Sexual activity is an important part of a healthy life. Intimacy offers pleasure, stress relief, and a deep connection with your partner. Some evidence suggests it can even help relieve chronic pain. But all too often, fibromyalgia affects your ability to feel, touch, and move freely during sexual activities. In fact, as many as half of all women with fibromyalgia report issues with intimacy. Some experience less desire and arousal. Others have pain with intercourse. Your doctor may not ask you about these concerns. It can be difficult to bring them up on your own. But their effect on your life—and your partner’s—is very real. An open discussion with your partner and your health care team can be the first step toward restoring sexual health. Physical and Emotional Concerns A healthy sex life involves both mind and body. Fibromyalgia may negatively affect both. People with fibromyalgia have a heightened sensitivity to pain. Sensations and pressures that might be pleasurable to some may be uncomfortable or painful for you. For instance, if you have pain in your face or head, even kissing can be excruciating. Other symptoms of fibromyalgia—including stiffness and trouble sleeping—can also make intimacy difficult. And side effects from antidepressants or other medications can decrease your desire. Psychologically, fibromyalgia and depression often go together. Depression is known to lower sexual desire. What’s more, the stress of living with a chronic disease can cause tension in your relationship that disrupts intimacy. Because so many more women than men are affected by fibromyalgia, scientists know more about these issues in women. However, sexual difficulties are likely to affect men who have the disease as well. Breaking the Pattern Following your treatment plan for fibromyalgia can improve all aspects of your life, including your sex life. Pain, depression, and sexual issues create a vicious cycle. Taking medications and receiving counseling to improve your fibromyalgia symptoms can stop this downward spiral. Having an open, honest conversation with your spouse or partner about intimacy is also critical. Turning to each other in times of stress can improve your relationship and help you identify root causes of your issues. For instance, you may find that he or she would like more intimacy but is afraid of causing you pain. A sexual or relationship counselor can help you work together to address both of your needs. Not Just Talk Beyond discussing the problem, you can also take practical steps to cope with fibromyalgia’s effects. A physical therapist with expertise in treating fibromyalgia can teach you exercises that build your strength and endurance. He or she can also recommend ways to modify sexual activity to reduce pain. On your own, try exploring different sexual positions that avoid pressure on your tender points. You may find poses that don’t place weight on your abdomen—such as those in which you lie on your side—more comfortable. It might be helpful to use pain-relieving therapies such as medications or heat before or during sexual activity. And consider trying alternative methods of sexual expression besides intercourse. These can offer similar physical and emotional benefits and bring you closer to your partner as well.