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    Sex and Intimacy in Fibromyalgia, Part 1
    Mark Pellegrino, MD posted:
    Fibromyalgia and its chronic pain can affect sex and intimacy FM affects everything else, so why shouldn't it cause unique problems with sex and intimacy as well? FM introduces new fears, concerns and anxieties into a relationship and we must understand them and address them.

    First, understanding the unique problems FM causes with sex:

    1. Pain. The physiological equivalent of a cold shower! We hurt all over and any pressure or weight or squeezing aggravates the pain. Sex is not supposed to hurt.

    2. Fatigue. No energy = less sexually active. Mental fatigue = decreased motivation = loss of libido = less sexually active. The person with FM may go to bed several hours before the partner and be asleep by the time the partner gets into bed. It is difficult to have successful sexual intimacy when one person is asleep! Since sleep is so valuable and so short-lived for many with fibro, any deep sleep will be more desired than sex, esp. at 11:30 pm!

    3. Associated conditions. IBS can cause nausea, abdominal pains and more bowel alertness than sexual alertness. Depression can cause additional loss of libido, interest, and motivation. Anxiety can interfere with sexual responses. Poor self esteem can lead to lack of interest or embarrassment.

    4. Medicine side effects. SSRI's can decrease libido or cause sexual dysfunctions, including ED in men. Muscle relaxers, tricyclics, and antiseizure meds can cause extreme sedation. Different meds can cause nausea or GI symptoms and shift the focus from the bedroom to the bathroom.

    So with so much "negative stuff" going on with fibro, how do we possibly figure out a way to enjoy sex? We focus on the positives of sex rather than the problems. We reassure ourselves that intimacy is good for you, your relationship, and your fibro. Sex can be therapetic. Let's count the ways.......

    1. It is a physical activity. Isn't physical activity good for fibro?!

    2. It increases our body's endorphins

    3. It improves blood flow, removes toxins from cells, and boosts our immune system.

    4. It results in stretching and then relaxation of our muscles.

    5. It reduces stress.

    6. It re-connects us emotionally and intimately

    7. Usually we forget about pain during sexual intimacy!

    We should reassure ourselves that we are not hurting ourselves by being intimate; rather we are helping both the fibro and the relationship. Your partner is also dealing with fears and anxieties about hurting you, so you both need to be reassured about the positive aspects of being intimate

    So once we understand, we can address. That's for Part 2. Feel free to comment on Part 1. But keep your comments C-rated (community-rated)!

    Dr. P

    Click here to read Sex and Intimacy in FM: Part 2
    dollbug responded:
    Hello Dr P.....comments? I think you perhaps covered it all....

    Thanks for always....

    Take care..

    IN GOD WE TRUST....MAY GOD BLESS AND GUIDE AMERICA.... My personal exchanges are Vitamin D and Pain and Wrath of the Dragon....if you care to visit..
    pnaturegirl responded:
    Good for you doc!!

    Yes, I think you covered it great doc!

    Not that right now I have to worry about it, Yes that in of itself is depressing, Ha!!

    When I was in a relationship awhile back, I was shocked at how the very act of intimacy brought out so much more fatigue!!

    In the moment, Yes you forget everything, That wonderful world of distraction as a earlier in a more G rated post I shared about.

    Man, Afterwards though, It was exhaustion as I felt like I ran around the block several times!

    As in anything worth anything in life as they say, Sometimes being extra tired out can be worth it, If not for a brief spell your mind was happy and pain not the focus, Right?

    Oh, Those days seem so long ago now but again if your not clicking with the right person, It does not mean much afterwards.

    There was time, It was worth it all but right now, No one special and not worth it to me at this point in my life!

    Omg, I have said enough for a chapter! LOL...

    Take Care,
    Check out my facebook page called, This Crazy Thing Called Pots My new Exchange on WebMd called, Pots and Dysautonomia Exchange and you can always find me here on FM Exchange or through my email!
    cali824 responded:
    DR P
    first how can i find the first post i sent about pain during sex?

    there is no way i can not focus on the pain during sex i try so hard to enjoy it. between the back pain and the feeling of being stabbed by my husband i cant. we have tried everything. we have luck after i go to the hospital and pharmacy. hes sweet and is trying to understand and always tells me to tell him if i hurt but i feel horrible, we are young and it shouldnt be like this what can we do

    i just saw something on dr oz about vulvodynia do u know anything about this?
    xoxo -Cali
    BEACHAHOLIC responded:
    Hi Dr. P
    The issue I have is if I am capable of watering my plants my husband thinks I am capable of that...

    My issue as a nurse/caretaker is that I am married to someone withou any compassion.....and since that is my middle name I need to add I don't have it in me anymore......

    Do you know where I am coming from??? If you aren't understanding my is that something to celebrate togetherness in love....

    I just feel like that is shallow....He is someone that thinks you can wish things away.....We should all be that trust me if I have a PULSE he thinks I am capable....So sad!!!!

    I guess I just thought God gave everyone compassion......

    Oh well it's hard for me to remove that from the equation....Ya know what I mean?

    Gentle Hugs,
    pocotaz responded:
    Dr. P,

    I have tried to "block" out the pain during intercourse... but my legs hurt real bad..different position and it hurts inside..different position and i am feeling crushed in the arms and chest an can't it is very frustrating to not be able to enjoy ...

    I know it's surposed to do all the things you've mentioned but it doesn't... i dread it..and feel so bad about disappointing my husband...

