Intimacy and sexual health as you recover from a serious crash
A rehabilitation physician and a sex therapist on comfort, choice and care
Right after a crash, sex may be the last thing you’re thinking about. Later, you may want closeness but run into pain, fatigue, fear or embarrassment. You may wonder if an injury or a medicine has changed your sexual response. These are everyday health questions. A rehabilitation physician can check physical safety and symptoms. A sex therapist can help with communication, expectations and emotional hurdles. [1, 2]
Decide what closeness means to you right now
Intimacy can mean talking, holding hands, cuddling, kissing or sex. Each partner may want a different kind of closeness at different times. Nobody owes sex as proof of recovery or thanks. Talk about what feels welcome now and what doesn’t. You can have that talk outside the bedroom. Pick a time when neither of you is being asked to decide right away. [1, 2]
Use plain words. You might say, “I want to be close, but I’m worried about hurting my shoulder.” Or try, “I don’t know what I want yet. Could we sit together tonight?” Words like these tell a partner what’s going on so they don’t have to guess. Consent and the freedom to stop matter at every stage of recovery. [2]
Ask about physical safety without embarrassment
A pelvic injury, surgery, broken bone, wound, concussion or spine injury may call for specific limits. Ask the clinician treating you which activities and positions are safe. Find out which symptoms mean you should stop and when a change needs a checkup. Don’t borrow a recovery date from some other condition. If intimacy brings new pain, bleeding, dizziness or another worrying symptom, stop and get medical advice. [1, 3]
Medicines, fatigue, pain and mood changes can affect desire or sexual function. After a brain injury, physical, hormonal, thinking and relationship changes may all add to the problem. A clinician can review your medicines and symptoms. Don’t stop a prescribed treatment on your own. [1, 4]
Let yourself go at a different pace
Start with kinds of touch and closeness that feel safe. Pick a time when pain and fatigue are easier to manage. A quiet setting may help if it’s hard to concentrate. You can pause or change course without calling it a failure. If you have a partner, talk about what support helps and what feels like pressure. [1, 4]
- What kind of closeness feels comfortable right now?
- What physical symptom or fear do I want a clinician to look at?
- What word or signal will mean “pause” with no explanation needed?
Take the question to a professional
You can tell a clinician, “Since the crash, sex is painful.” You might also say, “My desire has changed,” or “I am unsure what is medically safe.” Ask for privacy. If that clinician isn’t the right person, ask for a referral. [1, 4]
Depending on the concern, help may come from a rehab clinician, gynecologist, urologist, pelvic health therapist or mental health professional. The goal is to find the cause instead of assuming it’s just stress. [1, 4]
If fear, shame or conflict in the relationship stays strong, a qualified sex therapist or couples therapist can help. Trauma symptoms can affect intimacy even after the body has healed. The work should respect each person’s choices and pace. [2, 5]
Words to bring to your appointment
If this is hard to bring up, write it down and take it with you. Try this: “The crash has affected intimacy.” Then add: “I would like help understanding what is physical, what is emotional and what I can safely do.”
Sources and further reading
- 1MSKTC: Sexuality after TBI
- 2MSKTC: Relationships after TBI
- 3MSKTC: Sexuality after spinal cord injury
- 4MedlinePlus: Rehabilitation
- 5VA: PTSD and family relationships
General U.S. education from the fields of rehabilitation medicine and sex therapy. No one return date fits everyone. Ask your clinician about injury limits, new symptoms and medicine side effects.
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