In How I Have Sex, we bring you candid retellings of people’s sexual lives that explore the multidimensional nature of this human experience. In this installment, 30-year-old N.N. recounts her search for sexual pleasure whilst living with chronic pain.

My father is in the army so we moved around a lot in my childhood. Things were a lot worse in the small towns we lived in. For me, personally, sex became something you don’t discuss, you don’t ask questions of your parents. It was very hush-hush, you don’t speak about it. You just become somebody who doesn’t think about what she really likes, what she really wants.

In the early part of my 20s, I spent thinking ‘I’m not sure I’m enjoying myself but I guess this is what it’s supposed to be like.’ Around 24, I started opening up, I started living on my own, started having lots of conversations around women’s experiences of sex, and realized my experience was actually quite common. I slowly developed the sexual confidence to say what’s okay and not okay, to just be honest about it.

Then two years ago, I developed this issue with my spine, my lower back. There’s a lot of inflammation. I also have sciatica — it can’t entirely go away but you can manage it with physiotherapy. I also have herniated discs. I’ve developed it earlier in life than most people do — it’s a genetic thing. The pain, or the threat of it, is a constant in my life — it comes if I walk too fast, or run, or if I twist or bend wrong. This is something I always have to think about when I’m doing any physical activity. With my partner, I’m always very alert, constantly thinking about what action I should do to avoid pain. It creates an imbalance of pleasure — you have to tell your partner ‘hey don’t do this’ or sometimes, abruptly stop things.

It makes you feel inadequate like you’re screwing the other person’s experience. I see myself overcompensating for it — I’ll go the extra mile to say ‘I hope you’re having a good time, because of my pain I know we can’t do a lot of things we could have done.’ I sort of berate myself for not giving importance to my partner’s needs. My chronic pain feels like a flaw, and I have to compensate for that flaw.

For example — we don’t do a lot of positions. If I’m in pain, I can only try four or five. You and your partner are restricted; sometimes we can’t even do missionary because it hurts the spine. I find myself faking it a lot more — if it’s the 10th time I have been more in pain than in pleasure, I just don’t want him to know it isn’t working for me. We’ve already abruptly stopped the past few times because I sensed a threat of pain. I feel like it cannot happen so often, which is why I continue sometimes despite everything. We could be in the middle of it, and I feel a tingling of a nerve in my back, but I keep going anyway.

Related on The Swaddle:

Some Doctors See Pain Just as a Symptom of Being Female

For me personally, the things I am able to find enjoyable in sex have reduced. I don’t completely give in to the experience, which leads to the inability to always have an orgasm, mostly because you’re fearful of pain. When my current relationship with my partner was new, for a long time, I used to underplay the pain, thinking ‘maybe he doesn’t have to put up with it, he could do without this in his life.’ But then my pain worsened, I ended up in the hospital a couple of times, and I realized I couldn’t do it anymore.

And my partner constantly asks, ‘are you hurting, is your back okay?’ It makes me worry that he may not say it, but that he thinks the person he is with isn’t as adventurous as he’d like. It takes away from being seen a certain way. This is an honest insecurity I have because of the pain.

In sex, I feel like communicating a lot. I generally like things to be slow-paced. I don’t like things to be over very quickly. I don’t want a speedy experience. When a partner tries to do that, I’m not into it. I like being soft, not too aggressive. There’s no hurry to move onto the next thing. But with this pain thing, I have to just get it over with. If I take it slow, I have to deal with the possibility of the threat of pain, and I’m not comfortable with it. So now I just want it over and done with so we can move on. It’s a complicated feeling — the hormones in my body are conflicting. I want to feel pleasure in sex, and at the same time, I’m afraid of the pain it can bring. Pleasure and pain are always conflicting.

Now, I’m usually unable to climax. The pain comes and goes — I have a month when the pain in my back is constant, then I do physiotherapy, take medicine and it gets better for a while. Then I may twist wrong or move in a way in which the pain comes back. So the window in which I can actually engage with sex in my own way is short, and I have an orgasm maybe 40% to 50% of the time.

I asked my physiotherapist: am I screwed for life? She said no, and is teaching me to relax, not worry so much about avoiding the pain. The main thing I have to work on is strengthening my core. I do intense workouts and have to make sure my lower back muscles are at their optimal for the rest of my life. One hack is to keep my abdominal muscles tight, by sucking in my stomach so that it supports my spine. I can never gain weight, and I have to keep my abs tightened at all times. My physiotherapist says I have to make it my second nature to keep my abs tightened, so even during sex, I’m trying to focus on that. For now, I have to consciously keep my mind on doing that, which again takes me farther from the actual experience of sex. But my physiotherapist reassures me it will become second nature at some point.

Until then, I’m struggling with the overcompensating part. On one hand, I want to prioritize myself, but on the other, I want to make sure he has a good time. I’m still working at a base level — I don’t have the guts to talk about fantasies, and what my partner likes in bed. Because the basics are getting compromised anyway, and if we have a conversation like that, and he tells me a fantasy, I may not be able to do anything about it anyway. I’d rather not know than have to disappoint all over again. Let me just figure out how to get the basics right. I’m not giving up hope.