A Beginners Guide to RA: Love & the Horizontal Tango

Patient Expert

One of my favourite frog stories -- as in, "you have to kiss a lot of frogs before you find a prince" -- was the man who said he didn't want to date me because he wanted an equal partner. As I'd managed to have a number of equal relationships with family, friends and past lovers despite my disability, I inquired what prevented me from taking on that role. To which he muttered something about wanting a woman who could help paint the house. And that was the moment I realized that someone not being able to "handle" my RA was entirely about them and not me. Quite a liberating moment.

_"Let your freak flag fly, and if someone doesn't get you, move on."

  • Drew Barrymore_

Whether you're single or part of a couple when you receive your diagnosis, you may wonder how it will affect your romantic life. When do you tell? How will your partner or potential lover react to the disease? How will it affect your sex life?

If you're single and you've met someone interesting, the timing of "coming out" about having a chronic illness can be a little delicate. Keep in mind that your RA is part of what you are, not who you are and therefore, perhaps not relevant in the initial few conversations. Yet, the sad truth is not everyone is going to be able to adapt, so it's a good idea to discuss it before you get attached to the person. When you feel the time is right, I recommend a quiet conversation with relatively few details, yet indicate that you are willing to answer questions. Be yourself -- pretending your RA just involves "minor arthritis pain" is too exhausting in the long run. Finding love isn't easy, even if you don't have a chronic illness, but the good thing about someone running screaming for the hills is that you know right away they wouldn't make a good partner for you. And there's every chance that you'll meet someone who will look at you and see a goddess. They're worth waiting for.

When one of the partners in a relationship has a chronic condition, it adds extra stress and makes it essential that the two of you communicate well. On days where the pain and fatigue takes all the coping skills you have, leaving you unable to be as loving as you would like -- OK, at times as irritable as a cat trapped in a room full of toddlers -- it's important that your partner understands you may need a hug or some space until you've regained your equilibrium. It's equally important for you to let your partner know that you're having a bad day so the situation doesn't disintegrate into hurt feelings or a fight. If you find the two of you are having trouble reaching each other because the RA is in the way, counseling can help you nurture the relationship so you can face the stresses of life, including your disease, as partners.

Sex is 90% mental- unknown

When you're on day 13 of feeling like crap, the knuckles of your hands are barely visible through the swelling and you're knocked out on the couch because it's the day after your medication, it's hard to feel sexy. You may even start to wonder how your lover can be attracted to you. But our brains are the biggest erogenous zone we have and once you pass your mid-20s or so, being a babe or a hunk has more to do with who you are inside.

RA can affect your energy levels, so you may end up using all your energy getting through your day, wanting to use your bed only for sleep. But here's something the rheumatologists don't often tell you: sex is a fantastic painkiller. In addition to making you feel cared for, sexual arousal and orgasm releases endorphins (similar to opiates) that make you feel good, relaxed and in less pain. Keep in mind that because of this, you may be tempted to do more than your body will like in the morning, so don't go swinging from the chandelier unless you have very few plans for the next day.

When you have RA, safe sex means more than just protecting yourself against STDs and unwanted pregnancy. If you're on methotrexate, use two kinds of birth control with a high effectiveness rate as the drug can cause severe birth defects (your doctor will be able to give you more information). As well, you need to be careful of joints that are damaged (for a list of sexual positions that ease the strain on your joints and what to avoid, click here for a recent article by Dr. Mark Borigini). You can also go here for a website with information and illustrations regarding sex for people who have chronic pain or disabilities. Both these links may help reassure your partner if s/he is worried about hurting you.

If limited mobility or pain makes intercourse difficult for you, there are many other things you can try. To ease the strain on aching arms, hands and jaws, you can use props and toys like vibrators, dildos, feathers, food, etc. Don't be afraid to try new things - books, movies and the internet offer inspiration, try role-playing, talking sexy or getting a little kinky and unusual. As long as it involves consenting adults and you're both having fun, there's no wrong way of having sex. And for the times where sex is just not an option, cuddling and emotional intimacy can be very satisfying, letting you express the love you have for each other in a less physically demanding way.

It may take a while to find a way that works for you and your partner, but keep the lines of communication open and remember that sex is play for adults, so don't take it too seriously.

_See also: _

Beginner's Guide to RA: How to Deal With Friends and Family

You can read more of Lene's writing on The Seated View.