RA and Sexual Independence: Part Two

Patient Expert

Welcome back.   We have been discussing the many ways in which RA and medication side-effects can affect your sex life. For some suggestions on finding intimacy and satisfaction again, catch up with our discussion on sexual independence with Part One where we discussed self-confidence, impotence in men, causes of dryness and lubrication options for women.

Sex Toys

Feathers are fun but any discussion of sex toys is incomplete without the mention of vibrators which come in a seemingly unlimited variety of shapes, materials, and actions.   A popular vibrator design discussed on one message board I consulted was the Silver Bullet, another the Rabbit.   And for women who need a little extra jump start in plumping up the genital area, there are also clitoral pumps which work on the same basic principle as penis pumps.

Use of these tools would be extremely helpful for couples who, due to decreased sensation and arthritis-affected hands, need help in bringing a satisfactory level of enjoyment to themselves or their partner.   Move the vibrator or other tool gently over any sensitive area of your partner's body, especially against breasts and the underside of the penis or clitoris.   Caution however, a vibrator may irritate tender genital tissues if used too frequently or long.   A wide variety of adult toys and videos can be found at websites such as Xandria ®, BetterSex ®, MyPleasure ® and EdenFantasys ®.

New Positions

Arthritis in the hip, knee, leg, or arm can cause considerable pain during sexual activity.   Experiment with different coital positions which put less strain on painful joints, and let your partner do most of the work if movement causes you pain. Consider what you do to be most comfortable lying in bed and start from there to find a position which could be adapted for greater comfort and mutual pleasure.

Adapted from an Arthritis Foundation brochure, the following descriptions may give you new ideas or starting points from which to find new positions to enjoy.   Be sure to work together to find something comfortable and satisfying for both partners.   Caution: If you have problems in your neck, Dr. Mark Borigini warns that you should not place a pillow under your head during sex.

  • Both partners lying on their side with the man behind and a pillow between the woman's knees.   This position is good when the woman has hip problems.
  • The woman lies on her back, knees together, with pillow under hips and thighs.   The man supports his own body weight on his hands and knees.   This position can be used when the woman has hip or knee problems, or is unable to move her legs apart.

  • Side position with partners facing each other.   This position can be used if man has back problems and also allows for either partner to pull away quickly if pain strikes.

  • The woman lies on her back with knees flexed.   This position can be used when the woman has severe contractures.

  • Both partners stand with the man behind.   While standing or bending forward, the woman uses furniture at a comfortable height for support and balance.

  • The woman kneels with her upper body supported by furniture.   Pillows can be used under her knees.   The position may be helpful when the woman has hip problems, but not good if arthritis affects her shoulders.

  • The man lies on his back using pillows for support.   The woman can support her own body weight on her elbows and/or knees.   This position is good when the man has hip or knee problems.

Pillows are very useful to support the body and take pressure off of painful joints.   There are a number of swings, slings, and pillows commercially available to adjust position.   In fact, there is furniture designed specifically for ease of positioning and support.   Check out the shapes and furniture pieces available at Liberator ® Bedroom Adventure Gear.   They also sell a unique soft/satin throw which has an inner moisture barrier to protect surfaces.   Even better, it is machine washable.

Plan Ahead
If morning or evening fatigue or morning stiffness prevent you from being able to engage with your partner, consider setting aside time in the middle of the day to focus on each other.   If pain interferes with sexual activity, consider taking pain medication 30-60 minutes beforehand.   Take a warm bath or shower to relax and soothe your joints and muscles.   Maybe take that shower together and enjoy a lotion massage afterwards as foreplay.   Get creative and have fun.

Sex is Not Always Intercourse
Please keep in mind that intimacy and sexuality DO NOT require intercourse nor orgasm.   Gentle caressing and cuddling can be rather enjoyable and may increase sexual desire overall.   I'll leave you with one more recommendation which came from an MS patient on a message board.

"For all of you that are having difficulties...try this exercise...it revs up the engines so to speak.   Stand facing each other naked.   In order to rev the mental and physical energies needed... do not touch your partner.... take turns almost touching each other... your hand about an inch way from your partner's flesh.....   The warmth of the other being's body almost touching you will allow your body to start reacting and yearning.... The longer you can go with just feeling the other person's energy... the more you allow the biology of it all to kick in....   trust me it works......"

Finally, remember that the largest sexual organ is the brain.   Keep a sense of humor and open communication with your partner.   Discuss sexual difficulties with your physician even if he/she doesn't ask.   Maintain intimacy in your relationship and know that love transcends physical limitations.

Please add other tips or tools which you recommend in the comment section below.


Sex and Arthritis. Adapted from the pamphlet originally prepared for the Arthritis Foundation by Graciela Alarcon, MD, MPH, JoAn Boggs, MSW, Sandra L. Curry, PhD, Stephen B. Levine, MD, and Lewis Neemme, PhD.

RA and Sex:

Rheumatoid Arthritis and Sex: Relationships Matter

Rheumatoid Arthritis and Sexual Independence (Part One)

Rheumatoid Arthritis and Sexual Independence (Part Two)