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Sex, Aging, and Rheumatoid Arthritis

Is it possible to maintain intimacy and a good sex life through RA and menopause? Yes. Here’s how.
By Camille Peri
WebMD Feature

Some women with rheumatoid arthritis sail through menopause without a care while others experience a full menu of menopause symptoms: hot flashes, insomnia, mood swings, weight gain. Menopause can also increase symptoms of RA, such as joint pain and fatigue.

There is actually a slight rise in new diagnoses of rheumatoid arthritis in women around the onset of menopause. Experts think this -- and the fact that menopause can aggravate RA symptoms -- are probably related to the body’s drop in estrogen, which is believed to affect RA. That may also be why pregnant women -- who have higher levels of estrogen while they're expecting -- may see their RA symptoms get better for a while.

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Whether you've lived with RA for a while or just been diagnosed, menopause can pose new challenges to sex, intimacy, and overall well-being. You may feel that because menopause signals the end of fertility, it also means the end of sex. But women with RA can have a thriving sex life well past menopause. Work closely with your doctor, talk honestly with your partner, and try these strategies to help you move smoothly through this life passage.

RA, Menopause, and Vaginal Dryness

One of the first symptoms of menopause that many women experience is vaginal dryness. And it can be a special problem if you have Sjögren’s syndrome, a condition often seen with RA that includes eye, mouth, and vaginal dryness as well as fatigue and achiness. Vaginal dryness can make sex uncomfortable or even painful.

“Your rheumatologist or gynecologist can advise you on various lubricants that might be helpful,” says Linda Russell, MD, assistant attending physician in rheumatology at the Hospital for Special Surgery and assistant professor at Weill Cornell Medical College in New York. You may need to try different over-the-counter lubricants or moisturizers to find the right one for you. Staying sexually active also helps reduce vaginal dryness.

Putting Out Hot Flashes

Do certain foods seem to aggravate your RA symptoms? Some women may find that foods trigger their hot flashes, too. You may want to avoid or cut back on spicy foods, alcohol, and hot beverages if you’re having hot flashes.

Some medications may also trigger hot flashes. Evista (raloxifene), for example, is sometimes prescribed during menopause or postmenopause to prevent or treat osteoporosis. It belongs to a class of drugs known as selective estrogen receptor modulators, or SERMs.

“If a woman is put on a SERM for their bones, it can exacerbate hot flashes,” says Nathan Wei, MD, clinical director of the Arthritis and Osteoporosis Center of Maryland. If you’re burning up, talk to your doctor about switching to another medication for bone health.

Lowered Sex Drive

Some women feel less interest in sex during or after menopause. That's true for some women even without RA. But living with RA can also stifle your libido. For example, if you take high doses of steroids to control inflammation, it may cause you to gain weight -- which in turn could make you feel less interested in sex.

Worrying about pain during sex can kill desire too. And your partner may hold back from sex out of fear of hurting you.

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