How Do You Deal With Intimacy When You Hurt Too Much?

And not only when you hurt too much, but when you are tired all the time, and your meds dull your libido.

A sex therapist I interviewed for my book (to be released in Jan 2011) about couples and illness said that not all intimacy has to be: "Insert penis in vagina and shake." Intimacy at its core is about giving and receiving physical pleasure, ideally accompanied by emotional closeness. This latter recipe can be achieved in many ways. Sexual touching can happen anywhere on the body.

But sometimes the well partner may just want intercourse. What then? And sometimes the ill partner may want intercourse, but is physically unable to engage. What then?

The path to a resolution will be different for each couple. Each couple's sexuality and emotionality is unique to them. But the path to getting to some resolution requires open and honest communication. No matter how hard it is to talk about such intimate matters.

If, at the end of the day, you still want to stand, or sit, or lay together - you have to tell each other what feels good and what doesn't. And you have to talk about what you miss and what you want, and how you might get it, together. And what about giving each other permission to get what you need outside the relationship? is that OK?

If you don't talk to each other about your intimacy needs, they will not go away. They can turn into an invisible barrier that can erode your sense of closeness in other areas.

I think this is one of the most difficult terrains for couples to navigate. What have been your experiences of dealing with the intimacy side of living with illness in your relationship?