Intimacy After Burns
In most instances there should be no reason you would not be able to resume your sexual relationship after discharge. If the genitals or surrounding areas were involved, remember that this area will be sensitive for a few months. Resume your relationship slowly and set your own level of tolerance. This will increase as time goes on. Also keep in mind that it is not uncommon for your sex drive to be decreased following a prolonged illness. As you return to a more normal state of health, your sex drive should return. If this becomes an area of major concern, there are counseling services in many communities. The clinic nurse, physician, or social worker will be able to provide you with appropriate information.
A wife of a burn survivor said, "I just want to be a wife again."
A burn survivor who prided herself on her looks said, "I can’t believe that anyone would ever find me desirable again."
Another burn survivor wonders whether he will ever be able to do the things he used to do.
If this sounds like your life, understand that these concerns are normal. It takes patience, understanding, and lots of work on the part of everyone–burn victims and loved ones–to adjust to these life-changing events.
Sometimes you may need to take a reality check on yourself.
Sometimes you must allow your partner’s needs and wishes to take precedence.
Relationship and intimacy issues
When you’re first admitted to the hospital, your focus and that of your family is on your survival and physical condition.
Once you begin to heal other concerns begin to surface:
- How normal can life be?
- How will I handle relationships with others?
- How will others see me?
One of the realities of burns is that your perception of your body has changed — often challenging your self-esteem.
Because sexuality is something patients and health care providers hesitate to discuss, this pamphlet was designed to help you and your partner address your expectations and feelings related to sexuality. Sexuality is an integral part of being human and is inseparable from body image and self-esteem.
What is a normal sex life?
A normal sex life is one you and your partner decide is comfortable and gives you both pleasure. It can be gentle and healing. It can be holding a hand, a caress, or gentle and loving words.
Key ingredients to staying sexually healthy
- Gather as much information as you can about the effects of burns on sexuality. It is realistic to expect grafts to take eight to 12 weeks to heal. Sexual intercourse after that time is fine. After intercourse, check your skin grafts for signs of irritation.
- Keep an open mind about ways to feel sexual pleasure. A gentle massage or cuddling are ways to enjoy physical touch.
- Because your usual routine has been disrupted, don’t limit yourself in the ways you express caring and feeling alive.
- Establish good communications with your partner about sex–what works, and why. Talking can be the best sexual aid; the worst enemy of sexual health is silence.
Effects of burns on sexuality — and possible solution
Loss of skin sensitivity
"I can’t feel when she touches me."
"I can’t feel his body when I touch him because my hands are so scarred."
Skin is our most basic sexual organ. When the skin is disrupted, it can change how we experience giving and receiving touch. There must be a shared understanding of what feels good for each person. One exercise is for partners to slowly explore each other’s bodies with touch to learn what causes pain or gives pleasure. (During this exercise sexual climax and the genital areas should be avoided.) The goal of this exercise is learning what feels good to each of you.
Decreased energy level
"I’m just so tired all of the time."
This is a common complaint that can interfere with intimacy. Choose a time during your day when your energy level is optimal and when your pain is less. Planning times for intimacy allows you to save energy for your time together.
While perfumed and scented body oils must be avoided, scented candles, soft lighting, mineral oil as lotion, and soft and/or satiny bedding and clothing contribute to a romantic atmosphere.
Decreased mobility and pain
"I’m stiff and it’s hard to move. How am I supposed to have sex?
Decreased mobility and the resulting discomfort can affect what is comfortable for you sexually, and may require you both to be creative and patient.
Slow down and take small steps. Have fun with each other. Use some humor and give yourself time. If at first you don’t succeed, try, try again.
If you experience pain from your burns during sex, try taking pain medication about one-half hour to one hour before the anticipated sexual relations. If decreased mobility is a problem, take time to stretch before or as a part of lovemaking.
You and your partner may find your usual sexual positions are affected by pain and decreased mobility. It is OK to say, "Let’s try it this way." Be creative and find alternate positions that are pleasurable to both of you.
Communication between you and your partner is an essential part of your lovemaking. Do not expect your partner to read your mind. You may have a certain way or place you like to be touched. Share what feels good to you.
Redefining yourself and your relationship
"If I can’t look at myself, how can I expect anyone else to?"
"When I look at myself, all I see are scars."
Changes in your body image challenge your self-esteem and may cause tension in your relationships. Narrowing your focus to healing can help you save your limited energy, prioritize your concerns and may give you the opportunity to tackle the often-difficult task of self-acceptance. However, to your partner this narrowed focus may be viewed as selfish and uncaring.
Your partner needs to know that as you heal–and this may take months–things will get better. Your partner may tend to take personally any reluctance on your part to be intimate but this is part of the normal healing and adjustment process.
It is hard to feel romantic when you question your identity and purpose, or spend much of your day as a caregiver.
It is important to remember than any unresolved relationship issues prior to being burned will likely resurface during stressful periods and may require outside counseling.
Tips to help you improve your self-esteem:
Don’t use your past level of achievements as a gauge for what is acceptable today. This is comparing apples and oranges right now.
Establish a goal for the day. It doesn’t have to be big, but it has to be there. Establish small goals and celebrate successes as you meet the goals.
Realize that the healing and adjustment takes time. Just like other tings in your life, you have to work at it.
Overcoming depression and anxiety
"I cry at the drop of a hat."
"It’s more effort than it’s worth."
While burns change your life, they don’t cause depression and anxiety. Those are caused by the forced changes in your life and your reaction to those changes.
Staying active is a good way to fight stress. Ask your health care provider about what exercises are best for you.
Identify your strengths. Recognize what you can do. Don’t focus on what you can’t do. If feelings of depression and anxiety persist, discuss them with your health care provider. You may benefit from medication or counseling.
- The Phoenix Society of Burn Survivors
- National Burn Victim Foundation
- Your local mental health center
- Your local burn treatment center
University of Iowa Hospitals and Clinics
Peer Review Status: Internally Peer Reviewed