I've just started seeing a new woman for the first time in two years. I have fibromyalgia and terrible, often disabling chronic pain. I have had some S/M play and oral sex with her, and we had intercourse one time. But even with one of the major erectile dysfunction (ED) meds, I still couldn't keep an erection for more than a few minutes, and I definitely couldn't have an orgasm! The next day, and for the next 4 days, I hurt like hell! There was no flogging or bondage—just CBT and nipple twists. My legs, arms, and back hurt so bad, I thought I was gonna die! My doctors don't know WTF to do with me. Pain meds are so far the only answer—that and getting massage and acupuncture.
How can I not screw up this new relationship? She is INCREDIBLY understanding, which kicks ass! I do need to have my testosterone checked, as I have read that taking the opiates I am prescribed for pain can lower a guy's levels and contribute to ED. Not being able to come sucks, too! The thing is, when I masturbate alone, I can come. No pressure to please anybody else, right? I just need some suggestions on how to make sex and play a bit easier so I won't hurt so much! What is safe for somebody like me to do? Also, I just feel bad about the 'typical guy shit' like erections and orgasms. The cool thing about the other night was that she was all about pleasing me and then letting me go down on her, which really wore me out! I definitely couldn't get my cock hard again, much less come. There has got to be a happy medium. Help!
In Your Head
Hurt So Bad
My deepest sympathies! My partner has fibromyalgia, and I know how unpleasant it can be. Chronic pain, being tired all the time—it wears you out.
Chronic pain causes a lot of stress for the body, and stress can cause erection difficulties. Plus, stress (from whatever cause) can increase the pain of fibromyalgia, so it’s a really unfortunate cycle. I can’t tell from your question whether you’ve explored these options, but for some people, managing diet, reducing overall life stress, getting enough sleep, yoga, gentle exercise, biofeedback, and meditation can be helpful in lowering the level of stimulation to below your pain threshold. If you haven’t looked into these approaches, you might find them helpful. Also, for some folks with fibromyalgia, massage can actually make it worse, so I recommend finding a bodyworker who’s familiar with fibro rather than someone who’s just skilled at massage.
A lot of doctors don’t know what to do about fibromyalgia, so they often prescribe pain meds. There’s evidence that fibro affects the neural pathways, so pain meds may not work since they focus on a different part of the body. Think of it like trying to fix your phone when the problem is in the wires. For some people, Norepinephrine Serotonin Reuptake Inhibitors (NSRI's) can be helpful. I’m not a medical doctor, so get professional advice, but you might want to look into these as an alternative to pain meds. Since they address the nervous system directly, they can have a positive impact on fibromyalgia. And a lot of people find that medical marijuana helps, although you’d need to make sure that it’s compatible with whatever other meds you take.
As far as making sex more enjoyable, there are some different ways you can go. Try soaking in a warm bath before sex. The heat can decrease muscle stiffness and pain, while the support of the water can help your body relax. It’s also really helpful if you can let go of the idea of spontaneous sex. When dealing with fibro, you’ll probably do better if you plan ahead. Make sure that you have a relaxing day in order to keep your stress level to a minimum. Or have sex in the morning, before the hassles of the day wear you out.
Another helpful approach is to widen your definition of sex. If it feels good, then it counts whether you have an erection or not. Sensual massage, oral sex, prostate play, vibrators—do whatever feels good and brings you and this lovely woman together. The more goal-oriented you are, the more likely it is that you’ll just get in the way. The more you can let go of the goal, the less stress you’ll be under and (ironically) the more likely you are to have fun sex.
You could also try using pillows to create support so your muscles can relax. I like the Liberator Wedge because it’s firmer than a regular pillow and the machine-washable cover makes it easy to take care of. Or for oral sex on her, have her lie on her back with her hips at the edge of the bed. You can sit on a chair and go down on her without hurting your neck. Whatever you can do to keep your body as relaxed as possible will reduce your pain and make sex more fun.
Since you’re able to enjoy masturbation, how about a little solo sex while she kisses, massages, or strokes you with her hands, hair, and breasts?
While fibromyalgia can be really challenging, please don’t get discouraged. There are lots of great websites, blogs, and online community groups where you can get support, ideas, information, and community. One of the challenges of fibro is that it’s an invisible issue, and a lot of people simply don’t understand it. Building some support networks can often make a big difference. There are also lots of good books about fibromyalgia. The more you know, the easier it’ll be, so check some of them out and see if any of them are helpful for you.
Charlie GlickmanDr. Charlie Glickman has been working at Good Vibrations since 1996, when he joined the staff at the Berkeley store. Currently, he is the Education Program Manager and (among other things) runs the in-store After Hours workshop program, the Off-Site Sex Education Program, trains the Sex Educator-Sales Associates and writes copy for the website. In 2005, Charlie received his doctorate in Adult Sexuality Education from the Union Institute and University in Cincinnati, Ohio. In addition, he offers classes on sexuality for psychotherapists and workshops on teaching for sex educators.
