
Arthritis, including osteoarthritis and rheumatoid arthritis (RA), can cause joint pain, inflammation, and range of motion issues that might limit a couple’s sexual activities. But with some modifications, it’s still possible for people with arthritis to enjoy sex.

Arthritis affects sexuality in several ways. Pain and stiffness may make the physical act of sex difficult or uncomfortable. Fatigue is often a problem, and you might feel too tired for sex.
Inflammation associated with rheumatoid arthritis may also affect blood vessels in the penis, making it difficult for men to get erections. Women may find that their vagina doesn’t become adequately lubricated.
Anxiety and depression are also common in people with arthritis. Chronic pain that limits activities can take a huge toll on mental health. Some people lose interest in sex. Relationships may suffer as well. Partners may worry that sexual activity will cause even more pain.
Medications: Certain pain medications and antidepressants may have sexual side effects.

If you and your partner are coping with arthritis, consider these adjustments:
- Make a plan. Plan intimacy for your best times of day, when you tend to feel better. For example, if you typically wake up feeling stiff, try having sex in the afternoon or evening. If your pain medication is most effective at a particular time, try having sex then.
- Prepare. Relaxing before sex can alleviate pain. Some people with arthritis take a nap before sex. Applying heat to stiff joints (through a hot bath or shower or a heating pad) is another strategy. Or try making love under an electric blanket. Massage is also relaxing.

- Try something new. If weight or motion makes a certain sexual position painful, try another one. Using pillows or cushions or even a sex ramp can make some positions more comfortable. Sex toys may help with stimulation. Remember, too, that having sex doesn’t just mean intercourse. Other forms of intimacy – touching, kissing, massage, oral sex, and manual stimulation – can be exciting and satisfying.
- Communicate. Be honest and open with your partner about what is comfortable and what is not. Your partner might feel anxious about causing you pain. Being direct can help them better understand your needs and relieve that nervousness.

- Talk to your doctor. Many sexual problems have solutions. For example, your healthcare provider can suggest treatments for erectile dysfunction (ED). Vaginal lubricants or moisturizers may help women with poor lubrication.
- Try counseling or sex therapy. Mental health professionals can help you cope with the emotional aspects of arthritis and its effects on sex. In addition, a sex therapist can suggest strategies for more comfortable sex and help you and your partner build communication skills.
Resources
American College of Rheumatology
Richardson, Jan K., PT, OCS, FAPTA
“Sex and Arthritis”
(June 2018)
Arthritis Foundation
Watson, Stephanie
“RA and Intimacy”
HealthDay
Woolston, Chris MS
“Sex and Arthritis”
(January 1, 2020)