Building a Healthy Sexual Relationship

After working in the field of pain management in the U.S. for more than a decade, physician-assistants Gabriella D'Amore and Robert Rothrock had found so little written material on sexuality to hand out to their patients that they wrote their own: 'The Illustrated Guide to Better Sex for People with Chronic Pain.' Since it was published, they've kept copies of the book in their waiting room and offices where patients can pick them up. The result is often a frank discussion and earlier help for some of their patients, Rothrock says, 'because the stress of an unhealthy sexual relationship can have a profound effect on chronic pain.'

Women seem willing to ask for help sooner than men; a book like the 'Illustrated Guide' can be a good lead-in to discussion if it's presented to a male partner without embarrassment. D'Amore and Rothrock ease their way into that discussion by asking every new patient to fill out a form before seeing the therapist; the form specifically asks how their pain is affecting their sex life. 'We make the assumption that there will be difficulty in this area, and when we see the answers on the form, no matter how brief, it gives us an opportunity to help,' Rothrock says.

One of the things their counselling may address is the problem of self-image. Many people with arthritis succumb to the power of the media, which convey impossible standards of physical perfection-in fashion models and TV stars-that most of us are powerless to equal. The implied message in advertising and entertainment is that anything less than perfect just doesn't measure up. Don't buy the phony ideals. They only frustrate those already coping with pain and deformities. If you feel even further disabled because you're led to believe you 'don't fit,' it's going to make it awfully tough to take an active part in a sexually rewarding relationship.

The point is, you still have gifts to offer and happiness to share, despite your arthritis. Accept your imperfections, and learn to work around them. The key, of course, is frank, honest communication. Express your worries and fears, and listen carefully to what your partner is saying in return. Use the open lines of communication to develop strategies that will let you maintain a degree of intimacy and affection. You can caress with your voice if your hands are sore: Learn to talk to your lover; express what you're feeling. Use communication to strengthen your relationship and develop a richer understanding of one another's needs and desires; you may find a whole new basis for physical intimacy and closeness.

• Spontaneity may have to take a back seat to preparation: Pace yourself during the day so that you don't get overtired; try having a nap or resting beforehand to relax your muscles and relieve any strain on joints that may cause pain.

• Have a warm bath or a hot shower to further relax your muscles and joints. Some people find a hot tub is just the ticket.

• Take your medication before making love so that you get the full benefit of its pain-relieving effects.

• Experiment. Be gentle, but explore new positions that ease the strain on sensitive joints. If your hands are sore, try giving a back massage with your feet and a little warm oil.

• Tell your partner what feels good-and what hurts. If you can take some of the guesswork out of your partner's caresses, you'll not only spare yourself discomfort but reduce his or her anxiety, and thus increase his or her enjoyment.

Suggested Reading: 'The Illustrated Guide to Better Sex for People with Chronic Pain,' by Gabriella D'Amore and Robert Rothrock, U.S. The 'Guide' is small but jampacked with good, basic advice, including a chapter dealing specifically with arthritis. In fact, there's something for everyone; even readers who can't bring themselves to discuss the subject with anyone else will likely understand their sexuality in a way they'll feel much better about. The book is illustrated, but tastefully, so very few readers are likely to be offended.

This page was last reviewed/updated on : 05/30/2008