Your Sex Drive With Fibromyalgia & Chronic Fatigue Syndrome

Is it Gone for Good?

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You're tired. You hurt all over. Exertion can wipe you out for days. When you have fibromyalgia and chronic fatigue syndrome, is it any wonder your sex life isn't great?

On top of it being more difficult, we often find that, after illness strikes, we just don't have much sex drive. That can be hard on your self-esteem and your intimate relationships.

So where, exactly, does that sex drive go?

Why We Lack the Drive

When we know so little about many aspects of our fibromyalgia and chronic fatigue syndrome, it's startling to know that there's actually a fair amount of research on the libidos of women with these conditions. As you'd expect, multiple studies confirm that we have a lower sex drive than healthy people.

However, they don't always agree on why. One of the earlier studies on fibromyalgia and sexual function7, published in 2006, suggested that it was more of a psychological problem than a physical one. Researchers based that on their finding that mental distress was a predictor of sexual dysfunction while pain was not. Some later research finds a role for distress and other mental/emotional factors as well6 but also found numerous physical reasons.

Other studies link sexual dysfunction in fibromyalgia to:

  • Tenderness, judged by tender-point count;
  • Pain from sex;
  • Inadequate lubrication;
  • Being dissatisfied with the relationship;
  • Anxiety;
  • Poor sleep quality.

Chronic fatigue syndrome studies tie sexual dysfunction to:

  • Comorbid myofascial pain syndrome, or Sjogren's syndrome;
  • More cognitive and neurological symptoms;
  • More intense fatigue.

Interestingly, one study9 compared women with chronic fatigue syndrome to other healthy women to see how fatigue impacted their perceptions of sex.

They found that fatigue had a much greater negative impact on healthy women. The researchers speculated that the difference reflected an altered perception of fatigue in people who live with it all the time.

Drug-Related Sexual Dysfunction

Many of us are on medications (such as antidepressants or anti-seizure drugs) that can lower sex drive.

All three of the FDA-approved drugs for fibromyalgia – Lyrica (pregabalin), Cymbalta (duloxetine), Savella (milnacipran) – can cause a loss of libido, although it's not a common side effect of them.

Other classes of drugs that can cause sexual dysfunction include:

Re-Gaining Your Sex Drive

Some medications may help you regain your desire for intimacy, especially if the problem is drug-induced, so talk to your doctor about it.

If you believe relationships problems, anxiety, or other mental/emotional issues are causing your problems, you may want to work with a therapist.

If major symptoms like pain and fatigue are to blame for your low libido, the best approach is to keep trying to find treatments that help.

Regardless, you don't have to give up your sex life!


Ablin JN, et al. Clinical and Experimental Rheumatology. 2011 Nov-Dec;29(6 Suppl 69):S44-8Sexual Dysfunction Is Correlated With Tenderness in Female Fibromyalgia Patients.

Amasyali AS, et al. International Journal of Impotence Research. 2015 Nov 19. [Epub ahead of print] Effects of Low Sleep Quality on Sexual Function, in Women With Fibromyalgia.

Blazquez A, et al. Journal of Sex and Marital Therapy. 2015;41(1):1-10. The Effect of Fatigue and Fibromyalgia on Sexual Dysfunction in Women With Chronic Fatigue Syndrome.

Blazquez A, Alegre J, Ruiz E. Journal of Sex and Marital Therapy. 2009;35(5):347-59. Women With Chronic Fatigue Syndrome and Sexual Dysfunction: Past, Present, and Future.

Blazquez A, et al. Journal of Sex and Marital Therapy. 2008;34(3):240-7. Sexual Dysfunction as Related to ​Severity of Fatigue in Women With CFS.

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Ramzy EA. Pain practice. 2016 Feb 19. [Epub ahead of print] Comparative Efficacy of Newer Antidepressants in Combination With Pregabalin for Fibromyalgia Syndrome: a Controlled, Randomized Study.

Vermeulen RC, Scholte HR. Journal of Psychosomatic Research. 2004 Feb;56(2):199-201. Chronic Fatigue Syndrome and Sexual Dysfunction.

White HD, et al. International ​Immunopharmacology. 2015 Aug;27(2):249-56. Treatment of Pain in Fibromyalgia Patients With Testosterone Gel: Pharmacokinetics and Clinical Response.