In a previous post, we discussed how hormonal changes or medication side-effects could negatively affect your sex life when living with RA or any other disease. For example both men and women are subject to potential sexual dysfunction due to methotrexate use. Today we will explore any differences in men and women living with rheumatoid arthritis when it comes to sexual functioning, and how RA and sex affect relationships.
Studies repeatedly acknowledge that there are differences concerning the sexual health between women and men with RA, as noted in a literature review published in 2009 focused on the sexual health of women living with RA. Investigating areas categorized as general sexual problems, sexual satisfaction, sexual desire, sexual performance, and sexual functioning, researchers share that RA affects the sexual health of women as a result of pain, reduced joint mobility, fatigue, depression, and body image alterations. Very few solutions were offered in the literature with the most common being the need for increased information and communication, as well as physiotherapy.
Among 52 female RA patients who participated in a 2006 study, 62 percent reported difficulties in sexual performance, of whom 17 percent were totally unable to engage in sexual intercourse because of arthritis. Sexual desire or satisfaction were diminished in 46 percent of patients and completely lost in another 46 percent. Sexual disability correlated with disease activity, hip (but not knee) joint disease, seropositivity, and diminished desire. Pain, age, and depression were significant determinants for sexual dissatisfaction.
So far we have pain, reduced joint mobility, disease in the hips, disease activity, younger age, fatigue, depression, altered body image, and diminished desire as contributors to sexual dysfunction in women with RA.
A 2008 study involving 830 RA patients (74 percent female), echo the findings above. No impact on sexual activity was reported by 31 percent of patients. However 31 percent reported that RA affected their sex lives considerably, including 10 percent for whom sexual activity was impossible or nearly impossible. The latter group had worse health status overall as compared to the group who experienced little/no impact on sexual activity. Higher levels of fatigue, mental distress, functional limitations, lower levels of self-efficacy, and male gender (3.18:1) were associated with perceived problems with sexual activity.
More discussion of fatigue, functional limitations, and lower belief in one’s abilities. Add mental distress and being male to the contributing factors.
In a separate survey of 57 RA patients, 35 percent thought that their disease strained their relationship with their partner, and reasons for this included curtailment of daily and social activities, changes in the balance of the relationship, emotional changes and changed financial circumstances. Over half (56 percent) of the patients found that their arthritis placed limitations on sexual intercourse and the principal reasons cited were fatigue and pain. Sexual ability was important to a small majority of the participants (58 percent), although increasingly less important as patients aged.