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Intimacy in Rheumatology

This is one of the difficult questions that patients feel is to hard to raise and discuss with their doctors. Sexuality is an integral part of being human. It is linked to our quality of life and self-identity. Yet, living with the pain, stiffness, fatigue, limited movement, decreased strength, and depression associated with arthritis can reduce our ability for sexual expression and enjoyment.

I had this conversation with one of my clients earlier this week, it was bringing issues within the relationship, I felt it would be good to discuss it further ……

Common issues that our patients undergo

Men – erectile dysfunction


1.Some women find sex painful because they can’t find a comfortable position.  Symptoms of reflux (such as heartburn) can be made worse by lying flat and having the weight of a body on top

2.The vagina can become dry with less lubrication during arousal. This can make sex uncomfortable or even painful.

Both genders-

Joints may feel stiff and not move as easily

Fatigue is a frequent problem and can seriously alter your sex life.

Degree of pain

Physical limitations

Contribution of movement, touch, and bearing weight to discomfort

Self-perception, self-esteem, and emotional attitude

Side effects of medications- They may lower libido


What can I do to improve my sex life?

It’s important to have Open and honest communication between partners about feelings, desires, challenges, and sexual needs is critical. Be willing to define intimacy through creative touch, different techniques, sexual devices, and new positions

Ways to improve intimacy include:

Try to set up a calm and relaxed atmosphere

Find positions that are comfortable for both of you

Avoid sexual activity when you are really tired

Avoid sexual activity after a big meal

Avoid drinking alcohol before sex

Check with you doctor to see if you’re taking medications which may be interfering

Rest up and plan for sexual activity- Napping before sexual activity, Taking a warm shower or bath or using a heating pad or electric blanket to help ease stiffness and soothe joints and muscles and Timing pain medication so its maximum effect is during sex

Stay as active as possible

If you are having problems with arousal, or loss of interest in sex, it may be due to depression.

Remember, attitude is everything. Rather than setting intercourse as the goal, strive for emotional and physical closeness. The sexiest part of your body is your mind and how you use it.

Source: American college of Rheumatology

             Johns Hopkins Scleroderma Center