Couple in a sex therapy session.

Expert Advice For Improving Your Sex Life With RA

If living with RA has had a negative impact on your sex life, you are not alone. Many of us with RA understand exactly how fatigue and pain can make intimacy difficult or unappealing. And we can probably all agree that a strained sex life will eventually take a toll on your relationship as a whole. Unfortunately, even if you are proactive enough to go searching for advice on how to improve your sex life while living with RA, the vast majority of the articles on this topic are fairly depressing. They tend to be filled with disheartening facts and statistics and short on positive, uplifting advice on how to improve the situation.

I am not a sex therapist and I am certainly not an expert on this topic. (To be perfectly honest, my husband and I still struggle with these issues sometimes.) However, I did force myself to read more than fifty articles about sex and RA! And, after weeding out all the depressing stuff, I have compiled a list of all the useful information and advice about actually improving your sex life when you have RA. I have grouped the advice into several categories below. While I can’t say I personally agree with every single piece of advice, this list pretty much covers what “the experts” out there have to say on the topic of improving your sex life when you have RA.

Sex Is Not Just Intercourse

  • Remember that sex does not have to just be intercourse. There are many other ways for you and your partner to find pleasure with each other. This is probably the largest category of expert advice about sex and RA. The main point is to remember that there are still fun and intimate activities that you may be able to participate in even if intercourse is difficult or unappealing for you. I personally think this advice is relevant to improving the pleasure you get from your sex life, though obviously you will have to work past this point if you do want to include intercourse or if you are trying to start a family.
  • Ideas for other ways to feel satisfied and intimate besides intercourse include: synchronized breathing, eye gazing, fantasizing together, guided imagery, visual stimulation, holding hands, hugging, cuddling, touching, kissing, sensual massage, oral contact, stroking, and fondling. Be creative in finding other ways to improve your emotional and physical connection with your partner.

Work On Your Relationship

  • After promoting other forms of intimacy besides intercourse, the next biggest category of expert advice out there about improving your sex life with RA falls into the relationship category. Personally, I think every relationship should work on these things – not just those of us with chronic illnesses.
  • Open and honest communication with your partner about your needs, desires, and difficulties is vital. It may be easier to invite dialogue with your partner if you begin sentences with “I” rather than “you.” For example, “I feel loved when you hold me close” is probably better than “you never touch me anymore.”
  • Try to work with your partner as a team at all times. Find ways to work together to reduce as many sources of stress as possible, which will help you both relax.
  • Be patient with yourself and with your partner. Try to stay positive through the process of trial and error. If you encounter setbacks, try not to become discouraged. Maintaining a sense of humor can be key!
  • Let your partner know during sex what is working and what is painful with words, sounds, or a gesture you agree upon in advance.
  • If you have difficulty communicating with your partner about sex, you may want to consider outside help such as a couples counselor or therapist.

 Incorporate RA Into Your Relationship

  • Make sure your partner understands the basic facts about how RA works and the pain it causes you. If your partner understands the reality you live in they are far more likely to be understanding and accommodating.
  • It may help to try to think of any issues you are having with your sex life as “our problem,” an issue you will need to work together to overcome, rather than the sole problem of the person with RA. This will help the person with RA avoid feeling guilty, not to mention that working together will promote closeness between you and your partner.
  • Focus on promoting new forms of intimacy and appreciating what you have going forward. If you were with your partner before being diagnosed with RA, try not to have expectations of “good sex” before RA.

 Prepare For Sex

  • If you are the one who has RA, it may help to use some of these tips to prepare yourself for sex in advance.
  • Don’t be embarrassed to talk to your doctor about medications that may impact your sex life. Some RA medications can cause things like loss of libido or vaginal dryness, and if you are dealing with these side effects you may want to discuss possible alternatives with your doctor. You can also ask about pain medications or muscle relaxants that may assist with improving your sex life. Your doctor or physical therapist may also be able to recommend exercises that help improve your stamina and mobility.
  • Do things that help you feel good about yourself and improve your confidence - a new outfit, a new haircut, or listening to a song that makes you feel good. The more confident you feel about yourself the sexier you will feel and the easier sex will become.
  • In your everyday life, try to pay attention to the types of movements you can do without pain and consider bringing those types of movements into the bedroom.
  • Thirty to sixty minutes before having sex, try some gentle stretches to improve your range of motion. You may also want to consider taking pain medications or muscle relaxants at this time.
  • Try a warm bath or shower to help you limber up before sex. You could even include your partner as part of your foreplay. Or consider an electric blanket before or during sex to help relieve stiff joints.
  • Ask your partner to give you a gentle massage. This can serve as foreplay while also helping you deal with pain and stiffness.


  • It may help to plan ahead for sex and arrange your day so you won’t be overly tired from other activities.
  • Consider what time of day (morning, noon, night) you are least sore/fatigued and try to have sex at the times when you are feeling your best. Try having sex at different times of day to see what works best for you.
  • Not everyone likes the idea of planned sex, so it may also help to be open to having a “quickie” when you are feeling up to it. Sometimes a quickie can actually cause less strain and exhaustion, with the added benefit that there is no pressure in advance since it is a spur of the moment decision.


  • Experiment with different positions and be open to changing positions halfway through if necessary.
  • Focus on enjoying yourself and being close with your partner rather than the pain and fatigue you might be feeling. If you “fake it ‘til you make it” the enjoyment may eventually come naturally.
  • Try new things. For example, incorporating shared masturbation can sometimes be fulfilling if one partner is unable to be very active. Or even just whispering in your partner’s ear as they pleasure themselves can help you both stay connected and improve intimacy.
  • Be creative, have fun, and, perhaps most importantly, try to laugh together if something you try doesn’t work.

 Sexual Aids

  • Consider using an over-the-counter lubrication, such as KY Jelly. This can help if medication-related vaginal dryness is an issue, and it can also be useful if you are having difficulty overcoming pain or getting involved in an intimate act.
  • Use lots of pillows or other pieces of furniture for extra support. Check out The Liberator line of pillows, which are specifically designed to support you during sex.
  • To ease the strain on arms, hands, and jaws, try props and toys, like vibrators. You can order these items on the internet for discretion, or consider visiting a respectable sex shop with your partner to make sure you can operate the buttons.

According to my research, this is what “the experts” have to say about improving your sex life while living with RA. What do you think? Do you have other useful suggestions or advice? Please share!

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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