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Sex and AS: Position Pain Ratings and Tips for Pain Free Passion

Newsflash - people with chronic illnesses and disabilities enjoy sex too!

You wouldn’t think it as a lot of the time in society we are kind of desexualised by society – but we get horny just like the best of them! Only sadly, sometimes it is a little trickier or more painful to get down to business for us.

When I was diagnosed, I don't recall receiving any information from doctors about what my sex life might be like. In fact, the only aspect vaguely on the subject that was covered was being advised to consult a doctor before attempting to conceive a child. As a single man in my early 20s, parenthood was the furthest thing on my mind, leaving me to work out the rest on my own.

Oddly enough, I find my pain levels to be significantly lower during sexual activity. However, this doesn't mean that certain positions aren't uncomfortable or challenging.

So, I thought I'd provide some pain ratings and share a few tips on pain management for some of the classic sex positions that don't require delving into the shadier corners of the internet to discover.

I'd like to clarify that I'm offering this perspective as a heterosexual male with AS, and my pain rating is on a scale of 1 to 5, with 5 being the most painful.

Missionary: 2/5

Let's start with the original recipe!

I find that being in control of the situation makes this position relatively low on the pain scale for me. Managing the angles, pace, and intensity that I am having sex at allows me to safeguard myself and make adjustments to suit what my body is comfortable with.

Pain tip: Experiment with how much you arch your back during this position to discover angles that work for you. I find that alternating between a more upright position and being closer to my partner can add variety and sensuality while affording my spine a break from being in the same position for too long – a win-win situation!

Doggy style: 3/5

To be honest, the pain rating can vary here based on the height differential between you and your partner. You might need to stoop low or stretch upwards, depending on the target area. However, this can be addressed with a pillow placed under your or your partner's knees to level things out.

Though I've found that engaging in this position for an extended period can strain my back, regardless of adjustments made. Consequently, I often switch positions before I blow my own back out!

Pain tip: Try it with your partner lying down on their front. I tend to find that gives you greater control of the angles that your hip and spine have to be in, similar to the missionary position, all the while pleasing another in a different way.

Cowgirl: 1/5

It sounds ever so lazy to say that the position that involves me lying on my back is the least painful one! But in reality, it is the one that puts the least pressure on my damaged spinal cord!

Of course, in this scenario you are putting a lot of trust in your partner not to crush your fragile hips in the process. So, it is probably a good idea to have a word before to let them know how much force you are comfortable with and maybe place your hands under their thighs to cushion any blows to your pelvic area.

Pain tip: If lying on your back proves uncomfortable, don't hesitate to use pillows to discover a comfortable arrangement that suits you.

Spooning: 5/5

In my opinion, this is the most agonizing position I've dared to try. The angles my hips must assume to make it work don't agree with my SI joints. Not only do you have to lie on your side – which can be painful even under normal circumstances – but there's a bending motion that's ever so discomforting for me.

Any moans that I make in this position are absolutely not the enjoyable kind!

Pain tip: To be determined. Unfortunately, I don't have any advice on minimizing pain in this position, as I'm still searching for solutions myself!

Bonus pain tips

Don’t be afraid to have a conversation with your partner and communicate what aspects of sex are painful or difficult for you. It might seem like an awkward situation, but I guarantee it will be less awkward than having to call an ambulance halfway through for a sex related injury!

When something is causing pain, then don’t carry on out of fear in killing the vibe. Switch up the position to one that is more manageable for your body or take a break.

If you're feeling stiff (in a bad way!), consider stretching beforehand. Obviously, it may be a bit weird if you hit the pause button during foreplay and get the yoga mat out. So maybe try and do it earlier on in the day before anything romantic initiates. Or if it is one of those heat of the moment sessions, ease into the lovemaking. Don’t risk injuring yourself by jumping into pounding away from the get-go!

What positions do you find to be the most AS friendly in the bedroom? Do you have any pain management tips that you wish to share? Let me know in the comments.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The AxialSpondyloarthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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