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Bleb Disease and Sex

 

Understanding  How Bleb Related Pain Can Impact Your Sex Life (from The Center for Growth in Philadelphia)

People living with bleb disease may experience pain at various points in their life.  Recovering from a chest tube, pleurodesis or a  pleurectomy can be very painful.  In addition, some people with bleb disease will experience chronic pain as a result of the surgery they have endured.  Depending on the severity of your condition, you may experience pain from the leaking of a bleb.  This pain can last for days or months.  Obviously pain can impact sexual desire, attitudes towards sex, sexuality and their intimate experience of sex.  Sex is just as much physical as it is emotional and psychological.  If you associate sex with pain, sex can become a dreaded or even feared activity rather than a pleasurable and intimate experience you want to share with your partner.

Understand the role of anxiety. If you experience anxiety about having sex when you are in pain there will be physical effects on your body.  When people are anxious, chemicals such as adrenaline are released into the bloodstream.  These chemicals are effective in readying the body in certain situations  such as in sporting events or if you need to defend yourself.   Unfortunately, the body’s natural response to anxiety is not conducive to performing sexually.  As a result, men may experience occasional erectile dysfunction or premature ejaculation while women may experience pain with intercourse due to lack of lubrication or tensing of the pelvic muscles. While these sexual problems could occur just once or twice, they may become a long-standing pattern if you ignore your body’s reaction and engage in sex while in pain just to appease your partner.   This pattern will create an extremely destructive cycle.  When you’re in pain you will feel anxious which in turn negatively impacts your sexual response leading to more anxiety or fear.  Examine the checklist below to see if you experience any sexual issues that could be related to your anxiety about having sex while in pain.

For men:

  • Ejaculating sooner than desired or expected
  • Delayed or inability to reach orgasm
  • Low sexual desire
  • Losing erection before or during sexual activities

For women:

  • Pain or discomfort with intercourse
  • Lack of lubrication
  • Low sexual desire
  • Delayed or inability to reach orgasm

Be aware of dissociation. Sometimes when a person has sex when she/he does not want to, dissociation can occur.  Dissociation is the experience of feeling disconnected from your body and what is happening at the moment.  People who dissociate often report feeling detached from their body, emotions, and/or surroundings.  Dissociation is actually a natural and helpful coping mechanism when you experience a traumatic event such as being in a  horrible car accident or being raped.  However, dissociation during sex decreases the potential for real intimacy with your partner.   Dissociation will also impair your ability to experience a range of sensations and emotions during sex.  Determine if any of the statements below ring true to you.  If so, you might be disconnecting or dissociating during sex.  If you are disconnecting or dissociating during sex your goal should be to stay connected during sex.

  • I feel disconnected from a part of my body during sex.
  • Distraction is key for me during sex.
  • I rarely feel present during sex.
  • My partner tells me that I am not very active during sex.
  • Imagine that I am elsewhere while having sex is common for me.
  • Sometimes I feel like I am floating above my body.
  • I've been told by my partner that he/she does not believe I am with them during sex.
  • It's common for me to feel numb during sex.
  • I find it difficult to experience emotions during sex.
  • Things seem unreal during sex.
  • I feel spaced out during sex.
  • Sex feels robotic or mechanical to me.

 

Examine your attitudes and beliefs about sex. Our attitudes and beliefs about sex come from many sources: religion,  education, past partners, parents, friends, and our culture.  It could be that your own attitudes and beliefs about sex are influencing your sexual desire and your experience of sex.  Negative, unhealthy or unrealistic attitudes and beliefs could be limiting your sexual expression and your potential for a happy, healthy sex life despite bleb disease.  Write down at least ten attitudes or beliefs you hold  about sex and then ask yourself the following four questions:

  • How did I learn this or who taught me this?
  • How realistic is this attitude or belief?
  • How does this attitude/belief make me feel about my body?  My sexuality?  My relationship with my partner?
  • How can I adjust this attitude/belief to be more healthy and realistic?

Example of Examining Attitudes & Beliefs

Attitudes or Belief: Intercourse is the most important and ultimate sexual experience.

