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RA and Intimacy: Keeping Relationships Strong

How to keep your relationship strong and your sex life exciting.
By Camille Peri
WebMD Feature
Reviewed by Louise Chang, MD

So how's your sex life? With rheumatoid arthritis, that question may make you sigh instead of smile. Fatigue can kill desire. Fear of hip or knee pain can keep you from trying. Or perhaps emotional pain is holding you back -- you just don't feel as connected to your lover as you used to or you don't feel sexy. 

You don't have to suffer through sex -- or without it. Some expert tips can help. And thanks to aggressive treatment with newer advanced medications, some sexual issues that used to be common with RA may be a thing of the past.

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"Things are very different now than 15 or 20 years ago because our treatments are much more effective and we're getting to patients earlier," says Nathan Wei, MD, clinical director of the Arthritis and Osteoporosis Center of Maryland. That means that many women may be less severely affected by joint damage from RA than in the past.

But what if you still have pain, morning stiffness, fatigue, or emotional issues? Both experts and women with RA say it doesn't mean you can't work around them. "There are women even with severe rheumatoid arthritis who have very happy, warm, productive, intimate lives," says psychologist Robert Phillips, PhD, founder and director of the Center for Coping in Hicksville, NY. "I tell my patients, 'That means you can too.'"

In fact, sex may actually help relieve rheumatoid arthritis pain, at least temporarily. After sex, the body releases endorphins, which are natural painkillers. Their feel-good effects can last up to several hours.  

These tips may help you overcome common hurdles to intimacy when you have RA.

Figure Out Why Sex Is Difficult

The first step in getting your sex life back is to find out what specifically is standing in the way. For women with rheumatoid arthritis, medication-related vaginal dryness, decreased endurance, or loss of desire may be to blame.  

What to do? Ideally, talk to your rheumatologist. He or she knows the most about your condition, the medications you are taking, and their possible side effects. Your rheumatologist can also refer you to the right person to help -- for example, to your gynecologist if the problem is vaginal dryness.

Believe it or not, it may be easier to talk to your doctor about sexual issues if you bring your partner along. When making your appointment, let your doctor know that you want to focus on intimacy. That way you all can reserve plenty of time to talk about it.

Just can't imagine talking about sex with your rheumatologist? "Talk with whomever you feel most comfortable talking with," says Wei, whether that's a nurse or therapist or your gynecologist. Just don't suffer in silence.

Talk With Your Partner

When you have RA, both you and your partner may avoid sex instead of talking about it -- and that may harm your relationship. Don't make that mistake.

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