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RA and Intimacy: Keeping Relationships Strong

How to keep your relationship strong and your sex life exciting.

6 Tips for Better Sex with Rheumatoid Arthritis continued...

Don't keep your partner guessing. This is not the time for mystery.Let your partner know -- with actions, noises, and words -- what is exciting, comfortable, and painful during sex.

Once you've had some conversations, Lubbers says, you can develop your own language to indicate that the time is right. While planning ahead can be helpful, taking advantage of the moment can be good, too. RA doesn't have to spell the end to spontaneous sex. "You can have a shorthand signal for 'I feel good, so let's fool around,' so you don't have to talk about it," she says, "almost like the signals between the pitcher and catcher, to make it upbeat and fun."

Keeping Your Self-Esteem Strong

Confidence and self-esteem are sexy, and RA can do a number on both. You may find yourself feeling less attractive or youthful than you used to.

"Depending on where it hits you, you can have issues with putting on makeup, doing your hair -- things that may make you feel pretty," says Lubbers. Here, too, talking about it honestly and asking your partner to help can be vital. For example, when Lubbers couldn't raise her hands high enough to dye her hair, her husband helped. "You figure out ways to make it part of being a couple."  

M.E.A. McNeil, author of The First Year: Rheumatoid Arthritis: An Essential Guide for the Newly Diagnosed, says that accepting the disease and the changes it brings to your life helped her keep self-image and relationship healthy.

That doesn't mean it was easy. She sought psychological counseling after she was diagnosed with RA in 1993. Her first words to her therapist were: "I can't have this diagnosis." Over time, she discovered that she could fight the disease with denial and anger, or work with it by learning to accept it.

"You may have always had a certain feeling about flaky people and then you have to accept that you yourself are going to become flaky -- inconsistent and undependable sometimes," she says. "Being able to accept those conditions influences your sex life and how you relate to your mate. It's not very sexy to be a whiner -- the sexy part of people is that they have a self-assurance seated within themselves. That's one of the elements of being able to have a good relationship."

Working through negative feelings to develop a realistic acceptance of how your body may have changed can help your partner too. "If a woman is being proactive in dealing with it, that helps her partner deal with it as well," says Phillips.

Phillips says couples counseling can help. Working with a therapist who is knowledgeable about rheumatoid arthritis -- or willing to learn about it --  can be extra helpful.

"Don't look at it as one person's problem, but as an opportunity to learn some strategies to better communicate on issues," Phillips says. "If a couple can communicate effectively, they can deal with anything and everything."

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