Sober Sex: Overcoming Sexual Dysfunction
Is there such a thing as sober sex as you go through recovery?
Of course there is. You have a full and happy life ahead of you, with all the experiences that suggests, including a healthy sex life.
However, it may take some work, and there are some realities we need to address.
What is a healthy, sober sex life?
Before we can talk about how to live a healthy, sober sex life, we need to work out what we are talking about. What does healthy sexuality look like to you?
I have some answers. They might be different to yours, there might be some similarities; either way, have a think through them.
I would say that a healthy sex life involves several different kinds of wellbeing. It takes physical wellbeing into account, of course. It is also an emotional and mental process, with the wellbeing of each being fundamental to healthy sex. If you are spiritual in outlook, you may also include this: your sexual activities may need to take note of, fulfil, and improve, your spiritual wellbeing.
There is more to it than this, however. I would argue that a healthy sex life is a nurturing process. It is intimate, of course, and can be very serious. It also needs to be fun and playful. Sensuality is key to it, as is safety, honesty, and trust with your partner or partners.
This last point is incredibly important for sex in addiction recovery. Intimacy includes vulnerability and visibility. It needs to include and result in acceptance – of yourself, of your partner, of your imperfections and your history. Accept these things without judgement, if you can, for a healthy sex life.
The challenges facing us with sober sex
Sober sex can be challenging and alarming. We all have our hang-ups. We all have things that get in the way of our sex lives, from busy lives and lack of energy to poor body image, a feeling of inadequacy, and issues of honesty around our sexual desires, appetites, and fantasies.
Sexual dysfunction can also come into play. For men, we are talking about libido, erectile dysfunction (ED), ejaculatory problems, and concerns with sensitivity, for example.
This can become even more problematic for those coming through addiction recovery who are attempting a sober sex life.
We need to unwrap these issues and sort them out, preferably into one of three categories.
The three categories of sexual issues
If you have always had a particular issue, it is a primary issue. For example, if you have always struggled to get and maintain an erection, you have ED as a primary issue. If, however, it is a new concern, it is a secondary issue. For example, if you used to be able to get and maintain strong erections, but cannot now, you have ED as a secondary issue.
Then there are situational issues, in which context is key. For example, you may have ED with one specific person, or in some specific settings.
This will help you to work out a fair amount about yourself, your triggers, and the ways in which you feel safe and secure or, conversely, unsafe, insecure, and, as a result, unaroused.
If problems are situational, stay away from the situations in question, or learn to be comfortable with them, if you can and if it’s appropriate. If they are secondary, and you could do things before addiction that you struggle with now, accept it as part of the healing process. Likely, with medical intervention, counselling, and time, you will overcome your sexual issues.
If the issues are primary, you may need further medical care and/or counselling to get to the bottom of it as you pursue your sober sex life.
Sexual Dysfunction and Sober Sex
Primary, secondary, or situational, what are the various types of sexual dysfunction from which men might typically expect to suffer?
There are three common groups to look out for in men. These include.
1. Sexual desire disorder, which is marked by a decreased libido and desire for romantic, sexual activity.
2. Sexual arousal disorder, which is marked by an inability to become aroused or excited during sexual activity. For men, this is often manifested as some form of ED.
3. Orgasm disorder, or anorgasmia. This is an inability to have orgasms and can arise from physical, pharmacological, or psychological concerns.
Sexual dysfunction can become more common as we age. It is far more common in men over the age of forty, due to several changes in the body. These include hormone, neurological, and circulatory changes that occur naturally as part of the ageing process.
It can also be common during addiction and addiction recovery for the same reasons. It can become an issue as you attempt to live a sober sex life.
Addiction, Sober Sex, and Sexual Dysfunction
Drugs and alcohol can inhibit sexual function. Yes, the idea of ‘sex, drugs, and rock and roll’ is a little misleading. Sober sex is generally a better bet.
For instance, cocaine can delay or impair ejaculation, whilst heroin can diminish libido and make it hard to orgasm. Cannabis, meanwhile, can lead to ED and a loss of libido. It can decrease the sensitivity of certain stimulation receptors within the penis.
Alcohol can lower inhibitions, so lots of people prefer to have a drink before sex. However, it can also significantly decrease the physiological signs of arousal. It can lower libido, decrease orgasm intensity, and lead to ED.
These effects are often short-term. That is, they often only occur in the presence of an addictive substance. Sexual function should begin to return to a healthy level after detox and withdrawal, leading to a healthy sober sex life. This isn’t always the case, of course, but most people will enjoy normal sexual function within the first year of recovery.
However, not all sexual dysfunction through addiction and recovery is caused by the addictive substance itself. There are several psychological or medical reasons that sexual dysfunction might arise.
