EDITORIAL BOARDCheryl Koehn
Let’s talk about sex – the topic few ever voluntarily raise following their RA diagnosis. Sometimes the ‘sex talk’ with your partner or a supportive friend – especially your rheumatologist – can be difficult, but it’s an important one to have if you are experiencing difficulties with the person with whom you share intimacy.
Research shows that physical intimacy may be difficult as a result of having pain, fatigue and joint stiffness which makes body movement and positioning difficult.1 I have found that dealing with these symptoms during sexual activity or intimacy requires: good communication between you and your partner; potentially adjusting timing of medication if nausea is an issue; experimentation with different positions. Experimenting can be helpful, fun and exciting for you both. Not to sound too Zen about it, but essentially, you may need to consider new priorities that reflect your diagnosis and its impact on your relationships. In the spirit of openness that I hope this blog communicates, I’m happy to report my body has adjusted to my treatment and with that my libido is back. But now it’s my fatigue. It can be really tough to find energy to do anything in bed other than rest and sleep. It really starts with being open about the physical and emotional difficulties my RA causes and educating my partner about my disease. After long talks about how RA was affecting my daily life and our relationship, we actually have come up with a simple way to communicate my daily level of pain and fatigue by using a number scale. When I’m at a 2 or 3, he knows I won’t be feeling frisky in bed that night. We have found a way to talk about sex regularly. Last month, I asked him if he now was finding me undesirable because he had stopped touching me like he used to. That led to a great talk where he opened up and told me he still found me as sexy as ever but was not initiating contact because he was afraid of causing me more pain.
From my perspective, chronic pain suffered by one partner definitely ends up impacting the lives of both partners, so sharing your feelings, concerns, and desires is a really positive first step to enjoying your sex life again. While I understand everyone is different, I would just say to keep positive through the inevitable process of trial and error as you find new ways to satisfy each other physically and emotionally. Finally, it is paramount to keep loving and be proud of your body, but if you need support in doing that, the help of a trained professional such as a sexual health counsellor can be a (sex) life saver.
Reference:1. Hill J, Bird H and Thorpe R. Effects of rheumatoid arthritis on sexual activity and relationships. Rheumatology 2003;42:280-286.