Q: Pain from arthritis is affecting my sex life. Is there anything I can do to fix it?

A: “Doc, I’m having trouble at home. You know...?” Not a great conversation starter in an office visit with a rheumatologist, but it’s common to hear from patients with arthritis about how the condition affects their feelings of sexuality and their sex lives.

Inflammatory arthritis is a group of diseases characterized by inflammation of the joints and tissues, and includes rheumatoid arthritis, psoriatic arthritis, lupus, and ankylosing spondylitis.

Inflammatory arthritis can cause joints to be tender or painful, and when it hurts to move, sex may feel like the last thing on your mind. Additionally, swollen or misshapen joints or weight gain may make you feel older and less attractive. Often men’s penile blood vessels are affected, causing arousal and erectile dysfunction. For women, offshoot immune disorders like Sjögren’s syndrome can decrease lubrication.

These symptoms can reduce sexual enjoyment. But it’s important to make your sex life a priority as intimate relationships are part of a healthy, high-quality life.

There is no magic bullet to make arthritis complications disappear. But here are some recommendations that can help.

  • Foster open and honest communication. Allow yourself to be vulnerable with your partner about fears, sexual needs, desires, and difficulties.

  • Accept change. We’re all “in process” at every age.

  • Plan ahead. Take medication or muscle relaxants beforehand, nap with a heating pad, take a warm shower or relaxing hot bath, use an electric blanket to relieve joint stiffness and add more pillows.

  • But also, be more spontaneous. Consider intimacy at different times of day, rather than bedtime when you are naturally more tired.

  • Connect in other ways by hugging, kissing, cuddling, or try a massage. 

  • Experiment with new positions, oral or manual stimulation, lubricants, and devices.

  • Stay active with exercise to increase stamina, strengthen muscles, and improve range of motion.

  • Address any depression symptoms and seek professional help. 

  • After joint replacement surgery, discuss safe positions for sexual activity with your doctor.

Gary V. Gordon, MD, FACP, FACR, is a rheumatologist at Main Line Rheumatology with offices at Lankenau Medical Center in Wynnewood and Main Line Health Center in Broomall.