Psychological sexual dysfunction in addiction and recovery
The psychological reasons underpinning a person’s addiction might also contribute to sexual dysfunction.
For example, you might have used drugs or alcohol to escape depression. This same depression might lead to a low libido and an inability to make yourself vulnerable to a sexual partner. Or you may have tried to escape or treat anxiety, which can also lead to sexual dysfunction.
Counselling or working with a sex therapist is often a good idea, here. You will need to address the underlying conditions if you want to enjoy a happy, healthy, sober sex life.
Alternatively, addiction may cause psychological damage and conditions that can lead to sexual dysfunction. For example, you might become depressed or anxious through the recovery process. Or, you may experience feelings of guilt or shame towards your spouse or partner for your actions whilst intoxicated. This can interfere with romantic relationships, causing tension and distance.
Again, counselling may help. Couples’ therapy may be a good idea, giving you and your partner a safe space to conduct a healthy, constructive dialogue.
Sexual dysfunction through treatment medication
Some common forms of medication can interfere with sexual health quite drastically. You will likely come across a fair few of them during your recovery. For example, many types of antidepressants have been linked to sexual dysfunction, including common SSRIs such as Prozac. These can complicate your transition to sober sex.
If medications are affecting you, do bear in mind that sexual dysfunction should subside slightly as your body adjusts to them. However, if symptoms persist, or are really causing you concern, you should speak to your healthcare provider. Your doctor or consultant may be able to change the type of medication you are on, put you on a lower dose where appropriate, or may have some suggestions for overcoming medication-based sexual dysfunction.
You should never stop taking medication without your healthcare provider’s oversight and approval, no matter how bad the side effects may seem to you. Always talk to your doctor before changing your healthcare and medical regime.
Your overall health through recovery
Your overall health will likely be the biggest factor in overcoming sex problems in addiction recovery.
For example, sexual dysfunction can have a hormonal genesis. Hormone concerns are common in recovery, especially those overcoming alcoholism, or cannabis addiction. Both can cause feminisation in men – enlargement of breast tissue, a proclivity towards belly fat, a lack of muscular strength, a loss of body hair, a shrinking of the testicles, and so on. It can also diminish sexual drive and function. This is down to a loss in testosterone.
Low testosterone needn’t be too big a deal. In minor cases, certain natural supplements can help. In more severe cases, medical intervention can reverse the issue.
Your mental wellbeing will also be key to maintaining healthy sexual function.
For instance, low self-esteem can impair your sexual health and function, leading to a loss in libido, an increased risk of suffering with ED, and an overall lack of will to make love. Guilt can do similar things, especially if you feel guilt towards your romantic partner.
Losing the security of your addiction can also play a role. If you are used to being intoxicated during lovemaking, it can be overwhelming to suddenly have to perform sober. Self-consciousness can kick in, as can the simple unfamiliarity of the situation.
Overcoming your concerns having sober sex
These psychological factors will all take time to overcome. A good counsellor or therapist will help. So too can talking it out with others in your support network, especially those who have gone through similar issues.
Whatever concerns you have, it is important to be open with your partner about them. They will likely be far more understanding than you imagine. They will be able to help put your mind at rest. Ask them to take it slow, be prepared for good days and bad, and look for additional forms of intimacy. If sex is out of the equation some nights, pleasuring them in other ways, or simply cuddling and talking things through, will always be a good option.
Take your time
As with anything on this path, overcoming sex problems will take time as you go through addiction recovery. That’s fine. It won’t be like a light switch, though you will likely experience a few breakthrough moments on the way. Rather, it will be a gradual journey to the place you want to be.
Often, talking to others who are in a similar situation can reassure you you are not alone. You can connect with others in recovery by freely subscribing to our Community
Take your time. Also, feel free to treat it as an opportunity, especially if you are in a long-term relationship. Rebuilding your sexual health together can be very rewarding, a bonding experience like no other.
- Sexual dysfunction in persons with substance use disorders: https://journals.sagepub.com/doi/full/10.1177/2631831819849365
- Sexual Dysfunction in Patients with Alcohol and Opioid Dependence https://journals.sagepub.com/doi/pdf/10.4103/0253-7176.140699
- Prevalence of sexual dysfunction in male subjects with alcohol dependence https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917074/
- MARC WALTER, URS GERHARD, MANFRED GERLACH, HEINZ-GERD WEIJERS, JOBST BOENING, GERHARD A. WIESBECK, CONTROLLED STUDY ON THE COMBINED EFFECT OF ALCOHOL AND TOBACCO SMOKING ON TESTOSTERONE IN ALCOHOL-DEPENDENT MEN, Alcohol and Alcoholism, Volume 42, Issue 1, January 2007, Pages 19–23, https://doi.org/10.1093/alcalc/agl089