Body Talk: Sex with a Chronic Illness

According to a recent study, nearly 60% of Americans have at least one chronic physical condition, like multiple sclerosis (MS), diabetes, colitis, asthma or arthritis. Chronic illnesses can have a range of impacts on your life. Some people need help with tasks like bathing and brushing their teeth, some people have conditions that repeat a pattern of getting better and then getting worse and some people have conditions that can be kept under control with medicine or other treatments.

If you are one of the many people dealing with a chronic illness, wherever you fall on this spectrum, you deserve a safe and happy sex life, whatever that looks like for you. 

Talk to your doctor

There may be modifications you need to make to keep sex safe for you. For example, if you have Ehlers-Danlos, a connective tissue disorder that can cause super flexible joints (yes this sounds like it would be great for sex, but it can actually cause you to dislocate joints really easily) you may need to stick to certain positions to protect your joints. Or if you have Sjogren’s Syndrome, an autoimmune disease which causes dryness, you may need to use extra lube to keep it all feeling good and avoid irritation. Sex with diabetes may involve keeping a close eye on your blood sugar, and it may involve figuring out some logistics with an insulin pump.

Whatever you’re dealing with, talk to your doctor (or visit your nearest The Right Time health center, where they stock all methods of contraception and offer free or low-cost contraception to those who need it) about how it affects sex (or doesn’t). Need help starting the conversation? You can always ask “Is there anything I should know about when it comes to having sex with this condition?” Like anyone else, if you’re having sex, you’ll need protection from STIs. Also, if you’re having the kind of sex that can lead to pregnancy, and you don’t want to get pregnant, talk to your doctor about birth control. If you have to bring it up yourself, try saying “I want to make sure I’m protected against STIs and unplanned pregnancy. What are my options for birth control?” Check out our method explorer in advance so you can think about what might work best for you and be prepared with questions. 

Talk to your partner(s)

Communication is key in every sexual encounter, from “yes, I want to have sex,” to “a little to the left,” to “I’d like to see you again.” But when you’re dealing with a chronic illness, communicating becomes even more important. There may be certain things that don’t feel good for you or don’t work for your body right now (or ever). Your partner needs to know about those. Or, if you have a medical device, like an ostomy bag or an insulin pump, you may need to educate your partner about how to work around the device.

If you have a condition that impacts your interest in sex, either because it makes you too damn tired to have sex or because it lowers your sex drive, talking openly with your partner about these things is super important for avoiding any hurt feelings and making sure everyone feels heard and understood.

Talk to a therapist (yes, we know, more talking)

When you have a chronic illness, sometimes it can feel like your body is your enemy, like it’s not your own or like it’s totally out of control. When you feel that way, it can be hard to shift into a sexy mode. You may feel a whole range of emotions towards your body, including anger, betrayal, sadness and anxiety—none of which are really great for putting you in the mood. Talking to a therapist or counselor can help you work through these feelings so that you can feel better in general and also have whatever kind of sex life you want to have.

Know that you deserve a healthy, happy, consensual sex life

This is the key. Just because you have a chronic illness doesn’t mean you don’t deserve the same healthy, happy, consensual sex life that everyone deserves. If you are having sex with someone else, let us be very clear about one thing—having sex with you is not a drag or a favor, it’s a privilege, and if anyone makes you feel otherwise, it’s time to move on from that person. You, like everyone else, have a right to ask for what you want, to say no to things that you don’t want and to be treated with respect and care.

Part of this is respecting your birth control decisions. You are entitled to ask your partner to get tested for STIs and/or to wear a condom, and you’re entitled to not have sex with them if they won’t, just like everyone else. If someone you’re having sex with doesn’t respect your needs or wishes, there are people out there who will, trust us.

Updated September 2019