White boxer underwear strung up on a flagpole like a surrender flag

“Where oh where is my libido?” or The Time I Decided to See a Sex Therapist

Last updated: March 2021

Though it isn’t often talked about, I think most people living with RA would agree that RA can have a very negative impact on a person’s sex life. Pain and fatigue may make sex difficult or even impossible. Having a chronic illness can mess with your body image, which can mess with your confidence or desire. And some of the medications taken to treat RA (and co-morbidities like depression) can actually make some of these issues worse.

Parenthood is another thing that can have quite a negative impact on a person’s sex life, particularly when the kids are really little. Parents of babies and toddlers have almost no time to themselves – and when they do have time sleep can seem a whole lot more appealing than sex! There’s also a mountain of laundry lurking in the background (likely covered in spitup) and even having time to shower can feel like a luxury. Not to mention the physical recovery that a woman’s body needs after having a baby! So your sex life is often put on the back burner while your family adjusts to a new addition.

In my case, seeing as I was dealing with RAand I had a two-year-old and I had a newborn baby, I wasn’t at all surprised or worried when my libido was nowhere to be found by the time my second baby was six months old. There’s just way too much on my plate right now, I told myself (and my husband). I’ll be back to normal soon.

But I wasn’t. My second son’s first birthday came and went without any improvement in the intimacy department. I just need a little more time, I told myself (and my husband). I tried to put some more effort into locating my desire – take better care of myself, make time for a bubble bath, have a massage, try to relax, drink a glass of wine – but I started to get nervous when none of it worked. By the time my little dude was 18 months old, I was downright worried about my missing libido and the impact it was inevitably having on my relationship. My husband was being as understanding as possible, but it was still a strain on both of us.

I finally made an appointment with my doctor to make sure there were no physical issues that needed to be dealt with. She ran a bunch of hormone panels but everything came back normal. We switched me to a different anti-depressant, but it didn’t make a noticeable difference in the libido department. She recommended therapy, but I was reluctant.

Right about that same time I got invited to a summit of RA bloggers where, coincidentally, there was a presentation about sexual intimacy and RA by Dr. Logan Levkoff (who you might know from the show “Married at First Sight”). Since Dr. Levkoff is a sexologist and relationship expert, I was really excited to hear what she had to say.

Dr. Levkoff’s presentation had some great information. She talked about all the factors that can influence a person’s sexuality (perceptions of self, media representation, education, culture, religion/spirituality, family upbringing, perceptions of partner, and more) and then the common challenges that might be faced by people who are also living with chronic illnesses (pain/discomfort, fatigue, vaginal dryness, partner’s perceptions, etc.). She gave some suggestions for pre-gaming (take medications in advance, warm shower or bath, rest, massage), setting the mood and creating the right environment (candles, ambiance, soundtrack, fantasies), and some other suggestions for solving issues RA might present (lubricants, vibrators, pillows). We talked about improving communication between partners and between patients and doctors in order to work on these issues. She even included the “arthritis-friendly” positions developed by Arthritis Research UK. I was very excited to see these important issues getting some more attention.

However, almost none of what she said was new to me because I had already done so much research on this topic on my own. I had already written articles about how to talk to your partner about sex, how to talk to your doctor about sex, and summarizing all the expert advice I could find on how to improve your sex life with RA. I knew – and had already tried – all of these suggestions myself, and yet I was still struggling personally. So, when it came time for Q&A, I screwed up my courage and asked: what if all of that still isn’t enough to fix the problem? Then, Dr. Levkoff said, it’s probably time to talk to a sex therapist.

So that’s what I decided to do. It was a very weird feeling, because it seemed so taboo and there’s a certain kind of negative stigma associated with needing “sex therapy.” But I had run out of options and didn’t know where else to turn, so it seemed worth giving it a try. Almost a year later I can say that it was a very good decision – for me personally, for my relationship, and for my family as a whole. I learned a lot, and I plan to share some of what I learn in a series of upcoming articles.

But, for starters, I want to say this: it’s ok if you are struggling with your sex life. Really. A lot of us are. And, if you are struggling, it’s ok to consider asking for help from your doctor or a therapist. Because I strongly believe that having a healthy sex life is a very important aspect of any adult’s quality of life – and having a chronic illness shouldn’t mean having to sacrifice your quality of life.

To be continued!

By providing your email address, you are agreeing to our privacy policy.


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

Join the conversation

Please read our rules before commenting.

Community Poll

On average, how many times per month do you (or your caretaker) go to the pharmacy?