    I also get no...and i mean NO feeling in the woman area at all... but pain... i have not had a "completion" in a very long time and can not figure out how to get there either...due to the pain our intimacy is i am not getting any satifaction what--so --ever---.

    Now...i have talked to my PCP about this...and get so upset that there is no advice other than her saying to me.." Well, you are in peri-menapause" ..that's life...

    That's Life...yeah ...

    This area of our lives is affected TEN FOLD and it hurts me to see my husband of only 5 yrs. think i don't love him because i shy away from being intimate....

    Why do some Docotrs just shrug it off... this is not a funny situation to be in at affects our mates tremendously... and their emotions are all over the place... It is surposed to be an addtion to our relationship...not something we want to run away from...

    I'm sorry ..but no one seems to want to help... i am hurting deeply inside because of this one issue.. this is the only thing in my marriage that is the biggest problem...

    Please help us with ideas..i can not take pain meds... what do i do to make the pain disappear? What do i do to get feeling in the woman area? What do WE do?

    Thanks for letting me vent....Linda
    pocotaz replied to pocotaz's response:
    I needed to add..I have underactive Thyroid..which i take synthroid for..i am 47 yrs. old and going through peri-menapause..and FM... Gerd.. Osteoarthritis...

    I know all of this can affect me Physically... but it's the emotional..that is in a downer frame of mind...

    alispazz responded:
    What a topic!!!!!

    the prude in me just reared its ugly head....but it is okay....we are all adults....SO I guess I will comment...

    I am lucky, I have a husband who is not pushy and has never made me feel guilty...That in its self is the #1 thing....I never have to hear about a man's need....He is a jewel....

    We were at least 2 yrs without it....I was like the rest to much pain... One of the big things for us is that I always take top, then I can control the pressure.and the pain..and if it get to be to much....well we stop and that is that....cant say we have stopped more than a couple of times.

    We also tried different products that moisten and heighten, the female response. You can buy most of them in wal=-mart and figure out which one works the best.

    Don't put it on a time table....That is just nuts...our body is not able to go there...just go when the mood strikes....and enjoy.
    Follow your heart and not your dreams..the dreams are from your mind and can lead you astray, the heart never can..SMOLOL Hugs Ali
    Mark Pellegrino, MD replied to cali824's response:
    Hi Cali,

    Here is your post

    Vulvodynia is indeed an associated condition that can affect some women with FM and interfere with sexual activity. I'll be discussing this furthur and talk about overall strategies when I get a chance in the next few days.

    Dr. P
    FrancesMary52 responded:
    Dr. P. If I'm not getting any, should I seek out this activity for health reasons?
    MagPrincess replied to FrancesMary52's response:
    Frances Mary! You are so Funny!!!

    DH came up behind me last night and said so what is this your new excuse?

    It took us awhile to find a position that works for both of us but with all the family issues lately it just hasn't happened. Plus the shots. Don't feel up to it for a few days afterwards either.
    Erin Given the choice between the experience of pain and nothing, I would choose pain. William Faulkner
    Mark Pellegrino, MD replied to FrancesMary52's response:
    LOL. Funny one FrancesMary!!!

    You're giving proactive health care a new meaning!
    doxiesmom replied to BEACHAHOLIC's response:
    I too am married to a husband who thinks this is all a bunch of BS...I show him articles, etc., but as you said, as long as I have a pulse...this has been going on for so long for me and sometimes I just don't think I can stand it any more. I also have spinal stuff going on, so that just compounds the FM and CF. I will continue to monitor this site, as I am new to it, although why, I'm not sure...I have been the pain management route and have had a couple of bad experiences with the docs. I am scared to go back to anyone, so i just try to suffer through it.
    anyway thanks for letting me let off some steam.
    Anjl26 replied to doxiesmom's response:
    Doxiesmom and Beachaholic... you are talking more about the relationship side of this than the actual physical one. If your spouse isn't supportive, compassionate as well as passionate, then being intimate wouldn't be on anyone's priority list (even without adding FM to the mix).

    Dh and I are lacking in this area too. There are many reasons for that, not just my FM. (Dh has his own health issues to contend with.) I guess that's why it hasn't been a bigger issue in our marriage as we both have problems which affect intimacy.
    Being happy doesn't mean everything's perfect. It means you decide to see beyond the imperfections. hugs Sharon
    cybil53 replied to pocotaz's response:
    Hi Linda,
    Has your doctor ever mentioned you may have pelvic floor disfunction? I also have fibro, osteo arthritis, Hypothyroid among many other problems and just thought it was so painful because of my age and fibro. I went to a urologist for my Interstitual Cystits and he told me I also have PFD. I have started physical therapy and I have to say it is helping. I also do at home therapy with a tens machine, stretching and dialators. I was at the point it was too painful to even try anymore and of course that was causing a huge problem in my marriage.

    My therapist said many people with fibro have PFD because of the constant pain we are in. That muscle just tightens up and doesn't relax, also if you have had surgeries in that area you need to massage the scars to loosen the scar tissue. Do a google search and read about it see if it sounds like what you are going through. My progress is slow but I do feel like I am making some progress. The therapy is pretty uncomfortable but if it will help in the end it is worth it. We will always have the challenge of trying to have a healthy sex life because of our fibro so whatever we can share to help each other is crucial.

    Hope this information helps you or someone else. Take Care!

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