Rheumatoid Arthritis and Sex

Rheumatoid arthritis (RA) can be found in all areas of your life, including your sex life.

Mariah Leach, who was diagnosed with RA in 2008 when she was 25, knows this feeling all too well.

“Joint pain and fatigue can make physical intimacy extremely difficult, even sometimes uncomfortable,” she says. “When I was first diagnosed and we were still looking for an effective treatment, there were days when I had trouble getting out of bed and putting a cup of coffee to my mouth. – so physical intimacy did not attract me from a distance.

You can still have a healthy sex life if you have RA. Sex, says Hornsby, “is a very normal and important part of life. It releases endorphins and can help relieve pain. But you may need to find different ways that work best for you and your partner.

How RA can affect sex

It’s more than physical.

In a 2018 study, more than half of people with RA reported problems with their sex life, such as pain during sex, low libido, and overall feelings of dissatisfaction with their sexual health.

Common symptoms of RA like pain, fatigue, and stiffness can limit your energy and make you uncomfortable. Some people with RA “don’t feel inclined to be physically active. And they can have reduced strength, ”says JoAnn Hornsby, MD, associate professor of rheumatology at WVU medicine.

Today, Leach, who blogs about her life with RA on From This Point. Forward., Says that tackling RA-related sexual issues with her husband as a united front has only made their bond stronger. “[It] allows us to turn something negative into a chance to build a positive relationship and emotional connection.

While the physical symptoms of RA can affect your privacy, it’s important to note that they can also negatively affect your mental health. But it’s both common and normal when you’re living with a chronic illness. If you or your loved one has been diagnosed with RA, here’s an overview of what can happen and some simple steps you can take to have an active and fulfilling sex life.


What to expect

“Rheumatoid arthritis affects sex … in many ways,” says Ravi Prasad, PhD, clinical professor and director of behavioral health at the University of California, Davis School of Medicine. Limited range of motion, discomfort, and exhaustion may play a role. “People can also feel pain in other parts of the body not even involved in sex. This can make them uncomfortable, which can also affect their libido as a result, ”explains Prasad.

Mood and body image issues can stem from certain medications and limit confidence. “RA can also have a wider impact on your self-esteem. For me, some of the medications I took resulted in weight gain, hair loss and bruising all over my body, which didn’t really give me confidence in my skin, ”Leach admits.

Besides a low libido, sometimes RA can also cause sexual problems such as vaginal dryness and erectile dysfunction.

But there are ways to make a difference. If you are concerned or have difficulty in this area, be sure to talk to your doctor.

What you can do to improve your sex life

Prioritize your sex life. “For me, it helps to remember that everyone – including me – has the right to sexual health. My sexual health deserves to be addressed, whatever other health issues I am facing, ”Leach says.

Be open and honest. “Talk to your partner – people can misinterpret. Something like “My knee hurts today” can be interpreted as “You don’t find me attractive” by your partner. Instead, say, “I love you, I want to see you tonight, but it’s a bad day for me with arthritis. So that your partner knows where you’re from and doesn’t take it personally, ”says Hornsby.

Remember the old saying: it takes two to tango. “My husband and I know that building a healthy sex life requires the participation of two people. So we try to see all the limitations created by my AR as a problem we have to share, ”Leach emphasizes.

Don’t count. When a partner cares for someone with RA, it can sometimes give the impression of an unequal relationship. Over time, this can “breed resentment,” Leach says.


Instead of focusing on what each person does for the relationship, Leach says it’s more beneficial to appreciate the good things that each person contributes to the relationship as a whole.

Conserve your energy. It’s normal to feel tired when living with RA. “Pick times when you feel good. Like anything else, the best time to be successful might not be in the morning when you’re stiff, ”says Hornsby.

Time your pain relievers before engaging in sexual activity to get the most benefit from them. The nap also helps.

Experiment and keep an open mind. If pain and fatigue continue to keep you from reaching your sexual goals, it’s good to use it as an opportunity to get creative and try new positions or other forms of intimacy, Leach says. Sex doesn’t have to be the ultimate sex act to keep it interesting.

Use tools to relieve your pain, and look for other forms of pleasure that you and your partner can enjoy, like water-based lubricants, vibrators, or even rolled-up pillows to support your joints.

Keep it light. Humor can be helpful in awkward situations. On a practical level, Leach says it helps iron out and overcome problems in the bedroom.

“For us, humor is also a very important key to maintaining our privacy. On the one hand, sharing laughs together helps us remember why we love each other in the first place, ”Leach adds.

Try hot baths and massages. The stiffness caused by RA can make it difficult to move in different positions. Take a hot shower or bath to relieve stiffness in your joints. A heating blanket or pad can also do the trick, according to Prasad.

Ask your partner for a massage. This will not only relax your muscles and joints, but can also serve as a foreplay.

Talk to your doctor. Of course, it may seem embarrassing to talk to your doctor about sex. But it’s important that they know if anything is affecting your overall quality of life after trying everything. “Your doctor is the one who can help you control pain and fatigue, which can obviously benefit your sex life,” Leach says.

“I think it’s important for patients to know that there may be something that can be done. Often the assumption is that there isn’t much to change, but there are things that can be changed or identified, ”says Hornsby.

WebMD function



National Institutes of Health: “Sexual health in patients with rheumatoid arthritis and the association between physical condition and sexual function: a cross-sectional study.”

Arthritis.org: “PR and privacy”.

Mariah Leach, blogger, From this point on. Forward.

JoAnn Hornsby, MD, associate professor of rheumatology, WVU medicine.

Ravi Prasad, PhD, Clinical Professor and Director of Behavioral Health, University of California, Davis School of Medicine.

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