How To Have Sex With Abdominal Pain

Key Points

• A broad range of conditions can cause abdominal pain, temporarily or for the long term, but many are gynecological.
• Regular exercise could help increase your energy levels and reduce fatigue. For another organic pain killer, try self-pleasure.
• During sex, make sure you're comfortable to relieve pressure from the abdominals. Using position pillows during sex can help.

There is one universal experience that rips the joy out of sex and transforms desire from a fantastical retreat into an exhausting trial. Its name is pain.

A specific example is abdominal pain.

However, you should know from the outset that chronic abdominal pain is not a death sentence for sexual pleasure.

What causes abdominal pain?

Any type of pain interferes with our pleasure receptors and makes it a challenge to switch on and maintain our sexual brains. However, pain radiating from our midsection—where so much of the magic happens—presents unique challenges.

"There are a number of reasons patients experience chronic abdominal pain," said Sameena Rahman, M.D., an OB-GYN in Chicago and the founder of the Center for Gynecology and Cosmetics. "Most chronic pain in the pelvis or abdomen is noncyclic in nature and can be quite debilitating for some."

A broad range of conditions can cause abdominal pain, temporarily or for the long term, but many are gynecological.

Potential causes of abdominal pain include the following:

• Adenomyosis, when cells from the lining of the uterus implant in the uterine muscle
• Chronic pelvic inflammatory disease (PID)
• Cysts in the fallopian tubes
• Endometriosis, when cells from the lining of the uterus implant elsewhere in the body
• Fibroids or noncancerous tumors of the uterus
• Recurrent ovarian cysts

Vulvar pain conditions, such as vaginismus and vulvodynia, can also trigger abdominal aches and pains.

Nongynecological causes of abdominal pain may include irritable bowel disease (IBD), which encompasses ulcerative colitis and Crohn's disease.

What is the physical and sexual impact of chronic abdominal pain?

"Chronic abdominal and pelvic pain can be absolutely debilitating," Rahman said. "Many times, due to the chronic nature of the illness, patients can lose their ability to function normally in society, including exercise and sometimes working, depending on how aggressive the pain is."

The lifestyle impacts of abdominal pain are broad-ranging, but its inconsistency makes it difficult to navigate. There may be days when pain barely interrupts daily life, but other days may include abdominal pain so severe that simple tasks are impossible.

"Chronic illness or disability can affect individual sexuality and sexual enjoyment differently and may even vary on a daily basis," said Ness Cooper, a clinical sexologist and therapist based in Norfolk, United Kingdom. "Finances can affect access to sex wellness products that may help some with certain chronic illnesses or disabilities to experience sexual pleasure easier."

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Chronic fatigue, or extreme tiredness that does not improve with rest, can interfere with physical and cognitive function, making it difficult to maintain consistency in one's work and personal life.

"Sexual pain is often associated with many of these conditions," Rahman said. "With sexual pain, sometimes patients cannot consummate relationships and lose desire and arousal in the process. Depending on the condition and length of time they have had it, they can seek multiple clinicians without any success."

How can you better navigate the side effects of abdominal pain?

The methods for managing the effects of abdominal pain are as diverse as the reasons for its existence. There's no universal fix-all, but a multitude of options exist for keeping the worst of it at bay.

The first step is getting to the root of the problem and recruiting the right medical professionals to assist, Rahman explained.

"Usually, there's a primary gynecologist who can manage it medically, and sometimes a separate minimally invasive gynecologist will perform complex surgeries if needed," she said. "There are oftentimes physical therapists that need to be on the team, occasionally for orthopedic but also for pelvic floor therapy. There are sometimes pain management or interventional pain specialists that help on the team as well, particularly if there is neuropathic/nerve-related pain that is stemming from the spine."

If you're navigating this process with a partner, communicate your needs. A partner cannot accommodate needs they don't know exist.

Regular exercise could help increase your energy levels and reduce fatigue, according to a 2006 review. For another organic pain killer, try self-pleasure. However, don't let orgasms become an automatic for pain relief. Don't let them become mechanical and lose the pleasure associated with them.

"Additionally, we know of the mind-body connection, so I often utilize both traditional therapists and counseling and sometimes sex therapists," Rahman said. "Occasionally, acupuncture or nontraditional routes are helpful."

Learning to manage long-term pain is an experience unique to every patient. It's like good sex in that it takes experimentation and taking the time to get to know a new body.

How do you revive your sex life when you have chronic abdominal pain?

With the physical and mental side effects of abdominal pain relatively under control, it's time to reignite your sex life. Don't bench sex. It's easy to let fear overwhelm you, but resist the urge to put it off.

If you're navigating this process with a partner, communicate your needs. A partner cannot accommodate needs they don't know exist. The partner dealing with chronic pain should take the lead here.

"Making sure you're comfortable can be helpful to relieve pressure from the abdominals," Cooper said. "Using position pillows during sex can also help."

Don't be afraid to rearrange during penetrative or exploratory sex to find the best positions.

"Experiment with placements from between the legs to under the small of the back. Sex doesn't have to be orgasm-focused to be enjoyable, and if abdominal pain is triggered by orgasm, taking time to learn of other forms of sexual pleasure you enjoy can be helpful," she said.

The bottom line

We all have things that take our sex drive from 100 to zero in 60 seconds, ranging from our beloved grannies popping up mid-pump to a foot cramp bursting onto the scene. Chronic abdominal pain doesn't have to be one of those things.

Speak with a doctor and strategize how to get your chronic pain under control so you can reclaim your sex life.