A disability or chronic condition, whether it results in muscle weakness, pain, paralysis, or loss of sensation doesn’t necessarily have to cripple your sex life. Some impairments will directly affect your sexual functioning in a negative way, but fortunately there are treatments available. Others will indirectly affect your sexual life by throwing a monkey wrench into your usual sexual routine or messing with your head. Many will do both. As an expert on sex and disability and in my role as a sexuality educator, sexual counselor and sex coach I'm always promoting communication, creativity, and adaptive equipment as key ingredients in creating accessible sex.
• For men, talk to your doctor. Disability keeping you down? Whether the cause is neurological, vascular, or medication side effects, there are at least a handful of solutions for erectile dysfunction. These include oral medications, vacuum pumps, constriction devices (otherwise known as cock rings), penile injections, urethral suppositories, and if all else fails, surgical implants. While you’re at it, ask about the sexual side effects of the medicine you are taking and if there are any adjustments that can be safely made. If erection is your goal, no problem.
• For women, talk to your doctor. Feeling all dried up? A disability or chronic condition, or the related treatments, can interfere with vaginal lubrication and cause inflammation of vaginal tissue as a result of deterioration of the tissue. These problems can make intercourse painful and also results in vaginal itching, burning, frequent urination, or abnormal vaginal discharge. Treatments include over-the-counter vaginal lubricants applied before and during sexual activity, topical estrogen creams or tablets, estrogen releasing vaginal ring, oral estrogen (HRT), and Replens (applied daily or at other regular intervals independent of sexual activity). Also, ask about the sexual side effects of the medicine you are taking and if there are any adjustments that can be safely made.
• Schedule sexual activities when symptoms are least problematic and energy is highest. The idea of scheduled sexual activities may not seem very sexy but it can result in more and better sex. When we’re tired, fatigued, or in a lot of pain is not the best time to go for it. Morning sex or an afternoon delight should be on the menu.
• Take pain-controlling or antispasmodic medications prior to sexual activity. Timing is everything. While spontaneous sex can be great, in practice few of us have that luxury, except perhaps on vacation. As long as we’re planning, take any medication for pain or spasticity well enough in advance, approximately 30 minutes, so that the full benefits kicked in before you get physical. Taking the edge off the pain and spasticity leaves more room for pleasure.