Sexual Activity. Physical Limitations
Despite not having been advised to give up sexual activity, many people are nonetheless convinced that a physical setback is incompatible with lovemaking. A surprising number of those with a medical diagnosis are afraid to have sex or to ask for help, yet there are usually numerous ways to assist them to have sexual experiences safely and comfortably. Even people with significant spinal cord injuries and paralysis are able to be sexual, many enjoying orgasm and penetration. This isn’t to say that physical challenges are always easily overcome. It often takes perseverance and creativity.
However, the first step to making changes is to develop a positive attitude which allows you to see yourself as a sexual being and part of a sexual couple. Some people feel that it is wrong to be sexual when they are ill and that they will be judged. Often, performance anxiety and embarrassment about having to ask partners to adjust simply prevents them from being sexual at all. However, for many conditions, experimentation and expanding one’s sexual repertoire can offer numerous opportunities for sexual experiences. Health professionals are sometimes reluctant to mention sex in case patients find the conversation intrusive or the timing is wrong, but this doesn’t mean they aren’t willing and able to help.
Moreover, related charities and support organisations nearly all have information about sex on their website. Some also have helplines and specialist staff who have the knowledge and experience to advise you. Your GP or practice nurse should also know of expert organisations in your area. Some of the national support groups are listed at the end of the book . Do use them; the information in this chapter is only intended as a first step to encourage you to seek and obtain the professional medical support you need.
Sexual Activity. Fertility
The ovaries contain millions of follicles, some of which ripen into eggs during each menstrual cycle. The eventual release of one or more eggs can cause some irritation or disturbance to the ovary and surrounding area, which causes the discomfort. Sometimes ovulation is also accompanied by light bleeding or spotting. In the absence of bleeding, you will probably notice that vaginal discharge is clear and stretchy, indicating this is a fertile time. If you are unlucky enough to have fertility problems, the disappointment as each month goes by can, in itself, strain the relationship. Subsequent infertility treatment can put almost unbearable pressure on even the most loving couple.
Sex can easily become a mechanical chore, dictated by ovulation and associated with temperature-taking and record-keeping. IVF is especially arduous and those outside the relationship – friends, family and work colleagues – may have no idea what you’re both going through. Support may, therefore, be hard to come by and you may find it increasingly difficult to support each other. It may be no help at all to know that more than a quarter of pregnancies don’t end with a live baby when everywhere you look there seem to be healthy babies and children.
Indeed, contraception and unwanted pregnancy can create years of practical and emotional challenges – then you find yourself immersed in trying to become pregnant and, if you’re lucky, adjusting to having a baby. The more comfortable you are with physical and emotional intimacy before attempting pregnancy, the more readily you may be able to make it work for you subsequently. Regularly kissing and cuddling without sexual intent is a wonderful habit to ensure you continue physical connection and closeness even when sex isn’t possible.
Maintaining intimacy is important to your overall well-being as well as keeping the focus on you as a couple and not entirely on baby-making. Similarly, thinking about holidays and breaks to look forward to before you begin the process of making babies or investigating infertility means you will make time for your relationship as well as for trying to become pregnant. Sufficient leisure and time off from any treatment or tests also helps relieve stress and promotes your health and well-being as individuals and as a couple, putting you in the best shape to conceive.
Pregnancy And Sexual Activity
Once over the early nausea, you may find pregnancy is a very active time for you sexually, especially as some pregnant women find it easier to orgasm (though some also find it more difficult). As the bump grows, side-by-side intercourse is often more comfortable. Another comfy position may be lying at the end of the bed, knees up, supported by pillows if necessary, with your partner kneeling in front of you.
Nausea and fatigue put some women off sex in the early weeks of pregnancy. It is perfectly safe to continue intercourse throughout pregnancy unless you experience any heavy bleeding, once your waters have broken or as advised by your midwife or doctor. Until then, it can be a bonding and relaxing experience which cannot harm your baby. Indeed, once you reach full term, your midwife may suggest sexual arousal and orgasm as a way to induce or accelerate labour. Sex won’t cause premature labour, however.
