When it comes to dating or being intimate with a partner, navigating conversations around sex and intimacy can be difficult in the best of circumstances. These topics can feel more complicated when there are health concerns such as arthritis involved, or if pain is preventing you from enjoying intimacy or sex.
It is important to note that there can be many reasons beyond arthritis why sex may be painful. Previous negative experiences can affect pain or expected pain. It’s important to check with your doctor if you feel like sex is unusually painful or is causing you distress.
Not everyone is interested in sex or relationships, though there are still lots of ways to explore pleasure and intimacy for all abilities, orientations, and genders. This article explores common concerns from people living with arthritis about intimacy, relationships, and sex.
When experiencing a pain flare, especially for an extended period of time, it can feel isolating to have long breaks in intimacy. If sex is too painful, there are many ways to incorporate intimacy into everyday life without having sex. It's important that sex not be an implied part of intimacy.
For partners, follow the lead of the person experiencing pain in the moment. If light touch is painful, try experimenting with firmer touch, or other sensations such as water, heat, or cold. Consider taking a warm shower together, or letting ice cubes melt in places where light touch may be uncomfortable.
Keep communication open
Misunderstandings can happen in any relationship. It is important to communicate to your partner(s) how you are feeling. It can be helpful to let them know when things are going well just as much as when things are not going well (I.e., “That feels good” or “That hurts, let's try something else”). Being able to express what you are feeling can sometimes take practice. It can help to discuss ahead of time what your boundaries and ground rules are for engaging in sex or other intimate activities. It is always okay to stop things in the moment if one or both of you is not feeling comfortable or okay with the situation. Just because you planned to do something doesn’t mean it needs to, or should happen.
Intimacy doesn’t need to be spontaneous to be enjoyable. Sometimes it is necessary to plan in advance to manage how much energy you have for the week. Select a day and time that are best for your pain levels, and make sure to give yourself plenty of time to relax and enjoy time with yourself or a partner. Planning ahead can also build anticipation, which may increase excitement. Keep in mind plans can change. Just because you planned to be intimate doesn’t mean you need to stick to that plan if something changes, you don’t feel well, or are no longer comfortable with the plan. While planning in advance can help, it doesn’t mean you are committed to intimacy at that time.
For those interested in sex, there are lots of ways to adjust positions for you or your partner to more comfortably engage in sex. There are several types of “position pillows” or “sex position cushions” that can help provide comfort with sexual positioning that can be purchased online or from an adult store. The Arthritis Society’s Intimacy Guide [PDF 557 kB] also includes diagrams to help guide couples through different positions that may help with hip, back, or lower limb discomfort.
One of the many benefits of masturbation is that it doesn’t require a partner (though many partners can enjoy mutual masturbation together). If you are single, or just interested in getting to know your own body, masturbation is a great way to explore your likes and dislikes.
If there are concerns over hand grip or dexterity, consider experimenting with different sensations, toys, or vibrators to assist in providing pleasure.
If you are not in a relationship but dating and have concerns about intimacy, it's important to be honest with yourself and the person you are dating about what you want and don’t want. It may feel difficult if the things you want do not align with what the other person may want. Being able to have these honest discussions will help you to assert your boundaries over what feels comfortable for you and your body.
Not everyone is interested in having sex, and for others it isn’t always practical due to pain or energy levels. Consider alternatives to enjoying intimacy. Think about things that make you feel connected to yourself or a partner, and make time for those activities.
There are many ways to express affection and satisfy desires for intimacy. Many couples find kissing and caressing enjoyable alternatives to penetrative sex. The right touch on almost any area of the skin – the mouth, earlobes, neck, breasts, hands, wrists, small of the back and insides of the thighs and arms – can be very pleasing. Hugging and holding hands are other ways of showing warmth and caring toward each other.
Talk with your health care team
This may seem like an awkward conversation to have with your healthcare team, but if you are having difficulty engaging in intimacy or sex in a meaningful way due to arthritis, it is important to let your health care team know so they can help you. Your healthcare practitioner may be able to provide a referral to an occupational therapist or sex therapist, adjust your treatment plan, or recommend other resources to help you reach your goals for intimacy.
Arthritis can cause changes in the roles and responsibilities in an intimate relationship. While the challenges may seem daunting, they can also draw partners closer together. Intimacy is an important component to life enjoyment and can be maintained with arthritis.
To learn more about maintaining intimacy when you have arthritis, visit the Arthritis Society’s Intimacy Guide [PDF 557kB].