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    Maryann Lowry was 42 years old in 1995, when she woke up one morning with severe pelvic pain. She was diagnosed with vulvodynia -- which literally just means severe pain in the vulvar area. Today, 14 years later, she says that she’s “95% recovered” -- but the many years of dealing with chronic pain took its toll on her relationships, her personal life, and of course, her sex life.

    “I thought, how am I going to keep my marriage together if I can’t have sex? It was more of a gift that I tried to give my husband until I could feel better,” she recalls.

    Lowry is far from alone. According to the American Pain Foundation, as many as 50 million Americans have chronic pain, stemming from causes ranging from cancer treatment to back injuries to fibromyalgia and many more.And almost 80% of people living with chronic pain and/or disability and their partners report a significant reduction or loss of their sexual functioning.

    Chronic pain can lead to fatigue, insomnia, and symptoms of depression. Pain medicines may reduce libido. And for some people, intercourse itself can cause pain, says Meeru Sathi-Welsch, MD, an anesthesiologist and pain specialist with Long Island Neuroscience Specialists.

    “Chronic pain infuses every aspect of a person’s life,” agrees Daniel Kantor, MD, president-elect of the Florida Society of Neurology (FSN) and Medical Director of Neurologique, an organization dedicated to patient care, research and education. “You don’t see yourself as a romantic, sexual being, because you’re so defined by the pain.”

    How to Get Your Groove Back

    What can you do to light the fires again? “It takes a lot of creativity and patience!” says Sherrie Sisk, 43, a single mom who chronicles her 10-year struggle with fibromyalgia pain in a blog called “The Tramadol Diaries.”

    First, talk to your doctor about what aspects of your treatment might be changed to help improve things sexually. David Rosenfeld, MD, a pain specialist with the Atlanta Pain Center, says your doctor can help in several ways:

    • Change medications. “We can decrease opiates and use more other medications that we know are effective for treating chronic pain with less effect on sexuality, like Cymbalta and Lyrica,” says Rosenfeld.
    • Add new medications. For men with low testosterone levels, a prescription for testosterone may help with sexual desire. Drug treatments such as Cialis, Levitra, and Viagra may also be used for men with erectile dysfunction.
    • Refer you for biofeedback treatments. “We’ve found that biofeedback can be very helpful for women, in particular, who complain of significant pelvic pain and dyspareunia,” says Rosenfeld. Dyspareunia is pain with sexual intercourse.
    • Connect you with a support group. It can help to know that you’re not alone -- and other people in the same boat might have new ideas you haven’t tried.

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