Sexual Activity After Pregnancy
Sex once your baby arrives may seem like a scary prospect, especially if you have stitches. Your breasts may feel sore and be leaking milk, making it uncomfortable to hug your partner or even consider sex. Furthermore, arousal can encourage the breasts to leak, or they may start to feel hard and sore. Lots of cautious cuddles until any bleeding stops, your breasts feel more comfortable and any stitches heal will allow you to gradually consider lovemaking once again. Then very gentle, tentative sex may feel more possible.
If you are considering intercourse, make sure you are well lubricated and aroused before penetration is attempted. You may choose to use additional water-based lubrication for reassurance, but women often find intercourse after a baby is much more comfortable than they had feared. Any lingering pain from stitches or tears usually fades during the coming months; it is worth having any pain or discomfort medically checked though, if only for the assurance that all is as it should be.
Musculoskeletal Disorders And Sexual Activity
Unsurprisingly, joint pain significantly influences sexual behavior in those affected by both rheumatoid and osteoarthritis. As well as physical difficulty, including limited mobility and stiffness, associated fatigue and depression appears to affect libido. Recent studies have shown that people with arthritic pain are among the least likely to seek or take up help to continue or resume sexual activity. This may happen because both partners have chronic conditions and their energy is taken up with coping. By the time you feel these are managed well, and you feel more like being sexual, you may think the moment has passed, but help should continue to be available, however old you are or however long your condition has continued.
Back Pain And Sexual Activity
Understandably, chronic back pain can have an extremely negative effect on sexual relationships. This is not just due to the limitations imposed by pain but because partners are often frightened of causing more discomfort, which may occur powerfully and suddenly during intercourse. Also, partners may be willing participants but then suffer pain and stiffness for days afterwards. Experimentation and planning, taking analgesia before intercourse and resting afterwards can all help. Moreover, some people report that sexual activity actually improves their pain and overall sense of well-being.
Adequate back support and positioning for intercourse are significant in preventing post-coital pain. Frequent changes of position are helpful, as is the use of pillows or a foam wedge to improve back support. Some men like to sit in a chair, which supports their back well, with their partner straddling them during penetration. Arranging your bodies at right angles in an L shape can also relieve back pressure. Some men find standing for rear entry more comfortable than sitting or lying. Women may prefer a position where they can lean forward over pillows. Another possibility is lying side by side with the man behind the woman (spooning). Leaving thrusting to your partner may also be helpful.
Cancer And Sexual Activity
A cancer diagnosis is clearly a devastating blow for any couple and sex may be the last thing on your mind. Nevertheless, couples who are supportive of each other and able to maintain some form of intimacy during treatment often report fewer relationship and general health problems subsequently. A supportive partner is enormously important in easing issues with body image, which are so common following surgery. Any surgery affecting the reproductive organs, genitals or breasts clearly has the potential to affect sexuality and feelings about masculinity or femininity, as can hair loss. Though you may feel anything but sexy during treatment, and nausea can be a barrier to closeness, warm hugs and kisses may be appreciated by you both when you feel up to touch. Don’t worry if that doesn’t happen immediately; you need to feel comfortable and shouldn’t put yourself under pressure.
You may not feel up to it before the treatment, but it can be helpful to have some sort of a plan to manage physical closeness following surgery, even if the plan changes. For instance, you might decide to initially wear a top in bed following breast surgery, both to protect the wound and allow you time to adjust. If this was the agreement, neither of you will feel so hurt if it is what one of you wants. If your partner is frightened of doing some harm, and so avoids sex and cuddles after surgery, you may need to initiate some physical closeness yourself. Otherwise, you could both carry on walking on eggshells indefinitely. A prior agreement that you will dictate the pace of physical intimacy may assist with this.
