How to communicate during sex when you are in pain

Q: how do I bring up pain I’m in without making my partner feel bad or guilty even when it’s not their fault? usually, it’s fine just to mention it and try something different, but I feel like I’m ruining the vibe and end up downplaying the pain I’m experiencing.



A: I totally understand where you’re coming from and I do have a few suggestions! First, if you have not done this already, have a conversation with your partner in a non-sexual setting about your pain in general. Like what triggers pain, what you do to cope/help with your pain, what can your partner do to help (if there even is anything they can do) etc. Let your partner ask questions, so they can learn how best to support you. In terms of when you are having sex - a safe word is an excellent way to quickly inform your partner you need to stop or take a break. It is some times easier to just say one word/gesture than explain exactly what you are feeling in the moment. You don’t have to even explain what happened after you have stopped- you and your partner can just shift into aftercare mode or just take a break. You can also have something similar to a safe word/gesture that will quickly communicate that you need to try something else or that you are in pain without feeling like you are overexplaining/ruining the mood. If you do all these things, you will probably feel less hesitant to express when you are in pain and less likely to downplay your own pain. Remember that sex is all about pleasure - I am sure you’re partner wouldn’t want you to secretly be miserable during sex just because you don’t feel like you can communicate what your feeling.

Trauma and Sex

Q: “ (cw childhood sexual assault mention)


Hi, I have CFS/ME and fibromyalgia, but I also have chronic vaginal neuropathic pain following a not so successful genital upcycling surgery five years ago (I'm trans). I also have a csa history and consequent C-PTSD. I definitely have a sexuality but I'm afraid to express it in company, because I don't know how to work with fear of physical pain from being touched. Do you have any suggestions/recommendations for how to work with stuff like this? It's ruined a number of relationships over the years, and made me functionally asexual with others.”
A: Thanks for your question. I would suggest playing with sex that does not involve your genitals. That could mean making out, exploring the many other erogenous zones of your body, massage (which is also great for your fibromyalgia), using toys on your partner or your self (in areas that feel pleasurable -which could be anything from your nipples, neck, back of your knees, feet, etc! Everyones different).






In terms of your fatigue, telling your partner exactly how to get themselves off is a great way to be intimately involved without physically exerting yourself. You still have the control and can lie next to your partner while they are having fun. Also talking to your partners about how you need to take it slow is a good idea. You don’t have to go into why you need time to become comfortable, or why you might need to stop sometimes, but just explain that this is a part of being with you. There are many different ways one can have sex and feel intimate with their partner, so just keep an open mind, have patience, and communicate!

Chronic Fatigue and Surgeries & Maintaining Sexual Intimacy in a Relationship

Q: “My partner and I haven’t had sex for a long time - months, maybe even 6 months to a year because of all of my recent surgeries and chronic fatigue. How can I make sure we are meeting each other’s needs, even when I feel horrible?”




A: Thanks for the question. I have a few ideas. Mutual masturbation is a good way to get off but you don’t have to exert a lot of energy. If you don’t have the energy or ability to get off yourself, you can instruct your partner exactly how you want them to get themselves off. This way you are exerting less energy but are still involved. Talking dirty is also a great low energy way to still connect with your partner and make them feel sexy. You don’t even need to act on what you say to them. Lastly, talk to your partner and explain how you feel. Ask them what they need to feel fulfilled and maybe brainstorm together more creative ways to create sexual intimacy.

How do I support my girlfriend when she is talking to me about her depression?

Q: “My girlfriend has depression and I have rheumatoid arthritis, vitamin deficiencies, and symptoms of Hashimoto's and hypothyroidism (need further evaluation, high likelihood though, parents and grandparents have it). Whenever I talk about my physical struggles, she either doesn’t say anything and listens while she holds my hand, or says the most perfect things. I feel good talking about it with her and she just so darn good with words I feel better and understood. What she does is enough and I am so so so thankful to have her. Whenever she talks about her depression, I get quiet and uncomfortable. I’m uncomfortable because I don’t know what to say her. I do listen and let her talk and make sure I’m not talking over her, but I want to say something back to her. Sometimes I’m really really trying to listen but I get too into my own head about what I’m going to say to her and I feel guilty for not listening. I want her to know that I am there for her. I want to say more things other than “I love you,” “that sucks,” “I’m sorry,” “i don’t know what to say,” “I’m glad you’re getting the help you need” “oh.” What other things can I say and how do I feel less uncomfortable when she talks about depression?”




A: Thanks for such a good question. I have a few suggestions. I would say to have a talk with your girlfriend when she is feeling okay about what she would like you to do to make her feel more supported. You can even say that you want to say and do more when she is struggling with depression, but you don’t always know what to say. Also saying that your quietness does not mean you are uninterested or not wanting to talk about her depression will help. Discussing how perfectly she supports you and voicing that you want to do the same for her might be a good way to open up this conversation. I can not give you other things to say to help her feel better because everyone is different and depression doesn’t work like that. But hopefully just having this conversation will give you a better idea of what would make her feel supported when she needs it. You don’t have to overthink saying the right thing all the time, sometimes just being there and showing that you are physically and emotionally present and not freak out by her struggles will make her feel comfortable just voicing these things to you. I would also recommend doing your own research on what exactly depression is, because there are a lot of misconceptions, and many people will take other people’s depression personally or think they need to somehow “fix it”. But having this conversation, doing your own research, and just simply being there for your partner can make a huge difference. You sound like such a caring person that she will definitely appreciate this conversation.