My wife and I have been married for 15 years. About five years ago, she was diagnosed with MS. Her legs feel as if they have pins and needles all the time and she has severe discomfort or pain if she is touched below the waist. Obviously, this has dampened her sex drive, and she is no longer interested in any sexual contact. We haven’t had sex, and have had almost no intimate contact, for two years. I love her fiercely, but the complete lack of physical intimacy is wearing me down.
People living with chronic illness face a number of sexual challenges. Sometimes there are physiological barriers to sexual function, and this can only be determined by her doctor. But even if there are physiological reasons why she cannot enjoy sex in the same way she did before her illness, there are often ways to alter sexual style to adapt to her new situation – if she wishes. Some of these accommodations might include focusing on finding more comfortable positions for intercourse, trying oral or manual stimulation, erotic conversation, role-playing or massage, and timing love-making to take place when pain is well controlled by medication or other methods.
Many people with physical challenges manage to have highly satisfying sex lives through their willingness to try new methods. But the ability to be sexual is also reliant on a person’s psychological state. It is common for people with MS or other chronic conditions to feel undesirable or unlovable, and despair that they can never be a good partner. She may feel despondent about becoming more reliant on you, and this, too, can affect sexual desire. Self-esteem, body image and depression can be important factors as well, often reducing sexual interest in people with or without physical disabilities. Talk with her gently about her feelings regarding all of this, find therapeutic help and seek education. And know that – with willingness – intimacy is possible.
• Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.
• If you would like advice from Pamela Stephenson Connolly on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Submissions are subject to our terms and conditions: see gu.com/letters-terms
