Rheumatoid arthritis brings along joint pain and fatigue that can impact various aspects of your life. It can come come in the way of household chores, and daily activities. It can also get challenging to experience intimate moments while managing symptoms of the condition. This is probably why rheumatoid arthritis and sex don’t gel well. The condition can cause so much pain that it may be hard for you to get up every morning. Not only this, it can also lead to other sexual challenges such as a decreased libido as well as low self-esteem. However, there are some tips that can help you enjoy a healthy sex life even as you battle the discomfort and pain associated with the disease.

What is rheumatoid arthritis?

It is a chronic autoimmune disease that mostly affects the joints, causing inflammation, pain, and potential joint deformity over time. “It is a condition where the immune system mistakenly attacks healthy tissue, particularly in the lining of the joints,” explains rheumatologist Dr Soham Kadam. This immune attack causes persistent inflammation, leading to damage in joint structures and sometimes affecting other organs, such as the eyes, lungs, and heart. It usually begins in smaller joints, such as those in the hands and feet, and can spread to larger joints like the knees, shoulders, and hips. It is a health condition that is two- to three-fold more frequent in women than in men, according to research published in the Women’s Health journal in 2008.

The exact cause is unknown, but genetics can contribute to it. “Factors such as smoking, and obesity may act as triggers in people who are genetically predisposed,” says the expert.

What are the symptoms of rheumatoid arthritis?

The symptoms vary, but generally include joint pain, stiffness, and swelling that often starts in the small joints of the hands and feet. “One key sign of this condition is morning stiffness lasting over 30 minutes, which may ease throughout the day but returns with periods of inactivity,” says Dr Kadam. This stiffness, combined with swelling, creates a sensation of warmth and tenderness in the affected joints.

Other common early symptoms are –

• Fatigue
• Low-grade fever
• Loss of appetite

These often accompany joint discomfort. Rheumatoid arthritis can affect other body parts also, and cause dry eyes, inflammation around the heart or lungs, and small lumps under the skin.

Rheumatoid arthritis and sex: Here’s how it affects intimacy

This health condition can significantly impact your sex life. It can cause sexual dysfunction such as decreased libido, according to research published in the World Journal Of Orthopedics in 2014. An older study published in the Rheumatology journal in 2003, showed that 56 percent of the participants with rheumatoid arthritis had limitations when it came to sexual intercourse. The principal reasons cited by them were fatigue and pain. Restricted joint movements as well as problems with body image and self-esteem can also influence sexual function in people with rheumatoid arthritis, as per research published in The Egyptian Rheumatologist journal in 2013.

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Here’s the connection between rheumatoid arthritis and sex –

• Joint pain, stiffness, and fatigue can make sexual activity uncomfortable or even painful, leading to low libido.
• Chronic fatigue is common in people with this condition, so it can lower interest in sexual activities.
• Coping with a chronic illness can lead to anxiety, and body image issues, all of which can negatively affect sexual desire and intimacy.

Rheumatoid arthritis and sex: Ways to improve sex life

1. Open communication

Involve your partner and make them understand about rheumatoid arthritis and sex. Discussing feelings, needs, and boundaries openly with your partner is essential to improve intimacy. “This type of arthritis can be unpredictable, with symptoms like pain and fatigue varying daily, so sharing updates on how you feel can help your partner stay in sync,” says the expert.

2. Consult with your doctor

Some of the medications can help to deal with the pain, but can impact your sexual health. Methotrexate, a disease-modifying anti-rheumatic drug, is generally well tolerated, but may lead to decreased libido in some people, as per research published in the Brazilian Journal of Rheumatology in 2015. Reaching out to rheumatologists or physical therapists will allow you to adjust treatments.

3. Pain management techniques

Since this type of arthritis causes inflammation and joint pain, it is essential to manage these discomforts, especially during intimate moments. Common pain-relief techniques include –

• Taking a warm bath or shower before intimacy can relax sore muscles and increase blood flow to affected areas, reducing pain and stiffness.
• Using cold packs can help reduce inflammation and numb painful areas, especially around the joints, providing temporary relief, shares the expert

4. Experiment with sex positions

Finding comfortable sex positions that minimise strain on the joints is crucial. Side-lying position is one of the best sex positions for people with rheumatoid arthritis. It will allow both you and your partners to lie on the sides, minimising joint strain and making it easier to relax muscles. “Placing pillows strategically under your hips, knees, or back can provide extra support to maintain a pain-free posture,” says Dr Kadam.

5. Scheduled intimacy

Going for scheduled sex, especially when energy levels are at their peak can make a significant difference. Find times when you are naturally more rested, which is often after a nap, or following a relaxing bath, to improve the experience. This may also include choosing a time of day that is typically more comfortable, such as mornings or afternoons, as opposed to later in the evening when fatigue tends to set in more heavily.

6. Emotional support

The association between rheumatoid arthritis and sex life can bring about emotional challenges, including feelings of frustration, guilt, or body image concerns, all of which can impact your willingness or desire to be intimate. Seeking emotional support through individual counseling, couples counseling, or support groups specifically for people with rheumatoid arthritis can be helpful. They will help process the complex emotions that accompany chronic illness.

7. Stay active

Physical activity for everyone, especially people with this type of arthritis. “Stretching, yoga, or low-impact aerobic activities like swimming can improve joint flexibility, reduce stiffness, and enhance circulation, which may positively impact sexual function,” says the expert. Being physically active also boosts overall energy levels and mood, which can help improve sex drive.

Rheumatoid arthritis and sex life can be well managed with the help of communication with your partner, physical and treatment adjustments, and emotional support.