What used to be something that came naturally, more or less, now requires greater intent. Chronic pain and fatigue can be a real downer in our continued pursuit of a healthy sexual relationship. Even though we want to be engaged emotionally, fatigue and brain fog can make it seem like we're climbing Mount Everest. Pain, fatigue, and some medications (or their side effects) can diminish sexual desire and, perhaps, satisfaction. If our partner is also acting as our caregiver, it can be challenging to relate as a couple. Setting aside some time to listen to music, perhaps light candles, and generally set a mood for intimacy can be helpful. As much as we'd like our sex life to be spontaneous, it's not necessarily that way anymore. I think we could all use some variety and playfulness in our relationships. It takes the stress off "performance." Maybe using different scented massage oils or lotions (just not something strong if your partner is sensitive to smells), the above-mentioned candles, and plenty of time to set the mood is what we might need. The end goal is what you mutually decide on. No pressure to perform in a certain manner also helps build emotional intimacy, and helps to deepen your bond.