If you or your partner are living with chronic obstructive pulmonary disease, you may be wondering what effect COPD will have on your sexuality. Will sex be possible? Will it be safe? Satisfying?
COPD symptoms like coughing, wheezing, and shortness of breath will almost certainly change the way you and your partner express yourselves sexually. But that doesn’t mean you must bid adieu to sex or other forms of physical intimacy.
Of course, good sex isn’t automatic when COPD is in the picture. To get things right, it’s essential to talk about sex with your partner (or, if you’re single, with prospective partners).
“I tell my patients to approach the subject openly and directly,” says Robert A. (Sandy) Sandhaus, MD, PhD, professor of medicine at National Jewish Health hospital in Denver and a member of the medical and scientific advisory board of the COPD Foundation. “Starting the conversation is often the most important step -- and the biggest hump to get over.”
If you’re uncomfortable with a face-to-face talk, consider communicating with your partner or prospective partner via telephone or letter. Make it clear what you want and expect from sex, ask what your partner wants and expects, and do your best to agree upon the steps you’ll take together to overcome any sexual problems that arise.
Here are nine helpful strategies for sex and intimacy when you have COPD:
1. Get Fit
Not sure you or your partner has the stamina for sex? Ramping up your fitness regimens might prove helpful.
Maybe it would help to initiate a program of walking or gentle exercises. Perhaps it would make sense to join -- or rejoin -- a local hospital’s pulmonary rehabilitation program.
“Rehab programs aren’t limited to people who are newly diagnosed with COPD,” says COPD specialist Teresa T. Goodell, PhD, RN, assistant professor of nursing at Oregon Health & Science University in Portland. “They‘re for anyone who needs to build exercise tolerance. They provide a safe place to exercise and help show people with COPD that it’s safe to exercise.”
Rehab programs typically meet once or twice a week for up to six months.
2. Pick the Right Time
Good sex needn’t require expending lots of energy. “The energy requirements for sex aren’t that different from the energy requirements for doing other things,” says Barbara Rogers, president and CEO of the Emphysema/COPD Association in New York City.
“If you can walk up two flights of stairs or walk briskly, you can probably handle sex,” she says.
Still, people with COPD sometimes become fatigued during sex. To make sure you or your partner doesn’t poop out, schedule sexual encounters for a time of day when the partner with COPD feels most energetic.
True, scheduling sex means forgoing the spontaneity that often makes for good sex. But requesting sex in the form of a flirtatious note can add a dash of excitement. Or you and your partner might wink at one another (or come up with another sign) to indicate that you’d like to “turn in early.” Make scheduling sex an erotic game, not a chore.
3. Rid Your Bedroom of Irritants
Dust, vacuum, and wash the sheets regularly. Consider using a HEPA air filter. And watch out for smelly cleaning products -- especially chlorine bleach or ammonia -- as their odors can trigger symptoms.
If scented deodorant or shampoo poses a problem, consider switching to unscented varieties. If excessive mucus secretion causes trouble, keep a box of tissues at the bedside. Nasal irrigation before sex can help, as can using a mucus-loosening vibrating vest.
4. Get a Fan
Recent research has shown that a cool breeze on the face can help ease the distressing shortness of breath that people with COPD often experience during sex. The flow of air can come from an open window or a fan.
“A simple electric fan can really be helpful,” says Goodell. Similarly, keeping the bedroom cool helps keep a buildup of body heat from adding to breathlessness.
5. Take Your Medication Before Sex
The short-acting bronchodilators that many people with COPD use before exercise also help prevent coughing and breathlessness during sexual activity. Doctors recommend taking an anticipatory dose about 15 minutes before sex.
“For most people, two puffs or so is enough,” says Goodell. “It’s really a matter of patients testing the waters and knowing what their responses are.”
To get rid of the unpleasant aftertaste that might distract you or offend your partner, rinse out your mouth with an alcohol-containing mouthwash after using the inhaler.
6. Consider Using Supplemental Oxygen
If you or your partner finds supplemental oxygen helpful at other times, ask the doctor about using it during sexual activity.
“If you need to wear oxygen while walking, you’ll probably need to use it during sex,” says Sandhaus. The doctor might suggest increasing the flow of oxygen during sexual activity -- to accommodate the body’s increased need for oxygen during exertion.
If the partner with COPD doesn’t use supplemental oxygen but wonders if it would help during sex, you can find out with the help of an oximeter, a simple electronic device that the partner with COPD wears on their fingertip. If the readout indicates that the oxygen saturation falls below 88%, using supplemental oxygen during sex could prove helpful.
Ask your doctor. They might be able to loan you an oximeter. If not, you can buy one for under $50.
7. Don’t be Afraid to Experiment
Try different sexual positions to find which ones work best for you and your partner. In general, positions that put pressure on the chest of the partner with COPD are more troublesome than side-by-side (face-to-face and front-to-back) or seated positions.
“For a man with COPD, the missionary position is probably worst,” says Sandhaus. Maybe it would help to use pillows to prop yourself up, or prop up your partner. Maybe it would be better to forgo the bed and have sex in a chair.
Also, try different sexual techniques and aids. “It’s important for people to try things, even if they were reluctant to try them before,” says Goodell. “It can be really beneficial to think of different ways of expressing sexuality that they have done or haven’t done in many years.”
8. Take a Break
If at any point during sex the partner with COPD starts to feel breathless, they should slow down or pause to rest -- though there’s no need to stop giving and receiving caresses during the lull in the action.
Keep in mind that it’s normal to experience some shortness of breath during sex. Says Rogers, “People get concerned about shortness of breath, but shortness of breath during sex is no more dangerous than the shortness of breath they experience when doing everyday activities.”
9. Remember Your Goal
Good sex isn’t just about giving and receiving orgasms. It’s about intimacy. “The goal [for COPD patients and their partners] should be to have the most intimate experience that they can manage,” says Sandhaus. “Sometimes that means coming to orgasm, and sometimes not.”
Sometimes, simply lying together and cuddling are all that someone with COPD can manage -- and that may be enough to satisfy both partners. As Goodell puts it, “Running your hands through your partner’s hair can be an intimate act.”