Can you have a sex life with chronic fatigue syndrome?

Living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) means waking up every day in a body that doesn’t recharge. Fatigue doesn’t fade. Conversations can feel like marathons. Showering might take your whole energy budget or be impossible. And when it comes to sex and relationships? Things get complicated, too, physically, emotionally, logistically.

As someone who has lived with ME/CFS for over five years, and works as a certified sex educator and relationship specialist, I know how deeply this condition shapes our ability to connect. But connection is still possible. Pleasure is still possible. It just might look different. Whether you’re navigating this solo or partners, here are five ways to stay connected, supported, and sexually fulfilled when you live with ME/CFS.

1. Talk about it (even when it feels obvious)

Every relationship guide mentions communication, but here, it’s non-negotiable. Flare-ups, sudden crashes, energy crashes mid-activity and more. That means partners need to be in the loop. Conversations about changing needs, limits, and desires can’t be one-and-done, they have to be ongoing.

You don’t need to over-explain or apologize for what your body needs. You can say, “Hey, I might need to pause halfway through” or “Right now, I’m available for closeness, but not sex.”

2. Let adaptation be a form of care

Using tools mobility aids, positioning pillows, or vibrators can be amazing supports. And yet, internalized ableism can make us feel like we’re failing when we need support. But, trust me, it can be life changing to get the support you need.

Try vibrators, positioning pillows, less exerting positions, or alarms.

3. Protect your energy

There’s this old idea in relationships that you’re supposed to sacrifice for the other person. But if your tank is empty, you’ve got nothing to give.

Track your energy. Cancel when you need to. Take your meds, ask for touch, skip the guilt.

4. Redefine what sex means to you

Here’s the thing: most people inherit their definition of sex from porn or mainstream media: loud, performative, penetrative, and always ending in orgasm. But that’s not everyone’s truth, and it’s certainly not a requirement.

Ask yourself and your partner(s): What parts of intimacy feel most meaningful? Is it mutual touch? Eye contact? Playfulness? Emotional safety? Co-create your own definition of sex, one that actually works for your life and your body.

5. Ask for help when you need it

If intimacy has become a source of stress or sadness, you don’t have to figure it out alone. There are professionals, like me, who understand both sexuality and chronic illness. A supportive course or a one-on-one session can open up space for healing, creativity, and pleasure again.

Want to go deeper?

My self-paced course, Sex, Intimacy, and Relationships for People with ME/CFS, Long COVID, and Similar Conditions, was created with you in mind. It’s packed with guidance on navigating sex, relationships, body image, and communication through the lens of chronic illness. And it’s sliding scale—no one is turned away.

Prefer personalized support? I’m the only sex educator with lived experience of ME/CFS. I offer free consultations here:💚 www.sexedwithbyrd.com