Sex Barriers and Rheumatic Autoimmune Forms of Arthritis

Q: It’s a difficult topic to talk about, but my RA can get in the way of intimacy with my partner. I can be extremely fatigued, often not be “in the mood”, can find it hard to be flexible, and sometimes I get genital dryness. What, if anything, can be done about this?

A: RA and similar conditions (e.g., Psoriatic Arthritis, Ankylosing Spondylitis) can make its way into every aspect of your life, including your sex life. In one 2018 study, more than half of the people living with RA reported issues related to their sex life, for example, pain during intercourse, low sex drive, and feeling dissatisfied overall with their sexual health. These are all very common complaints/symptoms and it’s great we are addressing them because they aren’t spoken about often.

Joint pain and fatigue can make physical intimacy extremely challenging, and even unpleasant at times which can affect your libido and motivation to get started. But you can still have a healthy sex life if you have RA, you might just have to find different ways that work best for you and your partner.

Here are some things you can do to improve your sex life

  • First, it’s important to prioritize your sex life

Everyone has a right to sexual health. Everyone’s sexual health deserves to be addressed but you need to be willing to explore, research and seek professional health, ask your GP or specialist

  • Be open and honest

Practice open and clear communication with your partner to reduce misunderstandings or misinterpret, for example, something like, ‘my knee hurts today’ can be interpreted as, ‘you don’t find me attractive, or you don’t want me sexually anymore’ by your partner. Instead, you could say, ‘I love you, and I want to see you or be with you tonight, but this is a bad day for me with arthritis.’ This way your partner knows where you are coming from and they are not taking it personally.

Remember the old saying: It takes two to tango. Building a healthy sex life takes the participation of two people. Try to think of any limitations created by RA as an issue you both need to share

  • Consider energy levels

Pick times when you feel good. For example, the morning may not be the best time when you’re stiff…Time your pain medications before your you engage in sexual activity so that you can get the most out of it.

  • Experiment, explore and keep an open mind

If pain and fatigue keep getting in the way of achieving your sexual goals, it’s good to use it as an opportunity to be creative and try new positions or other forms of intimacy, for example, oral sex or even massage; intercourse doesn’t necessarily have to be the ultimate sexual act or form of intimacy to keep it interesting. You could explore the use sex toys, use water-based lubricants, or even use rolled-up towels or pillows to support your joints

  • Keep it light-hearted – Humour can be helpful in uncomfortable situations
  • Talk to your doctor

It can be difficult to bring up these issues with your doctor or Rheumatologist, but it’s highly likely that the “embarrassing” and/or “awkward” issues about your condition like genital dryness or psoriasis around the genital area are not new or surprising to your GP, and they will work with you to address the issue.

If you’d like to hear more about this topic and family planning for those with an autoimmune rheumatic condition, please listen to the recorded webinar Sex and Family Planning ( with guest speaker and Rheumatologist, Dr Ilana Ginges.

Kat Keane, Health Educator
30 November 2022