Navigating Intimacy with Chronic Pelvic Pain

When sex and intimacy feel difficult, it can be distressing, confusing, and even painful. I know how important, and often complicated, these parts of our lives can be.

Chronic pelvic pain can cause or contribute to these challenges. As someone who lives with endometriosis, I understand firsthand how pelvic pain can affect our connection to pleasure, intimacy, and our bodies. I also know that I’m not alone. Whether you have endometriosis, irritable bowel syndrome, pelvic floor dysfunction, or another condition that causes pelvic pain, I want you to know that fulfilling and pleasurable sexual experiences are still possible.

In this blog post, we’ll explore some of the conditions that can lead to chronic pelvic pain, how that pain can impact sexual and intimate experiences, and share tips for reconnecting with intimacy and pleasure.

What Is Chronic Pelvic Pain?

Chronic pelvic pain describes the experience of ongoing pain in the lower abdomen (below your belly button) or pelvic area that lasts for six months or longer. While it can affect anyone, it’s experienced most by people with a uterus.

The pain may be constant or come and go, but it’s often present or most significant during sexual activity (arousal, insertion, and/or orgasm), menstruation, urination, and bowel movements. Certain postures or positions may also exacerbate the pain. Beyond physical pain and discomfort, mood, sleep, relationships, and overall quality of life can also be impacted.

Conditions Commonly Linked to Chronic Pelvic Pain:

Endometriosis

A condition where tissue that normally lines the inside of the uterus grows outside of it; often on the ovaries, fallopian tubes, bowels, or other organs in the pelvic region. This overgrowth of tissue can lead to inflammation, scarring, and pain, especially during menstruation, sexual activity, or bowel movements.

Irritable Bowel Syndrome

A gastrointestinal condition that affects the stomach and intestines, often causing abdominal cramping, bloating, gas, and changes in bowel movements. The pain and discomfort experienced by people with irritable bowel syndrome usually extends to the pelvic region, which can complicate or contribute to chronic pelvic pain.

Pelvic Floor Dysfunction

Occurs when one is unable to relax and coordinate their pelvic floor muscles. These muscles support organs like the bladder, bowel, and uterus. When they’re too tight, weak, or uncoordinated, it can lead to pain and difficulty during sex, urination, or bowel movements, and a feeling of heaviness or pressure in the pelvis.

Other gastrointestinal issues, pelvic inflammatory disease, uterine fibroids, and vulvodynia are just a few more examples of conditions that can contribute to pain or discomfort in the pelvic region. If you’re living with persistent pelvic pain that’s affecting your quality of life, connecting with a trusted healthcare provider may be an important step toward understanding what’s going on and getting the care you deserve.

How Chronic Pain Can Affect Sex and Intimacy

Chronic pain, no matter the location or cause, can deeply affect our experiences of sex and intimacy. When pain is frequent or ongoing, it can make physical closeness feel uncomfortable or overwhelming, leading to tension, avoidance, or fear around sexual activity. 

We know that chronic pain can impact mood, but it can also affect energy and self-esteem, which may shift how connected we feel to ourselves and our partner(s). It’s very normal to experience frustration, sadness, or guilt when intimacy feels complicated by pain. 

Reconnecting with Intimacy and Pleasure

Intimacy may look or feel different than it once did, but it doesn’t mean that pleasure is off the table. With curiosity and self-compassion, it’s possible to find ways to connect that feel good and honour your body. Below are five tips to help you get started.

1. Prioritize Communication

Open and honest communication is a powerful tool when you’re navigating intimacy with chronic pain. Sharing what you’re feeling, both physically and emotionally, can foster a deeper connection and understanding between you and your partner(s). It may feel vulnerable, but expressing yourself and your needs can deepen trust and lay the foundation for more pleasurable experiences. You deserve to be heard and your needs matter.

2. Experiment With Touch

We often have clear ideas about what intimacy should look like, especially in long-term relationships, but veering off the script can be exciting. Experimenting with different kinds of touch, exploring new parts of the body or erogenous zones, and incorporating tools like a feather or massage oils can provide pleasure while honouring your body’s limits. When you approach touch and sensuality with curiosity, you may find new ways to be intimate that feel good for both you and your partner(s).

3. Focus on What Feels Good, Not What “Should”

Just like we might hold expectations around what intimacy should look like, it’s easy to get caught up in beliefs about what should feel good during sex. When you’re living with pain, tuning into what feels good is more important than meeting or managing expectations. Letting go of norms can open space for more authentic and enjoyable intimate moments with yourself and your partner(s). Whether it’s through exploring unconventional positions, incorporating props or toys for added comfort, or prioritizing different forms of connection, your pleasure is uniquely yours.

4. Practice Mindfulness

Chronic pain can often cause feelings of fear or frustration, pulling us out of the present moment. Gently noticing your thoughts, emotions, and bodily sensations without judgment can help to stay grounded during intimate moments. Mindfulness practices like breathwork, body scans, or other forms of sensory awareness can help you reconnect with yourself, tune into your body’s needs, and create a greater sense of safety and grounding during moments of pain.

5. Seek Support

Navigating intimacy with chronic pain can feel isolating at times, but you don’t have to go through it alone. Support is available. Connecting with a professional who understands your pain can be a significant source of healing. At New Moon Psychotherapy, we’re here to support you in exploring your relationship with pain, sex, and self-compassion. Together, we can gently navigate what intimacy looks like for you, centring approaches that feel in tune with your body and is needs, rather than against it.