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8 Ways to Make Sex More Enjoyable When Your Illness Makes You Exhausted

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Editor's Note

Any medical information included is based on a personal experience. For questions or concerns regarding health, please consult a doctor or medical professional.

Certain health conditions can make it difficult to have sex for a number of reasons. For instance, some illnesses may lower your sex drive, some can cause dyspareunia (or painful intercourse), while others cause symptoms, such as fatigue, that can make sex challenging. It can be incredibly difficult to have sex (or feel up to having sex) when you’re simply just exhausted.

According to The Mighty’s Fibromyalgia Condition Guide, fatigue is sleep that doesn’t make you feel refreshed when you wake up. You won’t feel better even with 10 or more hours of sleep because you’re not getting deep sleep. Many people describe chronic fatigue as severe physical exhaustion that can make it difficult to move or function.

Chronic fatigue is different than the “normal” tiredness the average healthy person may feel, as it can be completely debilitating. It is also different than myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a separate illness with its own set of symptoms. Fatigue can happen for many reasons and is a common symptom among many chronic illnesses.

According to Dr. Rose Hartzell, marriage and family therapist and AASECT certified sex therapist of San Diego Sexual Medicine, your energy levels can absolutely impact your love life.

“Low energy can definitely impact sex drive in a negative way,” Dr. Hartzell told The Mighty. “Connecting with another human being can be the last priority when you are just trying to get through the day.”

Although chronic fatigue may introduce some challenges to your sex life, there are plenty of tools and techniques available that can make sex more achievable and enjoyable. Dr. Hartzell believes a bright sexual future is possible for anyone who is able to have sex. She said:

Enjoyable sex is always possible! What’s needed may just be some planning, creativity and reframing of what sex “should” look like. Throw away the belief that sex needs to be spontaneous in order to be good and try to plan to have intercourse at times in the day/week in which you may be less fatigued (e.g. in the morning). This may give you and your partner something to look forward to (as an enjoyable release from your chronic illness) and also may help you to pace yourself.

Dr. Hartzell also explained there are other ways of being intimate, even if sex is too much for you currently. “If you are fatigued but still want to connect, you don’t need to look at intercourse as the ‘gold standard,’” she said. “Spending five minutes deep kissing and sensually touching your partner may be just as enjoyable as intercourse, or using enhancement products (such as vibrators) to help the arousal along.”

While your doctor should be able to provide you with insight and advice on having sex with your specific health conditions, sometimes it’s also nice to hear from those who are facing similar challenges. We asked our Mighty community to share which strategies work for them when sex is difficult due to chronic fatigue. Dr. Hartzell also weighed in on how these strategies can help those with chronic illness.

We hope some of the following tips can be helpful. Of course, it’s always important to check in with your doctor first if you have any concerns about chronic fatigue, exhaustion, low sex drive or any other sexual health issue you may be experiencing.

Here’s what our community told us:

1. Use Sex Toys

“Sexual enhancement products can be a great way to facilitate sexual activity and expedite the process for someone suffering with chronic illness or fatigue,” said Dr. Hartzell. “These products can be used on both men and women and during intercourse or other types of sexual activity. I often like to refer to vibrators as the ‘hearing aid for the clitoris.’” For recommendations from our chronic illness community, check out these 15 accessible sex toys and devices that can spice up your sex life.

“Honestly, toys. If you are too tired to do a lot of the work for your partner, toys help for both sexes. There are easy ways to get them and, while they are not cheap, if you get a good one it can help you and your partner for a while.” – Paige W.

2. Rely on Your Partner

“Sex is often about ‘give and take’ and connecting to the person you love,” Dr. Hartzell said. “Don’t be afraid to sometimes be the ‘taker’ especially if you are fatigued, but still wanting to physically connect.”

“Have an understanding partner who is willing to help you when you need it. You can return the favor on a day you’re less sore/tired.” – Karla P.

“I would say an understanding partner. One that makes adjustments to your body and issues.” – Allégra H.

3. Plan Ahead

“Planning sex is often needed in our busy lives (even if you don’t have a chronic illness),” said Dr. Hartzell. “Throw away the fantasy of sex being spontaneous; it’s just not realistic. If you wait for the ‘right moment’ for sex to happen you may be waiting forever. Plan time for sexual intimacy and stick to it. This can help you to prioritize and pace yourself (e.g. this is the day to shave your legs).”

