Problems pertaining to intercourse

Adapted sexual positions

A number of problems involving joint pain are of purely mechanical origin, with the result that they can be solved by using coital positions that are more comfortable for the partner with arthritis.

Although we live in an era of sexual liberation, most couples use only one or two traditional positions. The positions illustrated below (Figures 1 to 8) may help people with arthritis of the hip, knee, back or shoulder.

Like the oral and manual techniques discussed below, these positions are common manifestations of human sexual activity. However, you should try only those you and your partner are comfortable with. Most bookstores sell well-designed, illustrated books on sexual positions. These books can help you vary your positions and find those that suit you. Using cushions to support the joints enhances the comfort of the person living with arthritis comfort.

Man with back and hip problems

Side-by-side position with front entry.▼

Man on his back. The woman squats over him, facing him or with her back to him, and supporting her own weight. Useful in the presence of back problems, but also if the man is unable to support his weight with his arms and shoulders. ▼

Problems on one side only.Front entry.▼

Woman with problems in the lower limbs, especially the hips.

Side-by-side position with rear entry.▼

If the woman is unable to move her legs apart. Note that the man supports his own weight. Front entry.▼

If the woman has severe hip and knee contractures. Rear entry.▼

Standing position, with a piece of furniture providing support. Rear entry.▼

Kneeling position with rear entry. To be avoided in the presence of shoulder pain.▼

Reproduced with permission from Wiley-Liss Inc., a subsidiary of John Wiley & Son, Inc. Sexual problems in rheumatoid arthritis and ankylosing spondylitis. Elst P, Sybesma T, van der Stadt RJ, Pins AP, Muller WH, den Butter A. Arthritis Rheum. Feb 1984;27(2):217-20. İAll rights reserved.

Other methods of stimulation

Pain and the impact of the disease may be too severe for a mere change of position to eliminate the discomfort.

For many couples, manual or oral stimulation of the genitals is acceptable and satisfying. If the pain and the impact of the disease to the hand are too severe, using a vibrator can help. The use of these alternatives should be in line with both partners' feelings and beliefs.

If there is no partner, self-stimulation is a common practice for meeting sexual needs. According to statistics, 92% of men and 62% of women practice self-stimulation, without suffering the harmful consequences promulgated by certain myths during the Victorian era!

Surgery

A medical team can also help you with other problems. Thus, painful arthritis of the hip can be improved with prosthetic replacement surgery. Individuals who undergo this type of surgery can resume their sexual activities six weeks after the operation, provided that maximum flexion, such as bringing the knees to the chest, is avoided. Nowadays, several other surgical techniques are routinely used and can resolve problems that previously seemed without solution.

This page was last reviewed/updated on : 02/23/2008