Chronic Pain and Sexual Well-Being: Finding Positivity Despite Challenges

Chronic Pain and Sexual Well-Being: Finding Positivity Despite Challenges

Chronic pain, defined as pain lasting more than three months, affects one in five adults worldwide and often disrupts daily life and emotional well-being. It’s also linked to sexual well-being (SWB), a crucial part of quality of life. While past research has focused mostly on the effect of chronic pain on narrow aspects of sexual function (like arousal), a new study explored broader aspects of SWB, including sexual satisfaction, self-esteem, and motivation.

For the study, researchers surveyed people in relationships who live with chronic pain, examining how pain characteristics (e.g., severity, emotional distress, partner support) influence SWB. They recruited participants aged 18 and older from Facebook groups and Reddit forums focused on chronic pain. The final sample included 310 participants, mostly women, aged 21–50, who had experienced chronic pain for an average of 6.4 years and were in relationships lasting about 6.7 years. Common pain conditions were fibromyalgia (34.5%) and musculoskeletal pain (32.6%).

Participants completed an online survey after providing informed consent. They reported on their pain experiences, sexual well-being, and treatments like physical therapy (57.1%) and medication (57.4%). The results highlighted the complex interplay between chronic pain and sexual well-being, with diagnosed individuals generally experiencing more severe pain but greater perceived partner support.

People with chronic pain often maintain an active sexual life, engaging in various genital sexual activities weekly. Most reported moderate satisfaction, medium-to-high sexual self-esteem, and moderate sexual interest, though 27.7% experienced difficulties like orgasm challenges, low sexual desire, or genital pain. Distress about sexual function was common, especially among those with difficulties, as 72.1% in this group reported distress compared to 34.4% without difficulties.

Pain significantly impacted sexual well-being. Greater pain severity, disability, and emotional distress were linked to lower satisfaction, reduced self-esteem, and more frequent genital pain. Conversely, partner support positively influenced satisfaction and self-esteem, and participants who felt in control of their pain reported higher satisfaction and self-esteem. These findings underscore the importance of adaptive coping mechanisms.

Interestingly, sexual difficulties were less common in this study’s participants compared to the general population, but those who experienced difficulties were more likely to feel distressed. Participants also reported moderate-to-high levels of sexual satisfaction, self-esteem, and interest in sexual activity, though less frequent than the general population. These findings challenge the belief that chronic pain always leads to severe sexual difficulties and distress.

The study suggests that non-medical approaches like psychological therapies (e.g., Acceptance and Commitment Therapy) and couple-based interventions can improve SWB by addressing pain acceptance and fostering adaptive coping strategies. However, limitations include a less diverse sample and potential self-selection bias. The findings emphasize the need for a biopsychosocial approach to better understand and support SWB in people with chronic pain, showing that pain does not inevitably end a fulfilling sex life.


References:

  • Santos-Iglesias, P., Estey, J. L., Crump, L., LaChapelle, D. L., & Byers, E. S. (2024). It’s not all that bad: Associations among pain characteristics and sexual well-being in people living with chronic pain. The Journal of Sexual Medicine, 21(12), 1159–1168. https://doi.org/10.1093/jsxmed/qdae120
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