“Doc, I’m having trouble at home.”
I get this comment frequently from patients with arthritis. When I dig deeper, they often reveal that arthritis is affecting their sex lives.
There are ways to overcome the hurdles arthritis places in your way. They take patience, a willingness to try new things and honesty with your partner. But sex is an important and healthy part of life. Usually, the benefits are worth extra effort.
Pain is a major symptom of arthritis. Unfortunately, it’s also one of the major barriers to sex.
Sometimes a small change in your routine — such as trying a new position — can make a big difference. A few examples:
As sexually progressive as we are as a society, any of us can get stuck in a rut. For patients with arthritis, “mixing things up” is about more than variety. It’s practical. Finding the right positions for you will take time — and experimentation.
“For patients with arthritis, ‘mixing things up’ is about more than variety. It’s practical. Finding the right positions for you will take time — and experimentation.”
Scott Burg, DO
Department of Rheumatologic and Immunologic Disease
Pain is one factor. Fatigue is another. There are certain times of day when you may feel too drained for sex. And although most medications for arthritis don’t affect sexual function, drugs such as methotrexate (for rheumatoid arthritis) can add to your fatigue.
Planning can help. Do you feel most rested and energetic first thing in the morning or in the afternoon? Is your pain level at its lowest a few minutes after you take an anti-inflammatory? Make these your windows of opportunity. Bedtime is not the only time for sex, especially if that’s when you feel your worst.
“But sex is better when it’s spontaneous,” you may think. It’s a romantic notion, but it’s not always true. Couples often have to work to keep up a healthy sex life in the long term. Finding creative solutions for pain and fatigue is just part of that work.
“We don’t even talk about sex anymore,” some patients tell me. If you don’t talk about it, you can’t work at it.
Not all issues that come with arthritis are physical. You may have depression. You may feel less attractive than you used to. Don’t keep these issues to yourself.
If talking is too tough for you, consider bringing your partner to an appointment and letting your doctor start the conversation. In some cases, couples’ counseling can help you deal with the relationship concerns that come with chronic pain.
Being open and honest can lead to creative solutions. For example, if intercourse is simply too painful, using adult toys or trying other forms of intimacy such as massage offer alternatives. You’ll never know if you don’t start the conversation.
Sometimes rheumatoid arthritis brings physical concerns beyond pain and fatigue. About 15 to 20 percent of rheumatoid arthritis patients also have Sjögren’s syndrome, which leads to dryness in several parts of the body, including the vagina.
For women with Sjögren’s syndrome, intercourse tends to cause pain. Personal lubricants can make a world of difference. Just be sure to check the label for the ingredient propylene glycol. This ingredient causes irritation for some people.
If fatigue is your biggest issue, lifestyle changes can help. Cut out highly refined foods, which may affect inflammation. Eat more fresh fruits and vegetables to boost your nutrient levels. Add low-impact exercise to your weekly routine. Don’t burn the candle at both ends, because rest is crucial.
These tips are good for anybody’s health. But for people with arthritis, they can help boost the energy you need for all of life’s activities — including sex.