“Set aside multiple times in case you have a flare-up. That way, you have several times to choose from and can compensate for the bad times.” – Daniel P.

“It helps us if I plan time to rest before and after we are intimate. I also make sure I’m hydrated and have eaten.” – Sarah A.

4. Communicate With Your Partner

Communication and honesty are critical in any relationship. Expressing what your needs are, how you’re feeling and where your energy levels are at can help keep you and your partner on the same page, avoid miscommunication and find positions or techniques that work for both of you.

“Do not, I repeat… do NOT fake orgasm,” Dr. Hartzell warned. “Be honest with your partner regarding your desires, fantasies, etc. Your partner is not a mind reader and can only make changes based on the information you give them.”

“I feel communication is key – let your partner know your energy levels, let them know that your arms or legs are too tired or hurt and need to move. I feel slowing down can help make you enjoy it more plus not feeling self conscious if you need to move or rest your head. Having [no] glaring lighting can help and maybe a pillow or two to make you more comfortable. I also think foreplay helps you especially if you’re tired as your body knows what it wants, just might need to overcome the tired bit for a bit. Personally afterwards you may feel tired but [I believe] it’s always worth it.” – Rae A.

“Communication, communication, communication. If you or your partner are not feeling strong enough for one position, speak up about it. If you are the listener here, don’t take it personally. Listen to each other. Utilize pillows and different positions and/or locations.” – Mikki I.

“My partner and I treat sex like a conversation. I tell him how I feel, what I want, and he does the same. Due to this, he recognizes when I’m pain, tired, bored, etc. It’s nice and I don’t dread having sex on bad days.” – Mackenzie P.

5. Make Sex a Priority

Those with chronic fatigue may find that they have limited reserves of energy, and have to pick and choose which activities they “spend” their energy on. If you have a to-do list that just seems to keep growing, it may be hard to set aside a few days’ worth of energy for sex – but your relationship is important, and you deserve to “spend” some energy on some special time with your partner.

“Make sure your partner understands that using energy to have sex means taking energy away from something else in the future. This can be framed positively so instead of saying that sex will make it [where] I have a crash day tomorrow, say that time being intimate with your partner is more important than the things you were going to do tomorrow. We know the reality of choosing where our energy goes… and choosing to invest our limited energy in a person can be one of the greatest gifts we can give.” – Jenny C.

6. Use Pillows

“There are many companies that sell pillows and furniture to help facilitate sex. I often recommend the Liberator wedge,” Dr. Hartzell suggested. “This pillow can help you and your partner to position yourself in comfortable positions and help to make sex less ‘effortful’ (especially for a tired, aching body).”

“Lots of supportive pillows. I also can’t sustain a single position for too long so my husband pays attention to my signals and when it starts to be uncomfortable, we reposition.” – Nikita E.

“Creativity and problem solving skills and a ton of pillows.” – Samantha P.

7. Find a Quality Lubricant

According to the UK’s National Health Service (NHS), many health conditions – including chronic fatigue and exhaustion – can contribute to a loss of libido, or decreased sex drive. For women, this can cause issues with natural lubrication. Certain illnesses as well as medications can also lead to vaginal dryness. That means sex could potentially not only be more painful, but also require a bit more effort and foreplay. Having a quality lubricant on hand can help things go a bit more smoothly.

“Great lube. Positions that work for us both. Using our outdoor shower to warm up, relax and have good foreplay. Honesty and compromise.” – Nicole M.

8. Go at Your Own Pace

“Sex is about the journey not the destination,” Dr. Hartzell said. “Make the ‘journey’ your own as a couple (enjoy the landscape, highway eateries, etc). Take sex at the pace that the two of you enjoy and don’t worry about what other couples are doing in their relationships or what you think ‘should’ happen during sex.”

“Pacing as with anything else, positioning for comfort and a bit of preparation. Things don’t have to be awkward if you know what works best.” – Pandora P.

If you’re looking for more insight on having sex and being intimate while living with a chronic illness, check out these stories:

Originally published: April 10, 2019
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