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When you're in pain and feeling fatigued from rheumatoid arthritis (RA), it's hard to even think about sex. But when you're feeling good, it's a great time to put a little sizzle back in your relationship. Besides the obvious reasons -- you care for your partner, you miss being sexually intimate -- there's a medical reason, too. Sex is a pain-killer. It releases endorphins, and those feel-good effects can last for hours.

Do you ever talk openly with your partner about RA and sex?

Being able to talk about your RA and how it affects intimacy is critical if you both want to have a satisfying sex life. If you are nervous about talking, write your partner a letter. Share what feels good and what hurts. It's never a good idea to have sex if you don't feel like it. But speak up when you feel good! If you initiate sex on good days, your partner may be more understanding on the days you feel unwell.

Do you rush romance?

Take time to enjoy leisurely foreplay. Use gentle massage to relax muscles and joints. And plan for good sex. That's right: A little planning can vastly improve sex. If you know you feel energetic and sexy during the afternoon, make a date for some private time with your partner at home. Take pain medication -- and perhaps a nap -- at least 30 minutes before sex so you are more comfortable and energized.

Do you ever try different positions or props?

Get creative about sexual positions that don’t stress your painful joints. Use your imagination here. Let go of your traditional sexual position if it hurts.

Also, try using props like pillows or cushions to support your hips, shoulders, neck, or back. Or try a vibrator for stimulation during foreplay. Many women have vaginal dryness as they get older. It's particularly a problem if you have Sjogren's syndrome, a condition often seen with RA. For vaginal dryness, try vaginal lubricants (such as K-Y jelly), vaginal moisturizers (such as Replens) or vaginal estrogen creams ( Vagifem).

Have you ever tried warming up together?

Warm showers or baths can ease joint stiffness. So use them to enhance sex. Take a bath together as part of foreplay. Or gently wash each other with an aromatic body wash in a warm shower. You might even try an electric blanket on your bed to make it cozy.

Sex is important to humans, physically and mentally. So if you have sexual problems, talk to your doctor. It's worth getting a referral to a sex therapist who has experience helping people with RA.

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You Are Not Alone

  • 1.3 million Americans are living with RA.
  • 75% of people with RA are women.
  • 3 in 5 people with RA try to stay active.
  • 91% of people with RA are able to keep working.
  • 3 in 5 patients are satisfied with their doctors.
  • 80% say they hope for new, innovative treatments.
  • 75% want to feel better in 3 months of treatment.
  • 80% want treatment to resume full social lives.
  • 2 out of 3 say friends don't understand their RA.
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