Sexual Desire in Couples Living with Chronic Medical Conditions

Abstract

When chronic disease strikes a couple, both the ill and well spouse are affected. A literature review of chronic disease reveals that an overlooked area of concern for couples living with a chronic disease is sexual desire. Diseases such as multiple sclerosis, Parkinson’s disease, lupus erythematosus, diabetes mellitus, and breast cancer result in long periods of medical treatment and interfere with the couple’s normal routines. This can result in a loss of sexual desire. Specific causes of loss of desire in these couples include fatigue, changes in body image, concerns about fulfilling gender roles, fear, caregiving duties, sexual dysfunction, disease severity, and medical treatment. Counselors can design treatment plans that address loss of desire in couples living with a chronic disease by considering the underlying causes of loss of desire.

Support Experienced by Patients Living with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension

“…Some patients in both the current study and that of Guillevin et al [23] described how their fatigue caused sexual problems for themselves and their partner. Fatigue is common in chronically ill patients, and patients may need to rest before sexual activity, or when the fatigue is too pronounced, stick to gentle massage or caresses [24]. As this type of problems exists, it is important for the PAH team to ask and dare to talk about sex and intimacy.…”

Quality of Life and Sexuality among People with Mental and Physical Disabilities in the Italian Context

“…With regard to this point, it is common to find a lack and inadequacy of the initiatives related to the specific training of professionals in the field of psychology: the same psychologists, counsellors and psychotherapists who say they are unprepared and not at ease in dealing with issues related to the consequences of disability on sexuality, noting that, in general, in support services to mental health sexuality does not receive adequate attention and training opportunities, and these aspects are often sketchy [35,36]. In addition, it is important that professionals reflect first on their personal ideas about the connection between illness, disability and sexuality in the awareness of being strongly affected when they are working with couples who are carriers of these topics.…”

“…It also seems that couples are able to reformulate their intimate relationship in terms of mutual caring, sharing interests and leisure and social activities rather than purely sexually adapting more easily to the loss of the erotic component of the relationship. Even Samuelson and Hannon [35] dwell on the type of disability in defining the consequences on the well-being of the couple; in particular, the authors show that the onset of diseases such as multiple sclerosis, lupus erythematosus or Parkinson's disease often occurs in a phase of the life cycle in which the couple can expect to live years of full health, years where the generative component involves many areas of sharing and in which sexual life is expected to be intense and satisfying. The acceptance and processing of the diagnosis thus appear rather hard and particularly difficult: after the first phase of disease onset, in which most of the physical and emotional energies of the two partners are involved in the assessment of diagnosis and in the beginning of treatment, the crisis seems to flare up with the knowledge of an uncertain future and a permanent impairment of "normality".…”

“…If the integration is high, then most functional and satisfactory will be the "sexual beingness" [34, p. 269]. Even Samelson and Hannon [35], when referring to a definition of Levine (1995 in ibidem) about sexuality as a system of emotional response that orients towards themselves and towards others, focus on this area in the broadest sense, disengaging from the idea that sexual satisfaction is necessarily linked to genital function and the presence of erotic fulfillment: the intervention on the couple with disabilities related to sexuality must be, therefore, intended to identify the worst affected dimensions (first of all, the desire dimension), and take on all of them through holistic and systemic intervention [35].…”

“…In any case, the sexual functioning of the couple before the onset of the disease is an area that must necessarily be within the survey's counselor or therapist performing the treatment: Samelson and Hannon [35] consider it essential to support the couple in identifying different forms in which sexuality can be expressed beyond the mere physical act: helping patients in exploring new ways of expression of the erotic and passionate component of the relationship means to support them in giving continuity to an area of married life that threatens to come to an end abruptly, and sometimes irreparably, interrupted by disability [35].…”