1.  How did I learn this or who taught me this? Possibly culture, as it seems like intercourse is the most emphasized of all sexual activities.  Perhaps messages I’ve received from my friends who act like nothing besides intercourse counts as sex.

2.  How realistic is this attitude or belief? Not so realistic.  Many other activities besides intercourse like mutual masturbation and oral sex can allow both partners to orgasm and feel connected.

3.  How does this attitude/belief make me feel about my body?  My sexuality?  My relationship with my partner? This belief makes me feel disappointed in my body when I am just in too much pain to have intercourse.  It makes me feel like all other sexual activity doesn’t count or just does not compare.  This belief negatively impacts my relationship with my partner because I  often isolate and feel unmotivated to try anything sexual just because I cannot have intercourse.

4.  How can I adjust this attitude/belief to be more healthy and realistic? There are various sexual activities I can engage in with my partner that as just as enjoyable and intimate as intercourse.

Attitude or Belief: If I can’t get my partner off than I don’t deserve to orgasm either.

1.  How did I learn this or who taught me this? Past  partner put enormous pressure on me about “returning the favor.”

2.  How realistic is this attitude or belief? Not very realistic.  It’s not that I don’t deserve to orgasm–I just feel that way.

3.  How does this attitude/belief make me feel about my body?  My sexuality?  My relationship with my partner? This makes me feel depressed about my physical limitations when I am in pain.  I feel like an inadequate sexual being and partner when I  don’t have the energy or pain threshold to meet their sexual needs when he/she has been able to meet mine.

4.  How can I adjust this attitude/belief to be more healthy and realistic? As long as my partner and I are on the same page, it is okay if they want to pleasure me despite not being able to completely return the favor.  I  can still be an active participant in helping them pleasure themselves when I am unable to.

The goal of this task is to set realistic expectations for yourself and with your partner.  Make sure to tell your partner about the pain you experience and the impact it has on you.  Both of you need to change your expectations to adapt to your body's needs.

Remember... Pain is a factor that must be considered when you have sex.  However if you can stay connected, communicate with your partner, and have realistic expectations, your pain does not have to be labeled as a  “problem” but rather another factor in your sex life. Making these changes will also help you have a better and more intimate sex life with your partner that also respects your body's needs.

ABOUT THE AUTHOR

"Alex" Caroline Robboy,

“Alex” Caroline Robboy, CAS, MSW, ACSW, AAMFT, CSTS, LCSW is the founder and executive director of the Center for Growth Inc / Sex Therapy in Philadelphia, a counseling organization that has an office in Ocean City, New Jersey, Richmond Virginia, Alphretta Georgia and 2 offices in Center City, Philadelphia PA.   In her space time she launched the directory sextherapy.com as a resource tool for professionals dedicated to improving peoples sexual health.  Alex has 25+ years of clinical experience working with adults and children. Specifically, she works with people struggling with compulsion problems, personality disorders, neurodiversity (dyslexia, tourettes, sensory issues, adhd, and high functioning autism) anxiety, depression, postpartum depression, shame, trauma, low self-esteem, grief, relationship issues, sexual function & dysfunction, blended families and parenting concerns. Currently, she provides individual, couples, family therapy and group therapy. Lastly, she offers supervision to both staff and therapists outside of this agency seeking their LCSW or AASECT Certification in sex therapy.  Lastly, thru the Philadelphia International Women’s Project, she led a two year sex therapy group for West African women who experienced Female Genital Cutting as well as a sex therapy group for Sudanese women who experienced Female Genital Cutting. 

Ms. Robboy earned three graduate degrees at the University of Pennsylvania; Masters in Social Work, Post-Masters in Certificate Marriage and Family Therapy with a Specialization in Sex Therapy and a Certificate of Advanced Studies in Human Sexuality Education (otherwise known as ABD) as well as a Certificate in Home and School Social Work. Additionally, Ms. Robboy is an AASECT Certified Sex Therapist and Supervisor of Sex Therapy and an ABS Certified Sexologist. Lastly, she is a Certified Imago Therapist. She is currently pursuing certification in CBIT.