When you're living with chronic pain, it can put your sex life on pause. In some cases chronic pain is caused by a health problem such as arthritis, fibromyalgia or lupus, or, it may be caused by sex itself such as vaginal pain during intercourse. Also, pain medications can zap your sexual desire and make "not tonight honey" a standard refrain in your relationship.

 Sex is an important part of a fulfilling relationship. If chronic pain is making it unpleasant or impossible, you need to find ways to address what may be perceived as a loss by both you and your partner. Here are a few ways to cope with pain and revive your sex life:

• Start talking. For people who do not have chronic pain, it's very difficult to understand how it affects a person physically, mentally, and emotionally. Your partner may not understand how you're feeling about sex, or may not know what his role should be. Take some time during the day (not when you're "in the moment") to discuss your situation, your needs - physical and emotional - and also your partner's feelings.

• Continue intimacy. Just because you may not be able to have sexual intercourse, it doesn't mean you should give up intimacy altogether. Hugging, kissing, stroking, and cuddling are other ways to strengthen your bond. Seize opportunities to be affectionate and to whisper sweet nothings to your partner. Don't let pain put out your passion for each other.

• Reconsider your medications. Pain can become worse over time, or you may develop a tolerance to your pain reliever. Speak to your doctor about switching to a more effective drug. If a pain reliever causes loss of libido or sexual desire, you may also want to think about taking a different drug that doesn't have the same side effect.

• Stop stressing. Living with chronic pain is stressful. However, day-to-day worries about issues such as your job, finances, or children can make stress much worse, which directly affects pain. Find ways to reduce pain in your life; maybe a job change is long overdue, or calling those creditors and arranging payment plans can help.

• Exercise. Physical activity helps to reduce pain and to alleviate the effects of stress. It also releases feel-good endorphins that can lift your mood, which chronic pain takes a heavy toll on, sometimes even leading to depression. Exercise also strengthens your body and may address some of the underlying causes of your pain, for instance in conditions such as arthritis or an injury. A physical therapist can create a fitness plan to gradually ease you back into being active.

• Use sex aids. Sometimes you need a little help to maintain sexual activity when you have chronic pain. For instance, if vaginal dryness causes pain during intercourse, use vaginal lubricants or prolong foreplay. If you suffer from lower back pain, sometimes a pillow in the small of your back can provide relief. Also, using cushions or pillows for support may help.

• Try different positions. If pain is worse during a particular sexual position (which is often the case for back pain) it's time to try a new one. If you and your partner have run out of ideas, seek inspiration from a book such as the classic, The Kama Sutra of Vatsyayana. You'll also learn more about arousing desire, foreplay and enhancing sexual pleasure.

Seek counseling. Chronic pain affects your self esteem and mood, which may alienate your partner, and undermine your relationship and your sex life. Or, there may be other stressors on your relationship, such as financial problems. Counseling can help you and your partner to address and resolve relationship problems--and it's even more effective if both of you attend.