Yes, You Can Have an Active Sex Life With Arthritis

James McKoy, MD, a Honolulu-based rheumatologist and the chief of the pain service division at Kaiser Permanente in Hawaii, gives a lecture called "I Have Arthritis but I'm Still Sexy." He spoke with about how he helps his patients with arthritis reclaim their sex lives.

The physical and emotional concerns are very real when it comes to relating sexuality and arthritis. And many times nobody talks about that particular subject. I've had young women, and especially middle-aged women, who will tell me, 'I can't even imagine having a sexual relationship because it hurts to even hold my hand,' or 'Forget about sexual contact because it's too miserable to engage in,' or 'There'll be a lot of pain'.

Sex can help with your pain

But there are some studies to show you that sex might be very helpful as far as decreasing some discomfort. The key is to let patients know that the physical and emotional concerns related to sexuality and arthritis are real, and that they can weigh heavily on the enjoyment of life, but that thoughts, attitudes, and beliefs will definitely have a major effect on the overall outcome.

It's about trying to get patients to appreciate who they are, that they're still beautiful, that they're still sexy.

People have a lot of questions. Can sex cause flares of my arthritis? What if I have a joint replacement, can I still have sex, what about the pain? It's a matter of somebody sitting down, letting them know, hey, you can still have a wonderful sexual life but you might have to change the way you have been doing it, you might have to use different positions.

There are some things you might have to do—stretching or maybe having massage therapy, applying pain cream to certain joints prior to having sex. And just find a comfortable sex position.

But people rarely talk about those things and doctors rarely talk about those things.

The healing pleasure of touch

The other thing is just to let patients know that to touch, for the pure pleasure of it, can increase endorphins and other enzymes and proteins that can help with pain relief.

So it's a matter of teaching and educating patients because patients do have problems in this area. I see young women in their 30s who don't want to get married because they are afraid of pregnancy, they're afraid of sex and that becomes a problem. I've also seen young women with developed arthritis, they've gotten divorced because no one really sat down the spouse and the patient to discuss these things and let them know that life can still be beautiful, sex can still be beautiful, even with the arthritis.

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