Q&A With Dr. Laurie: Chronic Pain And Sex

Chronic Pain And Sex

Q: I’m a 59-year-old white straight female with a lot going on. I haven’t had sex in 23 years! Various different drugs that I’ve had to be on at different times, including opioids, have squelched my libido. I’ve been sick for 21 years.

From late ’99 to early 2000 I began having trouble breathing. I have a 21-year-long undiagnosed lung disease, adult-onset asthma, T2 diabetes are the big ones. The lung disease leaves me on 6L of O2, though my prescription reads 6 – 10L, I rarely go above 6L. I had been on 180mg of morphine/day in 3 divided doses, there was also 1 dose of 180mg of oxycodone, between each dose of morphine, for a total of 360mg of oxycodone/day for severe lung pain. Yes, I understand there are no nerves within the lungs, but it sure felt like there was! We had ZERO idea what was causing the pain. Because we didn’t know, once the pain was under control, I asked the doctor to allow me to decrease my pain meds. He agreed. I’d gotten down to 2 15mg/day of morphine. I mention all of this because this past summer I made it an issue with my primary doctor to get off of the last of the morphine by sending me to the pain clinic. Under a four-week plan, I was free of opioids. YEAH!

Since then, my libido has bounced around from not a big deal to…I was about ready to accost some guy down the side of the road. Not really, but pretty close. I don’t believe in sex outside of marriage, which further complicates things. I’m also not comfortable with porn or masturbation, but I’ve been about ready to go out of my mind! But, I’ve been able to maintain by watching the porn and trying to masturbate, but I’m having trouble with that as well. I’ll be watching porn videos and I want to cum SO badly and yet I can’t. The issue comes and goes, no pun intended… I would so appreciate if someone could help me understand what’s going on and help me resolve it.

A: I am so sorry for all of the suffering you have had to go through that few decades! Medications and illness can take a real toll on our sexuality, affecting libido, arousal, and orgasm. Now that you are on much less medication, your libido is bouncing back. Unfortunately, what you describe is difficulty with orgasm now which may also be a result of all the meds. Masturbation is definitely the way to go, and I would try using sex toys for maximum clitoral stimulation (try the Womanizer). To orgasm though, you need to be relaxed in your mind and body. So stop putting pressure on yourself to “get there,” and just enjoy the pleasure you can give yourself.