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Lupus, Sex, and Relationships

How lupus can affect your sex life, and what to do about it.

Pain, Dryness, and Sensitivity continued...

Water-based lubricants can help with vaginal dryness and sensitivity.

“Some lupus patients are very sensitive; the skin rips easily, and they get very irritated,” Rose says. “Water-based lubricants help with friction and vaginal dryness, and they work with condoms.”

Being in touch with your body can help you figure out when the moment is right, says Marisa Zeppieri-Caruana of Fort Lauderdale, Fla., a lupus patient who serves on the board of the Lupus Foundation of America's Southeast chapter.

“By the late afternoon, I need a nap due to exhaustion and fever, but afterward, I usually feel my best,” she says. “I try to schedule intimacy or sex then, when I have the most energy and feel refreshed. If actual sex isn't in the cards due to a flare-up, sometimes my husband and I take a bubble bath. Massages can also be very intimate, and they've helped soothe my muscle and joint pain.”

Extra foreplay works wonders for many lupus patients.

“In general, women need foreplay in order to lubricate, so with lupus they may need a bit more,” Jones says. “I also recommend masturbation. Having an orgasm may reduce stress, pain, and fatigue, and it reminds women that sex can be fun and pleasurable.”

Drug Side Effects

Steroids can cause unwanted weight gain. Antidepressants can sometimes reduce your libido. Other medications may cause different problems, including vaginal dryness or a tendency toward yeast infections.

If troublesome side effects are affecting your ability to become intimate, tell your doctor at your next appointment.

“Reviewing your medication list with your physician or a pharmacist may help,” Jolly says. “They can print out a list of possible side effects, and in some cases, trying a different medication could be an answer.”

Some women with lupus may feel reluctant to have sex because they're unhappy with their birth control options, since it's commonly believed that all lupus patients should avoid birth control pills. But that may not be not necessary for every woman with lupus.

“A lot of lupus patients and doctors feel that birth control pills can't be used by lupus patients, but it's a subset of patients who have had blood clots,” Jolly says. “Talk to your doctor and ask if birth control pills with low estrogen or without estrogen are OK. Some patients get progesterone injections every three months. There are also IUDs that people can use.”

Self-Image Issues

Some people with lupus develop a negative self-image because of disease-related weight gain or rashes, which make them feel less attractive.

“I have an extremely negative body image because I gained 70 pounds due to prednisone use for lupus, but my husband tells me he loves me just as I am and finds me sexy,” says Laurie Cook of Jamaica, N.Y. “We make love three or four times a week, and although I'm in pain a lot, we're careful to keep our physical love alive and recognize the importance of this fine part of life.”

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