to understand each others feelings. Being honest and clear about how you feel is vital as this will help you both work together to make your relationship stronger. Try and find a quiet time together where you can talk open and honestly about your worries. Listening to each other, problem-solving and finding solutions may even bring you closer together.

Try different approaches
If you are experiencing difficulties around intimacy with your partner or have started a new relationship, then there are plenty of things you can try to do in order to show affection, regain closeness and make sex more manageable. For example:

  • Plan time for intimacy (e.g., a time when you will feel rested)
  • Explore new ways of sharing sexual pleasure (e.g. trying different sexual positions to reduce discomfort)
  • Assume a less active role during sexual intercourse
  • Exploring non-genital areas of the body that you/your partner enjoy being touched (e.g., arms, legs).
  • Increasing the time you are intimate with your partner through cuddling, holding hands, date nights or touching each other
  • Try relaxation techniques together before sex to help arousal.
  • Share a bath or shower as this may improve muscle relaxation.
  • Use pillows for support around painful areas when possible
  • Building upon your compassionate self in order to be compassionate to your partner (see Body Image pdf for compassion focused exercises)

Remember to speak to your doctor or nurse if you have any concerns about having sex if you are undergoing any treatment.