Fibromyalgia and sexual dysfunction

Sexual dysfunction, including pain during and after sex, vaginal dryness, inability to achieve or maintain arousal, and inability to orgasm, is common among women with fibromyalgia.

More than 85% of women with fibromyalgia report one or more issues relating to sexual dysfunction (while only about 15% of healthy women report the same).

Why is this?

Sexual dysfunction can take on many forms. Studies examining sexual dysfunction in in women with fibromyalgia have found that women with fibromyalgia are more likely to experience:

• Lack of sexual interest or desire
• Decreased sexual arousal
• Pain during or after sex
• Difficulty achieving orgasm
• Decreased lubrication
• Difficulty reaching orgasm
• Increased vaginal tightness with penetration
• Lack of sexual satisfaction

There are many factors that play into these issues. Some of these factors are purely physiological, while some may have intermingled psychological factors, such as depression, anxiety, or relationship problems.

Add in co-morbid conditions including endometriosis, vulvodynia, and the general chronic pain that comes with fibromyalgia and you have a perfect storm of sexual dysfunction.

There have been many studies on this topic looking at the correlation between fibromyalgia and sexual dysfunction with different studies looking at different factors.

While some studies have looked specifically at the pain factors, others have focused more on sexual interest and ability achieving orgasm.

A 2009 review of five previous studies found that those with Fibromyalgia were more likely to report decreased sexual functioning, increased vaginal tightening, and decreased vaginal dryness, all in all leading to decreased sex.

Fibromyalgia and sexual relationships

In one study, included in this review, 71% of the women interviewed (out of 60 total) reported that fibromyalgia had put a strain on their sexual relationship.

78% of the women in the same study reported that fibromyalgia had affected their ability to “make love.”

Unfortunately, what can start off as a purely physical issue can become a psychological issue. The problem may begin with pain.

For many of us with fibromyalgia simply being touched hurts. This can seriously affect intimacy (both sexual and non).

That pain can then create anxiety that can cause even more pain as well as psychological distress that can make it virtually impossible to become aroused.

I’m happy to report that as my fibromyalgia symptoms have decreased so has the pain I have experienced with sex.

Unfortunately, I also have endometriosis, a common co-morbid condition with fibromyalgia. This can cause pain with sex and vaginal dryness.

Sometimes even when I’m not really experiencing vaginal dryness things still feel dry.

Other times, my vagina just feels tighter or shorter than normal leading to pain during intercourse. This usually will work itself out during the course of sex, or through a change in position.

An involved partner does not equal sexual satisfaction

Interestingly, one study found that while having an involved, loving spouse increases relationship satisfaction, it can decrease sexual satisfaction.

When the spouse tries to engage the chronically ill partner in discussions about their illness and constructive problem-solving this decreases sexual satisfaction for the ill spouse.

Thinking back, this makes sense to me and probably will to you as well, even though on the surface it seems counter-intuitive.

When my ex-husband would try to solve my health problems I often felt as though I was being questioned, as if I wasn’t doing enough.

When those discussions involved sex I felt as if I was being put on the defensive and that the discussion wasn’t about what I was experiencing or needing, but rather about what he was needing and missing.

In my experience, intimacy problems are not often easily resolved through constructive problem-solving, but rather through loving kindness and both partners attempting to put themselves in the other’s shoes.

Related: What chronic illness does to a marriage

What factors increase sexual dysfunction in fibromyalgia?

A 2017 study by Hayta & Mert looked at the potential risk factors that might increase sexual dysfunction in women with fibromyalgia.

When comparing women with fibromyalgia to healthy controls they found that over 84% of women with fibromyalgia were likely to experience sexual dysfunction compared to just over 15% of the healthy women. That’s a pretty huge difference.

A few of the factors that they found more likely to contribute to increased sexual dysfunction in fibromyalgia include:

• Duration and severity of fibromyalgia
• Duration of sexual partnership
• Severity of anxiety

As expected the longer the duration and the worse the severity of the fibromyalgia the more likely there would be sexual dysfunction.

Sexual dysfunction is negatively correlated to the duration of the sexual partnership, meaning that the longer the relationship the less likely there will be sexual dysfunction (and the opposite as well).

Related: How chronic pain affects sex in new relationships

Increased anxiety also corresponds to increased sexual dysfunction. Interestingly, the severity of pain, nor the severity of depression were linked to the sexual dysfunction.

I’ve talked to many women with fibromyalgia and it’s rare to hear from one who tells me that their sex life hasn’t been impacted by the chronic pain they endure.

However, what this seems to say is that sexual dysfunction isn’t so much directly related to fibromyalgia, but possibly moreso to anxiety and other relationship issues that may be involved in the relationship.

And, it’s likely that the stress of chronic illness has created stress within the relationship that increases that anxiety and causes other problems in the relationship that may also negatively effect sexual involvement.

What can you do to resolve sexual dysfunction with fibromyalgia?

If the factors that are causing sexual dysfunction are primarily psychological and related to your relationship health, the only thing you can do is try to resolve those.

Seek a good marriage counselor, preferably one that works with people with chronic illness so that they understand the unique challenges that entails.

However, it’s likely that the factors are not just psychological. Chances are that there are physical factors playing a role as well. Do your best to rule those out and / or deal with them.

If you experience pelvic pain seek out a good pelvic pain specialist who can examine you for other potential causes and treat those that you may have. It’s possible that pelvic floor physical therapy could relieve the muscle tightness and pain.

Don’t be afraid to try new ways and means of intimacy. If you suffer from vaginal dryness use lube. If you need extra help getting aroused try a vibrator. If pain prohibits touch, find other ways to maintain intimacy.

Related:

• How chronic pain affects sex in new relationships
• Fibromyalgia and sex: the unspoken reality
• The impact of chronic illness on marriage

Sources:

Hayta, E., & Mert, D. G. (2017). Potential Risk Factors Increasing the Severity of Sexual Dysfunction in Women with Fibromyalgia. Sexuality and Disability, 35(2), 147-155.

Kalichman, L. (2009). Association between fibromyalgia and sexual dysfunction in women. Clinical rheumatology, 28(4), 365-369.

Kayhan, F., Küçük, A., Satan, Y., İlgün, E., Arslan, Ş., & İlik, F. (2016). Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia. Neuropsychiatric disease and treatment, 12, 349.