Maintaining Intimacy When Arthritis Strikes
By Barbara Kornblau
Now that I’ve got your attention…
Yes, this article is about sex–sex and arthritis. “Sex and Arthritis” (the talk, that is) was a big hit at the 4th Annual ACHEY (Arthritis Can Hit Even If You’re Young) Symposium held in the Health Professions Division Complex of Nova Southeastern University, in Fort Lauderdale, FL. Dr. Yvonne S. Sherrer, a south Florida rheumatologist, presented the workshop.
Health professionals and individuals with arthritis listened to Dr. Scherer’s powerful message. People, she said, often have false expectations of love and sex.
The pain of arthritis can create fear and avoidance. Other symptoms, such as vaginal dryness which often accompanies rheumatoid arthritis and Sjogren’s syndrome, interfere with the movie-fantasy spontaneity of intimate relations.
Dr. Scherer recommends couples participate in activities to create a mood and foster a feeling of closeness. She stresses maintaining personal hygiene and using scented soaps and perfumes to help set the mood. Taking pain medication at the appropriate time can relieve some of the inconveniently-timed pain. Choosing the time of day when fatigue is least likely to occur can also be beneficial.
Some men may experience impotency due to pain or symptoms of various rheumatic disorders such as sclerederma. Depression may strike both men and women with arthritis causing a decrease in one’s interest in sex in spite of the physical ability to participate.
Arthritis medications such as steroid-based medications can cause weight gain and distortions of the facial features, often leaving the individuals uncomfortable with their bodies. Other medications may decrease desire for sexual activity or further contribute to the body image problem by causing weight gain and bloating. Joint changes can cause deformities which also add to the discomfort.
According to couples affected by arthritis, pain seems to cause major changes between the partners. One husband explained “When my wife was diagnosed with arthritis, I felt relieved at first because finally I understood why everything hurt; but then I was afraid even to touch her because I didn’t want to hurt her.”
Pain in the joints of the hands and lower extremities can limit one’s ability to participate in some aspects of intimacy. Painful hips, knees, ankles and feet can interfere with weight bearing and repetitive movement during intercourse. Stiffness and soreness may also limit one’s ability to participate in sexual activity or turn off his or her partner.
The same husband reported that once he got over the hurdle of being able to hug his wife and begin participating in sexual activities again, “in the middle of everything we would have to stop because my wife’s hip began to hurt her. This was frustrating for both of us.”
Couples may need to explore alternative positions as an answer. This requires an open relationship where the partners can discuss details of their painful symptoms and possible alternatives rather than avoiding sex altogether. As one wife explained “Sex was no longer pleasurable for me because my hips hurt so much. I felt uncomfortable discussing this with my husband, so I just avoided sex altogether.”
Young adults with arthritis, still of child bearing age, expect to continue to participate in sexual relations with their partners in spite of their arthritis. In situations where one partner finds intercourse painful, the couple may want to explore alternative methods of sexual expression and gratification limited only by their levels of creativity and inhibitions. Couples should discuss the effects of medications on the fetus prior to getting pregnant and consider birth control in the meantime.
As OTs, we often deal with very intimate aspects of a person’s life such as dressing, bathing, and toileting. Once the patient feels comfortable with the OT’s role in these things, he or she may feel comfortable enough to discuss problems or discomforts involved in sexual relations. Since sex is an activity of daily living, OTs may find themselves counseling individuals with arthritis in this area, just as those occupational therapists reach this subject with individuals with spinal cord injuries.
OTs should familiarize themselves with information regarding sex and arthritis. The Arthritis Foundation publishes an extremely informative and helpful leaflet titled “Living and Loving: Information about Sexuality and Intimacy.”
As one woman attending ACHEY put it, “The information we received from the Arthritis Foundation made it easier to discuss the problems my husband and I had trying to have sexual relations and come up with alternative, pain-free positions.”
Pillows, chairs and cushions can be used to assist individuals with arthritis to find alternative painfree positions for intercourse.
OTs can provide information to individuals with arthritis and their significant others to enable them to continue to participate in the activity of daily living called “sex.”
* About the author: Barbara L. Kornblau, JD, OTR, FAOTA, is an editorial consultant and columnist for
ADVANCE, a practicing attorney and ADA consultant, and a professor at Nova Southeastern University, North Miami.
* Readers seeking more information may contact their local branch of The Arthritis Foundation for a copy of its booklet titled ‘Living and Loving: Information about Sexuality and Intimacy.