Intimacy is a crucial part of a loving relationship, yet the physical and psychological challenges associated with rheumatoid arthritis (RA) can make having a healthy sex life and being intimate with a loved one difficult. In fact, people living with RA say the disease limits their ability and desire to be intimate, and that fatigue and pain are the main barriers to being physically close with their partners.

The intimacy issue

If you are experiencing problems with physical intimacy, you're not alone. In a poll of people with RA, half said they experienced a loss of interest in sex, and 85% of women reported that joint swelling and associated symptoms were major factors in deciding whether or not to initiate sex.

Even though it might seem difficult at first, talk to your partner or spouse, explain how you feel, and try not to put pressure on yourself. You may also want to discuss positions that hurt or are uncomfortable —as well as those that you find particularly enjoyable. Encourage your partner to do the same.

While these relationship challenges can be frustrating, extra support from an outside party might be helpful. Some couples living with RA have found that speaking with a relationship counselor helped improve their communication and gave them the tools to discuss these sometimes difficult topics.

Let's talk about sex

Expressing yourself sexually is very personal, and you may find it difficult to raise concerns with your partner. Similarly, your physician or nurse may not be proactive in discussing sexuality with you, and it may feel like an uncomfortable subject to broach.

However, if many of the problems you face in your sexual relationship are related to your RA symptoms, better control of these may help overcome some of the challenges you are experiencing.

Speak with your doctor or nurse and discuss solutions that are tailored to your disease and physical needs—and can best improve the quality of your sex life. Once your RA is better managed and you are comfortable, talk to your partner or spouse about ways that you can work around disease challenges and experience a more mutually satisfying, intimate relationship. Ask your doctor or nurse about different positions for sexual intercourse that you can try. Find a few that are most comfortable for both you and your partner or spouse.