Sex and intimacy are important components of being human, but having rheumatoid arthritis can rob a person of these pleasures. Take heart — there are ways to repair the damage.

Sex is supposed to be fun, but if you have rheumatoid arthritis (RA), enjoying sex is likely to be difficult.

The pain and joint stiffness associated with rheumatoid arthritis can cause sexual difficulties — like trouble getting aroused — and affect your desire for sex. These problems can be both physical and psychological in nature. 

Patients with rheumatoid arthritis face many challenges in the bedroom, depending on the level of disability, treatment course, commitment to a healthy sex life, and ability to communicate about these issues to their partner and doctor. The quality of a couple’s pre-illness relationship also affects the situation.

Rheumatoid Arthritis: The Pain

“My husband was always afraid he would hurt me,” says Lois Demeo, 45, who has had rheumatoid arthritis for eight years. Demeo, a hairstylist outside of Atlanta, attributes her pending divorce to her disease’s pain and the disability it has caused. “Hugging and other physical contact hurts, and there are times when I cannot stand to have even a blanket touch me,” she says.

“Pain is one of the most significant problems impeding many life activities for individuals living with rheumatoid arthritis, including sexual intimacy,” says Lara M. Stepleman, PhD, an associate professor of psychiatry and health behavior at the Medical College of Georgia in Augusta. “Pain makes the actual act of sex more difficult, as well as the ability to experience joy from it.”

Overwhelming fatigue and trouble with joint movement are other common physical barriers to intimacy and can cause the following difficulties:

• Difficulty becoming sexually aroused
• Limited mobility
• Decrease in sexual desire
• Feeling physically unattractive
• Lack of endurance
• Inability to achieve an orgasm

Rheumatoid Arthritis: Ways to Rekindle Intimacy

There are steps that both patient and partner can take to rekindle their romance. “First, the couple must be committed to creating meaningful intimacy and to not get hung up on what ‘good sex’ was prior to rheumatoid arthritis,” Stepleman says. She adds that the couple needs to focus on “creating lifelong sexual intimacy under new rules,” and approach sex with a positive, open attitude and a sense of humor.

“Physical intimacy is not just about intercourse and orgasm,” Stepleman says. “Many people find a great deal of pleasure from sensual massage, cuddling, and sex play that is less physically demanding than intercourse.” Relaxation exercises, fantasizing, and guided imagery may also help patients experience a more pleasurable intimate relationship.

Rheumatoid Arthritis: Help Outside the Bedroom

Couples should be open and honest with each other about their sexual needs, desires, and difficulties. If partners are uncomfortable discussing sexual issues, then one or both may find it helpful to write a note to the other expressing their feelings. Therapists and social workers can also help couples work through their concerns. 

Analgesics, muscle relaxants, and heat applied to painful joints prior to sexual activity may alleviate some of the discomfort associated with sexual activity. “A warm bath or shower can especially improve joint functioning,” Stepleman says. Using an electric blanket to stay warm before or during sexual activity could help relieve joint stiffness.

Your physician can also prescribe exercises that may increase stamina and mobility. Although many rheumatoid arthritis patients struggle with physical activities, exercise is still important, not just for sex but your overall well-being.

Focus on getting close physically and emotionally, rather than on intercourse and orgasm. It may be challenging at first, but couples affected by rheumatoid arthritis can continue to enjoy sex and find satisfaction with intimacy.