Are Chronic Pain Treatments Affecting Your Sex Life?

Many people complain about not being able to have a sexual relationship with their spouse due to the pain they are experiencing. Chronic pain can without a doubt end a person’s sex life.

However, according to Pain Medicine News, several doctors have said that a good sexual relationship can help alleviate pain. Studies have shown that pleasurable stimulation can increase pain thresholds by 75%.

Alex Shteynshlyuger, a New York City urologist, states that when people are in pain they release high levels of epinephrine, which narrows the blood vessels, making it difficult to have an erection. Therefore it is important to control pain to prevent erectile dysfunction.

Moreover, patients who have chronic pain usually also have problems such as obesity, high blood pressure etc.

Dr. Shteynshlyuger stated that pain patients who suffer from erectile dysfunction should use the tadalafil drug to alleviate the pain. Another advantage of this drug is that it does not need to be taken with the timing of any sexual activity. Chronic pain can reduce the libido in a person. Due to this patients go into depression, making them feel worthless and useless. Decreased activity can also lead to weight gain which is harmful to the human body.

Opioids can be used to decrease pain; however they lead to numbness and a decrease in performance. Moreover they prevent the release of the sex hormones as it suppresses the adrenal axis. Some doctors prefer not to use the opioids and therefore they use steroids to freeze the nerve.

However there are other non-narcotic options that can be used to avoid pain. Treatments can include physical therapy, non-opioid medication, trigger point injections etc. Multimodal treatments can also be used such as medication and interventions. Other options to alleviate chronic pain can include meditation, biofeedback, acupuncture and a lot more.

Moreover hormone replacement can also be used in both men and women. Those who have deficiencies in their hormone level, are sent to a urologist or a gynecologist. Men who have erectile dysfunction even with normal levels of testosterone are provided with an antidepressant known as trazodone which can be used to treat erectile dysfunction. In addition, trazodone reduces pain, improves sleep and prevents muscle spasms.

Doctors and therapists believe that communication is a key factor to help with this problem. It helps for each spouse to comprehend what the other is experiencing.

The late George E. Ehrlich, MD, of the American College of Rheumatology, expressed in a part on arthritis in a book about sexuality, “The person who has arthritis often feels insecure and sometimes misinterprets concern on the part of the partner as distaste. … Or a spouse may avoid sexual overtures for fear of hurting the arthritic partner; this may be perceived by the patient as a sign of revulsion.”

Couples may have trouble communicating about pain; however they should be able to talk about it even when they are not in the bedroom. Partners should try to figure out a way to make such conversations comfortable and thus helping them in a positive manner.

For alternative methods for Pain Management visit Dr. Tom Macek, book an appointment.

Warning: Cancer Patients At Risk of Opioid Abuse for Pain Management

There are many resources available for patients struggling with chronic pain. However, the most commonly used one still remains to be opioids.

There are several guides for clinicians that address pain management through drugs for cancer patients and survivors who continue to experience ongoing pain after successful treatment.

However, healthcare providers need to be made aware of the opioid abuse prevalent in cancer patients of the United States. The general attitude in the past had been a dismissive one, assuming cancer patients had little risk of being addicted to drugs.

New evidence has brought to light that the chances of cancer patients developing an addiction for opioids are as high as those for patients suffering from regular chronic pain.

What Can Be Done?

It is important for everyone prescribing pain medication to go through the Risk Evaluation and Mitigation Strategy training which is available for free online to learn how to prescribe opioids to the appropriate patients. Every patient should be scrutinized and analyzed for signs of opioid use disorder, misuse and diversion.

It is time to bring back the universal precautions taken before prescribing opioids which were first introduced during the 1980s when AIDs was an epidemic in the American society. Everyone wore gloves and protective gear as it was assumed that all patients coming in could be carrying the HIV virus.

The same way any patient who is a candidate for opioids should be treated as potential drug abuser and mis-user regardless of their age, economic class and biological disorders.

How to Identify Patients at Risk

High-risk patients are the ones who have had a history of alcohol or substance abuse or are on medication such as buprenorphine or methadone. Other than that cancer patients who have struggled with chronic pain prior to their diagnosis and have been on opioid therapy are also a candidate for drug abuse. These patients experience ‘central sensitization’ which renders them less responsive to increasing doses of opioid and calls for and nonpharmacologic treatment for pain management.

The patient history is key to identifying those at risk of developing an opioid addiction.

A comprehensive history will tell the doctor about the type of pain the patient is suffering from and help them ascertain whether it is an inflammatory pain, neuropathic pain or a nociceptive pain.

The pain could be either acute or chronic, related to cancer or premorbid chronic pain.

Once the pain has been understood their history with substance abuse should be analyzed to verify if they carry the potential to misuse opioids. This even includes those patients who regularly consume alcohol and have been doing so for many years.

There are many screening tools available for clinicians that can aid the identification process. Their validation amongst patients of oncology or other serious illnesses is yet to be made.

However, the chances of it helping a patient avoid a dangerous addiction outweigh the limitations.

Do you have chronic pain? Book an appointment today with Dr. Tom Macek.

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