I’d also encourage you to experiment with different positions. Since you mention spasms in your hands, having sex in a position where you are resting much of your body weight on your hands and arms may be particularly uncomfortable. The same goes for positions where a lot of weight is resting on your legs or you are trying to hold your legs in an uncomfortable position. You may also find it helpful to use pillows, chairs, or other props to provide support for you or a partner. A knowledgeable, sex-positive physical therapist or occupational therapist may be able to give you some good ideas about what might work best for you.

I think the most important step anyone can take when faced with spasticity or other physical difficulties is to talk with their partner about the realities of their physical limitations -- and about ways to minimize their negative impact so both partners can focus on pleasure. For people in relationships, this is an ongoing conversation, not a one-shot deal. This may feel uncomfortable or awkward at first. But, it helps ensure that your partner understands how you are feeling and reduces the chance that they’ll misinterpret your concerns. (For example, if you tend not to initiate sex as much as you used to because sex has become increasingly uncomfortable, your partner may interpret this as you not finding them attractive anymore.) It also shifts the focus from “how this condition is affecting sex” to “how we can together explore ways of increasing our sexual pleasure.” The latter is only more positive, but often also helps bring partners closer.

It can certainly be trickier getting a conversation about sexual pleasure and physical realities started if you are not in a relationship or are in the early days of one. (Often, people are very worried about how a new partner will react if they reveal that they are a sexual superman…) However, not having a conversation is likely to increase the chance of your being uncomfortable during sex -- and both of you coming out of the experience unhappy. (Some single folks actually use that conversation as a measure of whether they really want to get involved with a potential partner, figuring that, the sex isn’t going to go well if the conversation doesn’t.)

I definitely recommend "The Ultimate Guide to Sex & Disability" by Miriam Kaufman, Cory Silverberg, & Fran Odette. In addition to discussing spasticity, the book pays a lot of attention to the mental, emotional, and relational challenges experienced by people with a variety of health problems.

Reviewed by: Kathleen VanKirk DHS