Sex is a fundamental part of life and literally keeps the world alive. When living with chronic illness, frequent pain, and fatigue, maintaining a satisfying sex life can become an arduous task. But it doesn’t need to be. Focusing on intimacy and redefining your idea of what is sexy or sexual will open up a whole new world of sensual experiences.
So today, let’s talk about relationships and sex. One of the most important aspects of any relationship is open communication. A relationship without open communication makes it difficult for individuals to connect mentally, physically, or emotionally. Sexual activity provides more than a physical connection, it binds people mentally and emotionally as well. It also increases blood flow and releases endorphins which serve as the body’s own pain relievers, both which are good for RA.
Open communication requires a willingness to be honest. Rheumatoid arthritis may cause changes to the body which make sex more challenging. You may experience pain and stiffness which interfere with comfortable movement. Fatigue and depression (which are common with RA) may get in the way of desire and libido. Medications you take for RA may also impact libido and sexual response. Or your body may seem fragile, making your partner fearful of causing you additional pain or physical damage.
Communicate with your partner about your concerns and do not be afraid to ask for what you need to be more comfortable. Since RA can affect mobility and range of motion, experiment with different positions to avoid placing stress on parts of your body that are hurting or weak. Rolled-up towels or blankets, pillows, specially-designed furniture, or props can be used to support your body. The Department of Orthopaedics and Sports Medicine at the University of Washington offers tips for communication and new positions to consider when you have arthritis. However, please be aware that if you have RA in the spine, in the neck specifically, it can be very dangerous to put any pressure on the neck during sex.
Pain medication taken 30-60 minutes before sex may make sexual activity more comfortable. Water-based lubricants can be helpful, especially if you experience vaginal dryness due to medication, natural aging, or diseases such as lupus or Sjogren’s syndrome. Avoid petroleum jelly or oil-based lubricants as they can harbor germs which could lead to infection. Sex toys, such as vibrators, can be fun and sex tools, such as masturbation sleeves, are helpful for those who have difficulty using their hands. For men, there are a number of medications available to combat impotence.
Another way to improve your sex life is to aggressively manage your RA and keep your body mobile. Talk to your doctor about using traditional disease-modifying anti-rheumatic drugs (DMARD) or biologics to decrease disease activity and get your RA pain under control. Do what you can to keep your body and joints in good shape. Exercise regularly, eat well, and get plenty of rest. If you use certain medications, such as methotrexate, be sure to consistently use effective birth control to protect against severe birth defects. Your doctor can give you more information.
Keep in mind that intimacy and sexuality do not require intercourse or orgasm to be mutually satisfying. It is often the journey which is satisfying rather than an imposed goal. The sexual behaviors often labeled as foreplay, such as erotic conversations, touching, kissing, and genital stimulation, can be physically and emotionally satisfying sexual activities in their own right. Have fun and enjoy your time with the one you love.
Imagination, creativity, sense of humor, and playfulness are vital in maintaining a healthy sex life. If chronic illness has interfered with your personal relationship and things are falling apart, please consider counseling. Talking with a counselor can help you and your partner work through emotional challenges such as resentment, guilt, or other negative feelings related to your physical relationship.
A Beginner`s Guide to RA: Love & the Horizontal Tango