Respiratory Resource Center | LPT Medical

Intimacy & Relationships with COPD: Maintaining Physical Connection

Written by Eden Coleman | May 5, 2025 6:11:40 PM

Living with COPD affects nearly every aspect of daily life, from simple activities like climbing stairs to more personal matters—including intimacy with your partner.

Yet despite how common these challenges are, they rarely get discussed in doctors' offices or support groups.

Studies show that up to 70% of people with chronic respiratory conditions experience changes in their intimate relationships, but fewer than 15% ever discuss these concerns with healthcare providers.

This silence doesn't help anyone.

Today, we're addressing this important but often overlooked aspect of life with COPD.

Our goal is to provide practical, respectful guidance that helps you maintain this meaningful part of your relationship while managing your respiratory symptoms.

The Impact of COPD on Intimate Relationships

Physical Challenges

Breathlessness during physical activity is perhaps the most obvious challenge...

The increased oxygen demand during intimate moments can trigger shortness of breath, making what should be pleasurable feel anxiety-provoking instead.

Fatigue is another common barrier.

Coughing episodes can interrupt intimate moments, and concerns about when these might occur can create anxiety that makes relaxation difficult.

Additionally, some COPD medications may have side effects that impact intimacy.

Certain bronchodilators can cause tremors or rapid heartbeat, while some steroids may affect energy levels or mood.

Emotional Considerations

The physical challenges often lead to emotional ones.

Many people with COPD experience changes in self-image and confidence.

Fear of breathlessness during intimate moments can create anxiety that makes the very problem you're worried about more likely to occur—creating a difficult cycle to break.

For some, concerns about oxygen equipment, coughing, or other symptoms may lead to embarrassment or withdrawal from physical intimacy altogether.

Depression and anxiety, which are common with COPD, can also reduce desire and interest in intimacy, creating additional challenges for couples.

Communication: The Foundation of Adapting

Talking with Your Partner

Open communication is essential for maintaining intimacy with COPD. Though these conversations may feel uncomfortable at first, they're vital for preserving this important aspect of your relationship.

Start by choosing a relaxed moment—not during or right before intimate time—to express your concerns.

Be specific about physical limitations while emphasizing your continued desire for connection.

For example: "I've been worried about getting short of breath when we're intimate. It's not that I want this part of our relationship to change, but I might need to try some different approaches."

Listen to your partner's perspective as well. They may have concerns or questions of their own, or might not have fully understood how COPD affects you in these moments.

Remember that COPD symptoms can vary day to day.

Help your partner understand that your energy and breathing capacity might be different each time, requiring flexibility and ongoing communication.

Communicating with Healthcare Providers

Though it may feel awkward, discussing intimacy concerns with your healthcare provider is appropriate and important.

These are medical issues that affect your quality of life and deserve attention.

To start the conversation, you might say: "I've noticed COPD is affecting my intimate relationship with my partner. Can we discuss ways to manage this?"

Specific questions to consider asking include:

  • Could any of my medications be affecting my energy or desire?
  • Are there breathing techniques that might help during intimate activity?
  • How can I balance oxygen needs with physical activity?

If your regular provider seems uncomfortable or unable to help, consider asking for a referral to a specialist who has experience addressing these concerns, such as a pulmonary rehabilitation specialist or a sex therapist familiar with chronic illness.

Practical Strategies for Maintaining Physical Intimacy

Timing Considerations

Pay attention to when your breathing and energy levels are typically at their best.

For many people with COPD, this is often in the morning or after medications have taken full effect.

Consider planning intimate time around your medication schedule.

For example, if you use a bronchodilator, timing intimate moments 30-60 minutes after using it might improve your comfort and stamina.

Position Adaptations

Certain positions can reduce the effort required for breathing during intimate moments:

  • Positions where your chest isn't compressed
  • Side-by-side positions that require less exertion
  • Using pillows to support your upper body in a more upright position
  • Positions where you can control the pace and exertion level

The key is finding what works for your specific symptoms and comfort level. What works well for one person with COPD might not be ideal for another.

Pacing and Breathing Techniques

The breathing techniques you've learned for daily activities can be applied during intimate moments as well:

  • Practice pursed-lip breathing to maintain better control of your breath
  • Take breaks when needed without ending the intimate moment
  • Communicate with your partner about pace and intensity

One helpful approach is to agree on a simple signal with your partner that indicates you need to slow down or pause momentarily, without having to break the moment with detailed explanations.

Beyond Traditional Intimacy

Expanding Your Definition of Intimacy

Physical intimacy encompasses much more than just sexual intercourse.

