Sex can be an important part of a relationship, but all too often people with disabilities such as Fibromyalgia (FMS) and chronic fatigue syndrome believe they have to severely limit their sexual activity, or even give it up altogether.

Either pain or fatigue may be enough to make someone fear or avoid sexual activity. When you have the Fibromyalgia symptom of allodynia (pain from gentle touch) or the ME/CFS symptom of post-exertional malaise (exhaustion from moderate activity), sex can seem impossible.

However, with open communication, experimentation, and forethought, you may be able to reclaim your sex life.

Obstacles to Sexual Activity

Pain and fatigue may be serious obstacles, but they're certainly not the only ones we face with Fibromyalgia.

Self Image

It can be difficult to feel sexy when you don't feel good about yourself. Chronic illness can take a big toll on your self-esteem. You may feel flawed, broken and inadequate as if you no longer have anything to offer. You may also be feeling guilty about the things you can no longer do.

Illness can cause weight gain as well, which may compound the problem. Being unable to put a lot of effort into your appearance doesn't help either.

Strained Relationships

It's often difficult for our significant others to come to turns with our illness and the changes it inflicts upon our lives. Sadly, some of them have trouble believing that we truly are sick and not just "being lazy" or "trying to get attention."

This is a factor that can work in a couple of different ways. A drop in sexual activity may strain the relationship, or strain on a relationship can cause a drop in sexual activity.

Brain Chemistry

The neurotransmitter dysregulation of FMS may sap your motivation and interest in a multitude of things, including sex.

Depression

Depression is common in chronic illness, and even more so for these conditions. It can lower your sex drive, as can many of the medications for it.

Sexual Dysfunction

Antidepressants such as SSRIs and SNRIs can cause sexual dysfunction. These drugs are frequently prescribed for Fibromyalgia even if depression isn't present because they work on neurotransmitters that are believed to be dysregulated in these illnesses.

Sexual dysfunction may also result from Fibromyalgia, according to research. However, we don't yet know much about it other than that it exists, so further research is needed into why.

Overlapping Conditions

Other illnesses including vulvodynia (pain in the vulva) or interstitial cystitis (pain in the bladder) can make sexual intercourse extremely painful, on top of the pain you already have.

Fear

You may be afraid of sex exacerbating your symptoms, which could make you unable to relax and enjoy the experience. And you may not be the only one held back by fear -- your partner may also be concerned about hurting you or triggering symptoms.

Overcoming the Obstacles

Solutions to these problems start with communication - you need to communicate with both your partner and your doctor.

Open communication with your partner may be difficult if you're not accustomed to talking about sex. However, it's important for him/her to know where you have pain, the limits of your endurance, and what activity you're comfortable with.

If you're having other relationship problems, you'll need to work on those as well. A couples counselor may be able to help.

You may also want to see a counselor for problems with self-esteem and depression.

Your doctor can help you diagnose and treat any overlapping conditions, such as vulvodynia or interstitial cystitis, that may be getting in your way.

Talking about sex can be difficult, whether it's at home or in a clinical setting.

The Right Positions

You may find that certain sexual activities or positions sap less of your energy and therefore are less likely to trigger a symptom flare.