How does arthritis affect sexuality?

Arthritis is a chronic illness that causes joint pain, inflammation or redness of joints, and fever. It can change the way you feel about yourself. It may increase your dependence on others. The fear of hurting or being hurt may also limit the ability of you and your partner to share physical closeness.

How much arthritis affects your sex life depends on:

• how severe the disease is
• how much discomfort you suffer
• how much you can do physically
• how much pain is caused by touch, movement, and weight-bearing
• side effects of medication
• effects of surgery or radiation on movement.

The fear of hurting or being hurt can indirectly cause sexual problems by:

• decreasing vaginal lubrication and orgasm in women
• causing the man to lose his erection.

The Arthritis Foundation's "Living and Loving: Information about Sex" describes well the anxiety created in these situations. Aware of the possibility of causing pain, partners make avoiding pain the top priority. Thus, with the first wince, moan, or word, desire shifts to compassion and the sexual encounter ends.

What can be done about it?

To control the pain of arthritis, the condition must be diagnosed and treated.

The solutions for each couple will depend upon how much they value physical intimacy in their relationship. A person of any age may have little interest in sex. It may be the result of years of frustration or become a problem only after a crisis appears. Couples who had sexual problems or little interest in sex before the onset of arthritis often use the disease as an excuse to avoid sex.

While arthritis may cause one couple to avoid sex, it may increase the need for closeness and touch in another. Those who have always needed to share emotionally and physically will find ways to meet those needs.

Your healthcare provider or therapist can help you by:

• talking to you about your needs as a couple
• making suggestions to help you cope with the disability
• helping you understand the physical and emotional changes caused by aging, and any side effects of medications or surgery.

To overcome the frustration of both partners during sexual activity you may:

• Use a simple signal, such as a touch or a cough, before the pain is too severe.
• Use a lubricant such as Astroglide, K-Y, or Lubrin during foreplay.
• Take the emphasis off having intercourse and focus on touch, sharing, and closeness by using:
  • sex play
  • mutual pleasuring to orgasm
  • masturbation with fantasy to orgasm.
• Find positions that are comfortable.
• Use pillows to support and protect joints.
• Look at the diagrams of sexual positions in the Arthritis Foundation's "Living and Loving: Information about Sex."
• Avoid weight-bearing positions for the partner with arthritis:
  • If the man is on top and the woman has arthritis, he should support his own weight with his hands and knees.
  • If the man has arthritis, the woman should sit astride him or lie beside him supported by pillows.

The partner with arthritis should:

• Avoid sex after a heavy meal.
• Attempt intercourse only when well rested.
• Take a hot shower or bath before sex.
• Take medicines such as acetaminophen, aspirin, ibuprofen, or COX-2 inhibitors to reduce pain. Ask your healthcare provider what medicine would work best for you.

Written by James P. Semmens, MD.
Published by RelayHealth.
© 2008 RelayHealth and/or one of its affiliates. All Rights Reserved.