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How Rheumatoid Arthritis Affects Your Life

Tips on working and living with RA.

Sex and Intimacy With RA

Rheumatoid arthritis has no shame at invading the bedroom, either. More than half of people with RA report limitations in their sex life, usually because of fatigue and pain.  

"A lot of men and women have problems being physically intimate when their RA is active," says Maura Iversen, DPT, assistant professor of medicine at Harvard Medical School. "It's sort of a silent epidemic among people with rheumatoid arthritis, because neither they nor their doctors tend to bring it up."

Besides the physical symptoms, rheumatoid arthritis can create feelings of depression and low self-esteem -- simply put, not feeling sexy. And disruption in a couple's sex life can spill over into other areas of their relationship, says Iversen.

Taking pain medicine before likely intimate encounters, or experimenting with pillows and different sexual positions, can all help make sex more enjoyable for both partners despite RA, suggests Iversen. Sitz baths and relaxation exercises prior to intimacy can also help.

Iversen recommends speaking up if RA is hurting your love life. Talk with your doctor, or the nurse or physical therapist. Health care professionals are aware of RA's impact on sex, and can offer helpful suggestions

Getting Pregnant With RA and Having Babies

For young women with rheumatoid arthritis, dreams of having a family can be tinged with anxiety. Midnight feedings, hefting toddlers, running nonstop errands: motherhood is a physically demanding job. "They're asking, can I do this?" says Penny Cowan, executive director of the American Chronic Pain Association.

The decision to get pregnant is intensely personal, incorporating a woman's life goals as well as the realities of her rheumatoid arthritis.  

"Rheumatoid arthritis is not a contraindication to pregnancy," says Zashin. But realism about physical limitations is important. And because some RA medicines can cause birth defects, any woman considering pregnancy needs to talk to her rheumatologist.

Safe -- and Unsafe -- RA Medicines During Pregnancy

"Some medicines we use have a washout period ... methotrexate, for example, needs to be stopped for several months before trying to conceive," in both men and women, Zashin tells WebMD.

Other medicines, like prednisone, hydrochloroquine (Plaquenil), sulfasalazine, and biologic agents like Enbrel and Remicade, are generally considered safe during pregnancy.

One bright spot: pregnancy often turns out to be an effective treatment for rheumatoid arthritis. For unclear reasons, most women's RA improves significantly during pregnancy. Unfortunately, though, symptoms usually return soon after delivery.

Get Help and Enjoy Your Baby

A variety of assistive devices are available to help new moms handle the physical stresses of having a new baby on board. Special diaper changing tables, basins to bathe baby more easily, and slings to avoid straining joints while carrying the child are only a few.

Always consider your own rest and sanity during baby's first year, adds Iversen. "When the baby sleeps, you sleep," she suggests. "That's not the time to jump up and try to catch up on the laundry."

"I get photos from women with RA who tell me, I was scared, but [having a baby] was the best thing I ever did," says Cowan.

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How does RA affect your life?