When Making Love Hurts

I usually feel as though I'm 35, which is a massive distortion of reality. My denial, however, hit a big fat speed bump a few weeks ago when I had my first truly painful backache. I'm all better now, but my consciousness has changed. I've begun thinking about ways to incorporate cranky vertebrae into my life — including my sex life!

See also: Are you healthy enough for sex?

Health issues and hot sex don't exactly go hand in hand. But these tips can prevent the most common age-related problems from interfering with your love life.

The problem: "I've got a backache."

The solution: All backs are not created equal, so finding a comfortable position is a trail-and-error kind of deal. For many people, the easiest options are the "scissor" (where both partners lie on their side, facing each other, limbs entangled) or the "spoon" (where one partner cuddles up against the other's back). For men with back pain, try sitting on a chair that has good support. Your partner can then sit on top either facing toward or away from you. Then there's a technique I call "love from above": The guy lies on his back, while the woman lowers herself over him. (Beware: She needs to have strong legs and a good back for this one.) What to avoid? Stay away from the doggie position and classic missionary position, both of which require back strength.

The problem: "Sex isn't comfortable."
The solution: After menopause, vaginal tissues get more tender and natural lubrication diminishes. For some women, intercourse can be a "Yeow!" instead of a "Wow" experience. One solution may be hormone therapy, since additional estrogen can make a big difference. (Talk to your doctor to see if it's right for you.) This can also work for those women experiencing vaginal atrophy.

A less invasive option is using a commercial lubricant. Silicone-based ones are the safest. Remember to apply it as part of foreplay. Finally, taking sex slowly can also be enough to ease the discomfort for many women.

The problem: "I'm recovering from an illness."
The solution: For someone recovering from a stroke, heart attack or even surgery, returning to an active sex life can take time. Partners need to take it slowly and restart their connection with languid, sensual touch. Communication is key: The recovering partner should also let his lover know how vulnerable he feels.

It can also be helpful for both partners to talk to a doctor, who can reassure them both that sex is safe. Remember never to assume that someone who's been sick wants to be left alone sexually. Most people need to be touched, kissed and cuddled. They want to see love and admiration and passion in their partner's eyes. Unless a doctor has expressly forbidden romantic activity, don't be afraid of sex.

The bottom line: As we age, there are hurdles to overcome because of physical changes and medical complications. But they need not be the end of a couple's sexual connection. Even if we can't go back to some of the things we used to do, there are new things we can concentrate on that are also exciting and satisfying. A little innovation can bring great rewards.

Also of interest: Books that can add sizzle to your love life.