Let’s talk about sex

Sex is everywhere, but somehow it’s often the hardest thing to actually talk about. However, since arthritis can take its toll on your sex life (issues with pain, fatigue, mobility and self-esteem can be pretty heavy hitters) it only makes sense to keep it part of the conversation with your partner. “Sexual satisfaction is a key factor in overall relationship satisfaction,” notes Natalie Rosen [she’s a phD], a registered clinical psychologist, and associate professor in the departments of psychology and neuroscience, and obstetrics and gynecology, at Dalhousie University in Halifax. Read on to discover some approaches to talking about arthritis and sex.

Think about where you’re at

How long have you been together? An established couple may have settled into a pattern, which can be positive if it means you’ve figured out how to work around trouble spots in the past, but can also be a struggle if you get into a pattern of avoidance, where neither person is initiating sex or even talking about it because of negative associations, says Rosen. For newer couples, “a key barrier is ‘how do we navigate this? How do I bring it up? What if I’m rejected?’” she says. (And if you don’t have a partner right now, Rosen says this an ideal time to find out what works for you. “You can be sexual on your own, have control over your own body and find out what feels good.”)

Time it right

Regardless of the length of your relationship, timing the talk is going to be important. “It shouldn’t be right before or right after sex, because that’s when emotions are running high,” says Rosen. Rather, set aside a date night, choose a time when you’re not exhausted and give a heads-up that you want to talk about how things are going, sex-wise.

Put the focus on “we”

“You are problem-solving as a couple to see what’s going to help you as a couple,” says Rosen. “It’s not just about the person who has the pain, because your partner is impacted by the pain too. So approach it from a couple’s perspective, not ‘I’m the one with the pain and the problem.’”

Do other stuff

Sex doesn’t have to be intercourse, so pay attention to kissing, caressing and oral sex. Give each other a massage and gently guide your partner’s hand away from a sore spot to an area that does feel good. Pick up a water-based lubricant at the drugstore or online. Try different positions that take pressure off particular joints.

Say “I”

When you’re sharing how you’re feeling, say “I feel this way,” not “when you do this, it hurts” or “you don’t care about sex anymore,” says Rosen. Otherwise, the conversation is going to turn defensive.

Don’t give up

If sex is important to you, make it an important part of your life. “Everyone can and should be sexual if they want to be,” says Rosen.

Talking to your doctor

You may not be super-relaxed about talking to your health-care provider about your sex life, but hey, sex is a part of a healthy life for many people, so it needs to be discussed. For example, medications can affect your levels of desire and arousal, and your doctor or nurse can help you figure out the challenges. Planning for a baby or contraception is also a sexual health conversation. So, here’s your three-step plan:

  1. When you book, ask for a longer appointment time so you don’t feel rushed.
  2. Acknowledge your unease. “This is hard for me to talk about, but…”
  3. Write your questions down before your appointment.