Sometimes, a cancer diagnosis actually brings couples closer. Indeed, three-quarters of respondents in some surveys say this is the case. However, about half admit to developing sexual issues. Avoidance of sex may simply be due to extreme fatigue, especially while having radiotherapy. Some sexual problems are also caused by chemotherapy, including off-putting nausea, thrush, vaginal irritation or dryness and mouth ulcers. Premature menopause following some treatments can be an issue for women, who may be treated with testosterone to restore libido. Hair loss, weight gain or loss and sore skin can add to self-consciousness and threaten feelings of attractiveness – but be reassured that they do pass. The earlier you seek advice about any remaining physical issues and help with sexual and relationship difficulties, the more likely they are to be successfully resolved. Many hospitals have specialist nurses who are used to tackling sexual issues, as do many charities, so it’s worth speaking to them when you are ready. Expecting to experience some of these effects means you may be pleasantly surprised if they don’t appear and not taken by surprise if they do. Taking opportunities to discuss your experience can be helpful; some hospitals have specialist groups where you can meet others in a similar situation and there are numerous online forums. Individuals and couples who have been through cancer already often have excellent advice and are proof that you are not alone in what you are going through.
Cardiovascular Disease And Sexual Activity
Having had a heart attack is no bar to sex. Following a heart attack, however, apparently three-quarters of us decrease or cease sexual activity, usually due to fear of another attack. Chest pain and breathlessness caused by any exercise should always be investigated, but advice is usually that gentle exercise, including sexual activity, can be gradually resumed. Indeed, daily exercise is encouraged after cardiac surgery and doctors often advise that intercourse is fine so long as you can walk up a couple of flights of stairs without undue breathlessness or any chest pain. Nevertheless, men should be aware that medication for the heart condition and accompanying vascular disease can both cause erectile difficulties. Sometimes, the first sign of cardiovascular disease can be erectile problems, so it is always worth seeking medical advice as soon as possible.
If you or your partner are fearful that sex could put too much strain on your heart, resume sexual activity slowly, starting with deep kissing and gradually increasing sexual touch and activity to orgasm. Monitoring breathlessness and pain will demonstrate what is possible and you should gradually be reassured that sex can remain a part of your life.
Prostate Conditions And Sexual Activity
The prostate is a small gland, about the size of a walnut, which lies below the bladder, surrounding the urethra, in men only. It secretes a whitish fluid, which contributes to most of the semen. This protects the sperm and enables them to move. Stimulation of the prostate via the rectum, either with the fingers, a vibrator or through anal intercourse, can result in orgasm.
A number of conditions can affect the prostate. It sometimes enlarges as men age and can cause pressure on the urethra as a result. It is also the site of one of the most common cancers in men.
Prostate Cancer And Sexual Activity
Most of the symptoms of prostate cancer involve urinary abnormalities, but erectile problems may also be caused. Because symptoms are so similar to those caused by benign prostate conditions, it is always worth having any urinary or genital symptoms checked as soon as possible. A variety of different treatments are available for prostate cancer, depending on the type of tumour and its size. Some treatments are more radical than others and may cause sexual problems, but your surgeon will be able to explain the possible side effects and potential treatments in advance. Removal of the prostate is a common procedure to treat both cancer and a benign enlarged prostate which is causing unpleasant symptoms, such as frequent weeing during the night or a poor stream. Some operations remove the semen-producing organs with the prostate, which leads to dry ejaculation. A different operation may cause you to ejaculate backwards into the bladder, so that the semen is passed when you next wee.
If you are a man who enjoys anal stimulation or penetration, you may find that the sensations you experience will change without your prostate gland. Difficulties with erection, early ejaculation and orgasm may be temporary or lasting, but there are ways of managing the problems you may encounter, both medical and psychological. Though it can be several months before the extent of any problems is apparent, as they may improve alone, this is not a reason to avoid intimacy if you feel like being physically close or making love. Indeed, the more you behave sexually the more able you will be to determine what has changed and what problems are improving. Experimentation is important – don’t be afraid you could cause damage once initial healing has occurred. Some of the exercises to retrain your erection and manage ejaculation and orgasm in the chapter on sexual dysfunctions can be used to help you resume sexual activity. A positive, can-do attitude may be half the battle in finding ways to enjoy satisfying sexual experiences.
The Relate Guide To Sex And Intimacy
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