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Rheumatoid Arthritis and Sex

The pain of RA does not have to mean the end of sexual intimacy.

Sex, Intimacy, and RA: Self-Esteem and Depression Affect Intimacy

There's more to RA than pain and fatigue. "It is very common," Dobransky tells WebMD, "to develop anxiety and depression that is secondary to RA." When that happens, the antidepressants used to treat depression can have sexual side effects. That adds another dimension to the equation, Dobransky says.

In addition, people with arthritis can have a poor self-image stemming from their joint deformities or medication side effects. For example, steroids can cause weight gain and facial swelling. And methotrexate can cause hair loss.

Making emotional connections, Dobransky says, can help you feel better about yourself. That, in turn, can help you feel more desirable.

Sex, Intimacy, and RA: Love in the Afternoon?

With RA, people often feel the most stiffness in the morning. As a result, sex may be more pleasurable later in the day. But some people may find that pain worsens at the end of the day. That can make sex unappealing at bedtime.

"You need to develop teamwork and coordination with your partner," Dobransky says. "Some people with arthritis may be more open to a 'quickie' or daytime sex vs. evening sex." And once again, he points to the importance of the emotional connection. A good emotional connection, he says, "will promote better communication, more compromise, and more teamwork."

One approach he suggests is to say to your partner, "I seem not to have as much pain in the afternoon. I know you like having sex at night, but can we mix it up and try having sex in the afternoon from time to time?'"

If you are not sure when your pain flares or diminishes, Dobransky says you should track it and notice when it is at its lowest level and its highest. "Once you have established a pattern for your arthritis pain," he says, "you can team up with your partner to take advantage of this together."

Sex, Intimacy, and RA: More Than Just Sex

"Remember," Cadell says, "being intimate doesn't have to mean sexual intercourse." Synchronized breathing, eye gazing, hugging, and kissing are also on the intimacy menu.

"The sense of touch is the most healing," she says. "A lot of people with arthritis don't get massages because they feel discomfort. But being touched by their partner, whom they love and adore, can be healing."

Cadell suggests that you start by saying, "I miss you." Then you can ask for little things like a hug. Bringing intimacy up, she tells WebMD, can re-create that bond that's sometimes severed by an illness. "When one person is ill and the other isn't," says Cadell, "the other person feels helpless." As a result, your partner may be afraid to initiate intimacy because your partner doesn't want to hurt you or be rejected.

Talking about your feelings toward your partner helps your partner feel wanted. It can also let him or her know that advances will not be made in vain.

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