Sex and RA: How to Talk to Your Spouse

by Cathy Kramer Patient Advocate

It’s the end of the night. I crawl into bed, get in as comfortable a position as I know I will find, and then feel my husband’s hand on me. “No!” I know that touch and what comes with it. What do I do?

Talking to a spouse about sexual needs and wants is not the easiest of conversations, even without a chronic illness like rheumatoid arthritis (RA). However, sex continues to be a major part of many relationships with RA and to keep it alive, we must be open to uncomfortable conversations.

Share how you feel

For some, pain is literally a daily part of life. Some days we cannot lift a blanket over ourselves. Other days, the pain is much milder. RA has something different in store for each day. To be fair to our spouses, have regular conversations to explain the level of pain you are in. This allows your spouse the opportunity to know when to pursue fun in the bedroom and when to be respectful and keep hands off.

Be vulnerable

You would think that undressing at the end of the night might be a turn-on based on all the moaning that comes with it. And, while I have attempted to slowly take my clothes off in a sensual way pre-RA, it could in no possible way be considered sexy to watch me undress at the end of the night with RA. In fact, it can be downright embarrassing. There have been many nights I hoped my husband would be asleep when I changed into my pajamas, so he wouldn’t have to see or hear me. Yet, by sharing my insecurities with him, he learned more about me and the emotional issues that arise from living with RA.

Be detailed about what you can do

When you feel up to having sex with your spouse, share exactly what you are capable of doing. Perhaps it is just lying side by side naked or being present while your partner satisfies their own needs. Maybe you are up for sex, but nothing fancy. I have found that my husband does better when I am upfront with him from the beginning, knowing things may change as we get into things.

Additionally, allow your spouse to care for you during sex. Let him/her move your leg or lift you up a bit. This is a time for your partner to show they understand your pain and appreciate that you are making time to be intimate.

Ask questions

Ask your lover what it is they want. Sometimes, they simply need to know that we still find them attractive. Crazy, I know. But what we sometimes forget while wrapped up in RA is that our spouses are often neglected and still need to feel sexually attractive.

With time, our mates learn what sex with a flare is like and with a little questioning, they might relive some of the things you previously enjoyed together. Let them be the guides.

Don’t assume

At a time when I had to slowly drag myself onto the bed, I could not imagine how another human could find me attractive. But guess what? My husband still did. Despite all the stories I had made up in my mind, he still saw me as someone attractive. Talking about this was a game changer for me. If he could find me attractive, didn’t I owe it to myself to see myself the same way?

Say “no”

There are days when our bodies just can’t do one more thing and we need to appreciate that. It is okay to say “no” without guilt.

My goal has always been to keep the doors to sex open. I figure it is like movement: “Use it or lose it.” Unfortunately, RA does not wait outside our bedroom doors for us. It comes along with us in everything we do. Therefore, it is important to our lovers and ourselves that we continually keep the lines of communication open. We need to be open about how we physically and emotionally feel so that we can continue on in loving relationships.

Cathy Kramer
Meet Our Writer
Cathy Kramer

Cathy Kramer has been married longer than not and is a mom to two young adults plus an aging border collie. She splits her days/nights between two community colleges as an ESL/ABE instructor. She is a strong believer in gratitude and attempts to leave a smile everywhere she goes. Cathy shares her positive voice as an advocate in the rheumatoid arthritis (RA), chronic illness, and self-care communities. Her ongoing journey with RA can be found on her blog The Life and Adventures of Cateepoo. She often hangs out @cateepoo88 on Twitter, Instagram, and Facebook. Cathy is also a Social Ambassador for the RAHealthCentral Facebook page: