Changes in your sex life is often an overlooked consequence of living with arthritis. Difficulties in washing the dishes, vacuuming the floors or walking up and down stairs are common points of discussion, but unfortunately the topic of sex remains stigmatized. The truth is, your sex life may look different if you are living with a chronic inflammatory condition but that does not mean it can’t be satisfying and fulfilling.
A 2015 systematic review and meta-analysis by Liu et al looked at the impact of AS on sexual function. They found that males living with AS had decreased sexual function scores of erectile function, orgasmic function, sexual drive and intercourse satisfaction while females with AS had lower scores in domains of desire and arousal. While the exact mechanism of how AS can affect sexual function is unclear, it is clear that it exists.
There may be many factors that contribute to these changes. These include joint pain, fatigue and exhaustion, depression and mood disorders, low self-esteem and drugs that affect libido. These drugs include cimetidine and diclofenac as well as antidepressants which may decrease desire and ability to orgasm. It is always important to discuss the side effects with your prescribing physician.
Experts say that the first step to having a fulfilling sex life while living with inflammatory arthritis is to reject the idea that sex always means intercourse. There are many different ways to connect with a partner, and it doesn’t always need to be physical.
When it comes to getting physical, communication is key in order to figure out what works for you and your partner. Below are some suggestions that can help adapt you sex life when living with arthritis:
- Treat your underlying condition. In general, the best way to alleviate the discomfort you experience from your disease during sex is to treat the disease.
- Reject the notion that sex needs to be spontaneous. If there is a time of day when your body feels better and ready for sex, then plan around that time. You can also time your medications to ensure that they are having their maximal effect during your sexual encounters. It may also help to use heat packs, balms or stretches to loosen up your joints before having sex.
- Use props. The use of pillows, rolled towels or sheets and even specially designed furniture can help take pressure off of joints.
- Try different positions. Sitting, standing, or kneeling, whatever works best for you! Creakyjoints has an article depicting different positions that are more comfortable for people living with arthritis. https://creakyjoints.org/sex-and-intimacy/sex-positions-arthritis/
- Use sex toys. Sex toys can be a great for sex with yourself and they can also elevate sex with a partner. There are also a variety of adapted sex toys that exist for people with dsabilities.
- Listen to your body. A common theme when living with a chronic illness, it’s important to respect what your body needs and accept that your body is changing.
- Get help. A licensed sex therapist can be a great resource for those epxeriencing difficulties with sex and intamacy.
Remember that adaptability is an essential trait to have when living with SpA. Your symptoms and feelings can change from day to day, let alone from hour to hour. Like any other aspect of life, your sex life can be variable and it’s important to keep an open mind and make changes as needed.
Be creative and experiment. You too are entitled to a healthy and vibrant sex life.