Sorry to hear your chronic pain is so severe. As you're no doubt aware, this is a tricky condition because we don't really know what causes it—fibromyalgia, chronic fatigue syndrome, autoimmune reactions, psychosomatic illness, and chronic Lyme disease have all been blamed—or how best to treat it. In fact, an interesting study just out in Science magazine found that 67% of people with chronic fatigue & pain symptoms—but only 4% of those without—carried a retrovirus known as xenotropic murine leukemia virus-related virus, or XMRV for short, suggesting it may be treatable with drugs like those used for HIV.
It sounds like you're taking appropriate steps to manage the pain, combining prescription meds and therapies like acupuncture. In addition, many people swear by medical cannabis. A lot of people with chronic pain and disabilities find BDSM therapeutic, using it as a way to "own" their pain and deal with it on their own terms. But nipple and cock-and-ball play shouldn't cause days of agony in unrelated body parts.
It's hard to say what would be "easier," as that depends on a lot of individual factors. Are specific areas of your body more prone to pain than others? Do certain positions hurt more? Is repetitive motion a problem? Does sex hurt less when you're well rested? The best approach may be to try out different things and see what works best for you. Experimenting is probably safe as long as you stop if something feels wrong—most people can tell the difference between "hurts so good" and "this is damaging my body."
Checking your testosterone is also a good idea. Many men have low testosterone levels, especially as they get older, which can lead to low sex drive, lack of energy, and depression. But there are other potential causes of erectile difficulty, and the fact that you do fine when you're alone suggests you've already pinpointed the problem. Why not try masturbating while she watches? If that's successful, have her give you a hand, and go on from there.
Lucky for you, it sounds like your new girlfriend understands your pain issues and is willing to help you work around them. There are a lot of options you can explore together, and as you get more comfortable with each other, it's a good bet your anxiety about performing will subside.
Liz HighleymanLiz Highleyman is a San Francisco-based freelance journalist and medical writer who has written extensively on HIV, sexual health, queer politics, censorship, the sex industry, and the history of sex and sexuality. She is currently senior staff writer for HIVandHepatitis.com. Her work has appeared in numerous publications, including Bay Area Reporter, POZ, Drummer, and most recently Smash the Church, Smash the State!: The Early Years of Gay Liberation. She attended Harvard School of Public Health and is a certified Emergency Medical Technician.
So you've got some chronic pain and body complications, and the new woman you're dating is incredibly understanding of this. To my understanding, there are unfortunately no real solutions to your pain, as is the case with many chronic pain illnesses, but you've found out how to manage this with pain meds, massage, and acupuncture. I'm sorry to hear about your condition. I have known some folks who have struggled with chronic pain, and it sounds horrible, though it seems like you've been dealing with this for a while and understand your condition a bit, which is good. It also seems that this woman you're dating is interested in you AND accepting of who you are and what you are dealing with, which is fantastic.
Everybody's got some body issues to deal with when we start revealing ourselves intimately to another person—you've just got a very particular set. It sounds like you're pretty submissive, based on your description of CBT (aka cock & ball torture, which is what I assume you mean, and not cognitive behavioral therapy which is what I first assumed), which is part of why this is a challenge. And it sounds like the pain isn't so much coming from what you're doing at the time, but by how your body reacts in the following days. Your body will do what your body needs to do—I'm not sure if there's a way to make the recovery any less painful. As you play with her more, perhaps you can observe the ways that the play and the painful recovery time are related, and do more of the things that are easier for you to heal from and less of the things that are hard to heal from.
You say you've only had sex one time so far, so I'd like to challenge you on your definition of sex here. I assume you mean you've only been hard enough to fuck her once, and that ED issues have gotten in the way. What about using your fingers, or your mouth? What about buying a dildo? I know that's not quite the same, but there are lots of other ways to fuck, and you can play with making your sex life even more about serving her, if that's the kind of thing you're into (and I get the impression you might be).
You also might want to think about what it means to be submissive with this woman. You mention things that are physically painful, but are there ways to submit that don't involve masochism? Could you get down on your hands and knees for her? Say embarrassing things? Let her order you around verbally? Do things for her that you wouldn't usually do that are challenging but hot? There are ways to submit and ways to play with power dynamics that don't involve pain.
It's also possible, though, that the pain is part of what you actually like about this dynamic—somewhere in your subconscious. Perhaps if you take the pain dynamic out of the play, it wouldn't be as interesting. Ask yourself if this is related to the chronic pain you deal with, and if perhaps there might be a way you can find some healing in your pain through your masochism. (You also might want to take a look at Radical Acceptance: Embracing Your Life With the Heart of a Buddha by Tara Brach, a book on accepting the complicated things in your life.)
I don't know a lot about ED, so I can't really speak to that. I'll let my other panelists give you some suggestions on how to stay hard. In my limited knowledge, part of ED is mental, so it is also possible that as this relationship builds and grows, you'll be more confident and more able to be vulnerable with her.
Sex gets better as you know somebody better. If this woman is as good for you and to you as your letter implies, don't let this issue get in the way of what you're building together. Be honest and open about the pain it causes you, keep her updated, and brainstorm ways to make this easier on yourself. Take good care of your body and listen to what it's telling you. But listen to what your sexual self needs too, and listen to what this fabulous woman needs. Somewhere in the middle there is a space of overlap.