If you have arthritis, you may be able to lessen the pain and step up the pleasure.
Annette, a vibrant 32-year-old, has always enjoyed sex. Now that she has been diagnosed with rheumatoid arthritis (RA), she appreciates and enjoys sex even more. Annette is candid about her fears, though, that someday the pain of RA will prevent her from experiencing sexual pleasure. RA stimulates inflammation in the lining of the joints and can eventually cause deterioration of the bone and cartilage. RA can cause pain, stiffness, fatigue and restricted movement all of which can be detrimental to romance and passion.
Annette is realistic in her concerns. Although her RA can be controlled with medications, exercise, and rest, there may be days when sexual or physical activity will be more difficult for her. Many women with RA experienced a decreased desire for sex after its onset. Some women lost their full range of knee and hip movement, which prevented them from assuming familiar intercourse positions. Other women avoided intercourse because they felt the next day would leave them tired and in pain.
Sexual side effects of osteoarthritis (OA) have not been as extensively studied as RA, but many sex therapists report similar problems. Osteoarthritis, which breaks down joint cartilage, causes some of the same symptoms, such as pain and movement restriction, which may interfere with the joy of sex.
Arthritis may change a person's sex life, but that change does not have to signify the end of pleasure.
Part of learning to live with arthritis is being able to communicate with our partner. It may open new doors in your relationship that you didn't know were closed. Both partners need to be open-minded and realize that some things you were doing before may not necessarily work anymore.
One of those changes may be in positioning during sex. Some intercourse positions can be painful for people who have arthritis. For instance, people with hip problems say that being on top can be uncomfortable, since this position demands hip movement.
If you and your partner have been assuming the same sexual positions for years, it may feel uncomfortable to talk about changing positions.
But iff you do not feel comfortable talking about sex with your partner, not talking about it may make it worse. The bottom line is, if you're hurting, you have to let your partner know.
When you and your partner are ready for sex, here are some things you can both do to make the experience more pleasurable.
You are only limited by your imagination. It may feel awkward at first, but you will get used to it.
The keys to a healthy relationship are communication and understanding.
Although it may not sound like an evening in Paris, another way to relieve pain is to synchronize your medication and lovemaking schedules. Try making love after you have taken your pain medication. It is during this time when pain is most minimized. Be aware of the side effects of your medications. Some pain medications can reduce both the desire and/or ability to participate in sexual activity.
Of course, this all requires planning. The best sex is not always spontaneous. If you plan, instead of waiting for the right mood to inspire intimacy, you may find that intimacy inspires the right mood.
Even if you try all of the above, sometimes you will still feel pain. It is difficult to communicate this without making your partner feel like he or she is hurting you especially when the intention is to give you pleasure.
Sex researchers advise that it is important to communicate pain without embarrassing your partner. Focus on what is working, not on what hurts.
Don't endure pain for your partner's benefit. Consider coming up with a signal that indicates something is causing pain if you're not comfortable saying it out loud.
Perhaps the most difficult part of making love when you have arthritis is remembering that your body is a vessel for pleasure, and not just for pain. Don't think about what your body can't do, focus on what you can do, especially if it makes you feel good.
Pleasure may also simply result from making love, particularly if you aim for orgasm. Orgasm releases feel-good endorphins that may temporarily alleviate arthritis pain.
Sandra, who has arthritis, finds orgasm the perfect balm for pain. "I have been widowed for some time and in the last few months have found my soul mate," she says. "How handy for me, because...it seems that orgasm releases endorphins adequate enough to relieve the arthritis pain for some time usually the rest of the evening and through to the next morning!"
If you're not ready for sex, consider good old fashioned romance. Music, food, and candles add ambiance and help you reconnect with each other.
If you and your partner are still having problems, have an honest talk with your doctor. You may be referred a therapist, who can help both of you cope and find other ways to communicate with one another.
American Association of Sex Educators, Counselors, and Therapists (ASSECT)
The Arthritis Foundation
Areskoug-Josefsson K, Oberg U. A literature review of the sexual health of women with rheumatoid arthritis. Musculoskeletal Care. 2009;7(4):219-226.
Rheumatoid arthritis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated October 14, 2013. Accessed October 18, 2013.
Sex and arthritis. University of Washington Orthopaedics and Sports Medicine website. Available at: http://www.orthop.washington.edu/?q=patient-care/articles/arthritis/sex-and-arthritis.html. Updated October 14, 2011. Accessed October 18, 2013.
Tristano, AG. The impact of rheumatic diseases on sexual function. Rheumatol Int. 2009;29(8):853-860.
Last reviewed October 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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