Expanding your view of what constitutes intimacy can open new possibilities for connection:

  • Extended kissing and touching
  • Massage and sensual touch
  • Holding and being held
  • Sharing fantasies and desires through conversation

Creating Intimate Moments

The environment can significantly impact your breathing comfort during intimate times:

  • Ensure good ventilation without drafts
  • Maintain a comfortable temperature (too warm can increase breathlessness)
  • Remove potential respiratory irritants like scented candles or incense
  • Have water nearby to prevent dry mouth from medications
  • Keep rescue medications within reach for peace of mind

Building connection through shared activities that don't strain breathing—like watching a romantic movie, sharing a special meal, or simply holding hands while talking—can create intimacy that may naturally lead to physical closeness.

For Partners: Understanding and Supporting

Education About COPD

For partners, understanding the unpredictable nature of COPD symptoms is crucial.

Breathlessness or fatigue isn't a reflection of desire or interest—it's a physical limitation that varies from day to day.

Learning to recognize signs that your partner might be experiencing respiratory distress can help you respond appropriately during intimate moments.

Finding the balance between being supportive and overprotective can be challenging.

Ask your partner how they'd prefer you respond when they experience symptoms during intimate times.

Emotional Support Strategies

Maintaining attraction and desire despite illness is important for both partners.

Simple affirmations of continued attraction and desire can help counteract the negative self-image many people with COPD experience.

This could be making sure to tell your loved one how attractive he/she still is to you. Mention how their COPD hasn't changed how you see him/her or desire him/her—essentially you'll just needed to learn how to adapt with them!

It's also important for partners to acknowledge their own feelings about these changes.

Frustration, loss, or uncertainty are normal reactions that deserve attention and care.

When to Seek Additional Help

Couples Counseling Options

If intimacy challenges are creating significant strain in your relationship, professional support can be valuable. Look for:

  • Therapists with experience in chronic illness issues
  • Sex therapists who understand physical limitations
  • Support groups for couples facing health challenges

What to expect from therapy: A good therapist will help facilitate communication, suggest practical adaptations, and address emotional barriers to intimacy—all while respecting your comfort level with these discussions.

Medical Interventions

In some cases, medical interventions may help address specific physical barriers to intimacy:

  • Medication adjustments to reduce side effects
  • Pulmonary rehabilitation to improve overall stamina
  • Oxygen therapy adjustments for activity
  • Treatment for related conditions like depression

Don't hesitate to bring up these concerns with your healthcare provider—they're legitimate aspects of your health and quality of life.

Special Considerations

Oxygen Therapy and Intimacy

If you use supplemental oxygen, planning can help make intimate moments more comfortable:

  • Use longer tubing to allow for more movement
  • Consider nasal cannulas rather than masks during intimate times
  • Ensure tubing is safely positioned to prevent pulling or tangling
  • Discuss with your provider whether your oxygen flow rate should be adjusted during physical activity

One patient noted: "We joke that my oxygen tubing is just another thing to work around—like my partner's reading glasses that always seem to be in the way. A sense of humor helps."

Single and Dating with COPD

For those who are dating or considering new relationships, COPD brings additional considerations:

  • Deciding when to discuss your condition with new partners
  • Building confidence in dating situations
  • Setting boundaries and expectations about physical activities

Remember that the right partner will be understanding and willing to adapt with you.

Conclusion

Intimacy remains an important part of life and relationships, even with COPD.

Though adaptations may be necessary, maintaining this connection is both possible and worthwhile.

The keys to success include open communication, willingness to adapt, and remembering that intimacy encompasses far more than just the physical act.

As one long-married couple affected by COPD shared: "We've had to get creative and flexible, but in some ways, working through these challenges together has deepened our connection. We don't take any moment of closeness for granted."

We encourage you to prioritize this aspect of your life and relationships, seeking help when needed and remaining open to new ways of connecting.

COPD may change how you express intimacy, but it doesn't have to diminish the closeness and satisfaction you experience.

Additional Resources

Books:

  • "Sexuality and Chronic Illness" by Leslie R. Schover
  • "Chronic Illness and Intimacy" by Barbara Kivowitz

Support Resources:

  • COPD Foundation (copdfoundation.org) offers relationship resources
  • Better Breathers Clubs through the American Lung Association sometimes address relationship topics
  • Your pulmonary rehabilitation program may offer couples counseling referrals

Remember that you're not alone in facing these challenges. Many couples successfully navigate intimacy with COPD, finding new ways to maintain this vital aspect of their relationship.