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🧠 Sexual Functioning Among Adults with Chronic Pain
A
recent study of 247 adults living with chronic pain found that over
70% of those who were sexually active reported difficulties in at least one area of sexual functioning.
👨⚕️ For individuals who identified as men, the most common issues were reduced sexual interest and overall dissatisfaction with their sex lives.
👩⚕️ For individuals who identified as women, challenges were more strongly linked to broader health impacts — including low sexual interest, dissatisfaction, and increased vaginal discomfort, which were closely associated with higher pain intensity, depressive symptoms, and anxiety.
🤔 Interestingly, among male participants, these issues weren’t significantly tied to pain or mood — which raises questions about possible stigma or underreporting.
🔑 Key takeaway: Picture a room of 10 people living with chronic pain. Statistically, 7 of them may be navigating sexual health challenges — silently. Unless we create space for these conversations, they often go unspoken.
Shifting How we ask About Intimacy
There are many thoughtful, respectful ways to bring up sexual health with patients — especially when pain is part of the picture.
Instead of asking, “Are you sexually active?” — which may feel overly clinical, assumptive, or even shut people down — consider these more open options:
💬 “Has your pain affected any aspects of your intimate or romantic relationships?”
💬 “Are there parts of your connection with others — physical or emotional — that have changed since the pain started?”
💬 “Sometimes pain can affect things like closeness, confidence, or intimacy. Has that been part of your experience?”
These approaches can gently open the door, reduce shame, and signal to the patient that you’re comfortable having the conversation — and that they can be too.
Why is Sexual Health Still Taboo in Pain Care?
We talk about sleep, stress, mental health, and exercise — but intimacy still feels off-limits.
Let’s flip that. Think about these questions:
- What language do you use to explore this?
- Have you found ways to integrate it into your assessments or treatment plans?
📚 Resources Worth Sharing — For You and Your Clients
Pain, intimacy, and sexuality can be incredibly hard for clients to talk about — but having the right resource can open the door. Check out this excellent, client-friendly factsheet from Pain BC:
It’s practical, compassionate, and written in a way that normalizes the challenges people face when pain impacts connection.
💡 Pro tip: Scroll to the bottom — there’s a great list of additional resources for clients, partners, and care providers.
And if you’re looking for a deeper dive as a clinician…
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This is a good read for anyone working in persistent pain, pelvic health, or mental health. Nagoski breaks down the science of desire, context, and arousal — showing how pain, stress, trauma, and cultural messaging all shape sexual experience.
One of her big ideas? The
dual-control model of arousal — where the brain has both an accelerator and a brake. Skip to 2:22 of the video to learn more.
“Lack of interest isn’t a problem to be fixed — it’s information. It means the brakes are on. And that’s your body protecting you.”
— Emily Nagoski, Come As You Are
This idea hits hard when working with people in persistent pain. Their nervous system is often doing its job — sensing threat, avoiding discomfort, pulling the brakes.
✨ Our role isn’t always to push the gas — it’s also to help restore a sense of safety, reduce fear, and shift context so desire can return naturally.
Stay nerdy,
