Sex and arthritis

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Sometimes the physical and emotional symptoms associated with arthritis can affect relationships, including sexual expression and enjoyment. However, there are ways to overcome these challenges. This sheet provides general information about how to maintain sexual intimacy while living with arthritis. Further sources of information are also listed.

Will arthritis affect my sex life?
Arthritis rarely affects the sexual organs, although vaginal dryness may be experienced with some conditions. However, the emotional and physical effects of the disease can seriously impact on your appetite for, and enjoyment of, sex. If you experience a change in your physical appearance, such as weight gain or loss, or a decrease in mobility or energy, the way you view yourself may change. You may feel less desirable to others or physically fragile. If you are having a flare of your arthritis your joints may be simply too painful for you to have sex – and you need to be open about this. The fear of pain may make it difficult to relax and enjoy sex, and may even cause your partner to worry about causing you pain. It is important to remember that if you can openly and honestly discuss these issues with your partner, arthritis can make you closer and may even improve your sex life. Remember, emotional intimacy is equally important for a romantic relationship – trust, honesty and openness help to build a secure intimate relationship.

Will having sex affect my arthritis?
You will know from living with arthritis that moving an affected joint can be painful. Therefore any physically  demanding activity such as sex may cause discomfort, particularly if your hips or back are affected. Sex itself, however, will not worsen your arthritis, and there are ways to overcome any physical discomfort you experience. If sex is a regular part of your relationship, you should try to keep it so by finding new and comfortable ways to maintain and enjoy that intimacy.

What should my partner know?
It can be difficult and awkward to discuss sexual matters with your partner, even if you have shared a longstanding sexual relationship. However, it is important for you to try to talk about any concerns or fears you have surrounding sex. Work together to overcome difficulties by talking openly and honestly about how you feel both physically and emotionally. Expressing your fears with statements like ‘I am afraid that …’ provides your partner with the chance to reassure and support you. Remember that your partner will have his or her own feelings about how your arthritis impacts on your sexual relationship. Make sure you share your fears and concerns. Listen carefully to what is said, then work together to ensure you both feel comfortable and physically and emotionally satisfied.

If there are problems, how can we get back on track?
Arthritis does not have to signal the end of a mutually satisfying sexual relationship. With a little creativity, patience and planning, you and your partner can rediscover the pleasures of sexual intimacy.

Communicate
Talk openly about how both of you are feeling emotionally and physically – this will help you overcome problems together. For example, fear of physical pain, or causing your partner physical pain, may make you apprehensive about sex. This can cause couples to withdraw from any physical contact so that even kissing and cuddling cease. During sex you should let your partner know if something is either uncomfortable or pleasurable. Work together to find positions and techniques that give both of you the most amount of pleasure with the least amount of discomfort.

Get fit!
Your appetite for, and enjoyment of, sex is generally greater if you feel physically fit and well. So staying active is not only important for maintaining your muscle strength and joint mobility, it will also help you remain sexually active.

Plan ahead for sex
While it may not be spontaneous, planning ahead is worthwhile if it makes sex more satisfying. Think about the times of day you are likely to be more rested and experiencing the least amount of pain. For instance, if you have morning stiffness, afternoons or evenings may be better times for sex. Also consider:

• If pain is a problem, time pain medication for an hour or so before sex.
• Your joints may feel more comfortable after a warm shower or bath – why not share one with your partner?
• Use a heating pad or electric blanket to help soothe sore joints and muscles before sex.
• Use massage to help relax muscles, even as a form of foreplay.
• Pace yourself during the day to save energy for you and your partner.
• If fatigue is a problem, have a nap before sexual activity.
• Have pillows or rolled towels available to help support sore joints.

Get creative
If sex causes discomfort, you may need to try different positions. There are numerous positions that will ensure sex is both possible and enjoyable – for example, one or both partners could stand, kneel or sit. Finding positions that are both comfortable and rewarding will take patience and understanding from you both, but if you work together, you have the potential to reconnect with each other and develop a deeper level of intimacy. In particular, during this time of trial and error try not to lose your sense of humour as it’s important to ensure you have some fun along the way!

Arthritis does not have to signal the end of an intimate relationship. You can learn ways to make the relationship work.

For more information

A psychologist can help you cope with any difficult emotions you feel as a result of your arthritis. They can also teach you practical skills to help you stay connected to the important people and things in your life and assist you with effective communication. Ask your GP for more information about seeing a psychologist or call the Australian Psychological Society on 1800 333 497, or visit www.psychology.org.au

Relationships Australia provides a wide range of relationship support services, including counselling and courses to gain skills and understanding to enhance relationships. These services are offered in many locations across Australia. Contact Relationships Australia on 1300 364 277 or visit www.relationships.com.au

Books:
Miriam Kaufman, Fran Odette, Cory Silverberg 2003 Ultimate Guide to Sex and Disability: For All of Us Who Live with Disabilities, Chronic Pain and Illness, Cleis Press, San Francisco, USA.

Websites:
The Arthritis Research Campaign (UK) has a Sexuality and arthritis booklet available for download from www.arc.org.uk