Rheumatoid arthritis (RA) can change a lot of things, including your love life. Around half of men and women with RA say they’ve had some trouble in the bedroom, like pain during intercourse and low sex drive.
But an RA diagnosis doesn’t have to mean the end of your sex life. If anything, intimacy should stay high on your priority list. “It can improve the overall quality of your life and help take your mind off of your RA,” says Julia Kim, PhD, a clinical psychologist at the Hospital for Special Surgery in New York.
Here’s what you need to know, plus simple steps that can keep passion alive between you and your partner.
Know What’s Normal
Libido lagging? RA-related pain, stiffness, and exhaustion may be to blame. “RA can feel a lot like having a chronic cold. You just feel lousy, particularly when the disease isn’t controlled with medication,” says Matthew Husa, MD, an assistant professor of rheumatology at the Ohio State University Wexner Medical Center. “Until you start feeling better, sex might be the last thing on your mind.”
Even if you’re in the mood, pain and stiffness may make certain positions uncomfortable. Some men with RA may have trouble getting an erection. Experts aren’t sure why, but the body chemicals that cause the inflammation in RA may affect blood vessels in the penis.
The good news? “Treating RA with medication and lifestyle changes, like exercise and a healthy diet, can greatly ease most RA symptoms. And that can alleviate a lot of sexual issues connected to RA,” says Nathan Wei, MD, director of the Arthritis Treatment Center in Frederick, MD.
That’s why it’s key to tell your doctor what’s going on. “If you’re not feeling well or are having a lot of sexual difficulty, that can be a sign that you need to change your treatment plan,” Husa says.
Researchers don’t think RA meds cause sexual side effects. But if you’re concerned yours might be, tell your doctor.
Once you’ve done that, here are four more ways to keep your bond with your partner strong.
1. Talk it out. Yes, your partner knows you have RA, but does he really get how it affects your sexuality?
“He may think your lack of interest is his fault,” Kim says. “That’s why it’s good to be clear about how you’re feeling and what you’re experiencing, even if it seems obvious to you.”
Tip: Use a 1 to 10 scale. You could say, “Today, I’m at a 7. Yesterday, I was at a 3, which is why I wasn’t in the mood.”
2. Be open to change. Certain sexual activities you used to enjoy might not feel good anymore. But instead of focusing on that, think about what does feel good now and what you would enjoy.
“Ask your partner to try different approaches with you until you find something you both like,” Kim says.
Tip: Use pillows or rolled-up blankets or towels to support you during sex. That might help you and your joints be more comfortable.
3. Time it right. You and your partner might be in the habit of being intimate at the end of the day. But when you have RA, your pain and fatigue often peak later in the day, Husa says.
It may sound less romantic, but plan sexual activity when you’re at your best. And if you take pain meds, give them at least half an hour to take effect.
Tip: If stiff joints are an issue, warm up first by taking a shower or bath, using a heating pad or blanket.
4. Touch and feel. You may not want to hug, kiss, or hold hands when you’re tired or in pain, but you should. “Touch fuels intimacy and desire and plays a crucial role in your overall well-being,” says Stan Tatkin, PsyD, author of Wired for Love.
Research shows that touching can reduce stress. That can decrease RA symptoms like pain and could help you get in the mood, Tatkin says.
Tip: Ask your partner for a gentle massage.