Sex, Drugs, and Rheumatoid Arthritis

Mark Borigini, M.D. Health Pro
  • When a rheumatologist treats a patient with rheumatoid arthritis, the focus will naturally be on the joints: Are they swollen? Are they tender? How much morning stiffness does the rheumatoid arthritis cause the patient? Which drug is best for a particular patient?

    But both the rheumatologist and patient rarely discuss the impact rheumatoid arthritis has on a patient’s sex life. There was a study presented at a EULAR congress a couple of years ago which found that one-third of rheumatoid arthritis patients felt their disease had a significant and negative impact on their sex life. Many patients also expressed that RA caused them at least some degree of dissatisfaction with respect to their sexual activity.
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    Men were more likely to report a significant impact on sexual activity compared to female rheumatoid arthritis patients. Patients with a lesser degree of education were more likely to report a greater impact on sexual activity.

    Interestingly, it was not the pain of rheumatoid arthritis which contributed the most to difficulty with sexual activity; rather, it was the higher degrees of fatigue which affected sexual activity in these patients.

    Unfortunately, studies of the impact of rheumatoid arthritis on sexual activity have been limited. Similarly, opportunities for patients to explore the impact of rheumatoid arthritis on sexuality are also few and far between.

    In addition to the fatigue, many people with rheumatoid arthritis also suffer from dry mouth and dry eyes; and women must often deal with vaginal dryness, which of course can make sexual intercourse a painful proposition.

    Treatments for rheumatoid arthritis can obviously help in battling the joint pain, and also the fatigue. Lubricants can make sexual intercourse possible and painless in those patients suffering from vaginal dryness. Drugs for erectile dysfunction can help men whose potency has been affected by the fatigue of rheumatoid arthritis, or the depression associated with having a chronic, potentially debilitating illness.

    Couples need to be open with each other in discussing any potential limitations in the physical expression of affection due to rheumatoid arthritis, whether it be an unstable cervical spine or a painful wrist deformity. Human beings are creative creatures when it comes to things erotic.

    Communication is key here. Doctors and patients must shed inhibitions when it comes to discussing sexuality. It is only then that help can be found. A sense of confidence can belong to the patient who is able to express himself or herself through their sexuality. This sense of control should be part of the healing process. It should be part of the goal of making the feel patient “normal” again.
Published On: February 26, 2007