Rheumatoid arthritis and sex; how to heal low libido

Dia duit agus fáilte – that’s Irish for hello and welcome – to my blog about rheumatoid arthritis (RA) autoimmune disease (AD) and chronic pain. Let’s chat about sex…specifically, rheumatoid arthritis and sex – how to live with one and enjoy the other!! 

So you’re interested in learning all about enjoying sex with RA and other autoimmune illnesses; I hope you find the information and inspiration you most need today.

Id like to thank Emmy Gaines of Celebrate Again for many of the photos on this page.

When I was newly diagnosed with RA, the prospect of constant pain sucked the life out of me. Having witnessed several family members dealing with RA for decades, that possible future knocked me into a depression spiral. I was in physical, mental and emotional pain; I couldn’t do the usual activities that filled me with joy – yoga, hiking, woodworking – and I felt useless. (Read this post.)

It wasn’t until several months down the road that I realized my sexual desire had all but disappeared and intimacy had become not only less enjoyable but was now something I consciously tried to avoid.

If you want to skip to the good news, click #7 in the Table of Contents.

The fall and rise of my libido – rheumatoid arthritis and sex

It’s easy to ignore concerns in other areas of your life when faced with a major battle. The first nine months after my diagnosis with rheumatoid arthritis, all my energy went into:

• changing my diet and learning new ways to cook and eat (post)
• driving to my functional medicine physician (90 minutes one way) 2 or 3 times most weeks. Truth is, himself drove me most of the time.
• practicing a different style of yoga and exercising in new ways (post)
• adjusting to a life with restrictions
• dealing with even greater depression than previously (post)

And the great news is that after 7 years of officially living with RA, I have found a new way of being in the world. I have changed my diet and adjusted my yoga practice. We have altered how we clean our home and even how we vacation. But once I got a handle on “the basics” – severe pain, achy joints and fatigue, insomnia etc… – I realized I had other work to do and together, Tom and I both turned our attention to improving, or should I say, resurrecting our sex life.

What you need to know about enjoying sex with RA and low libido?

As usual, I want to remind you, I am not a doctor or a sex therapist.

First, what exactly is libido? I like the Wikipedia definition: “Libido is a person’s overall sexual drive or desire for sexual activity.” Basically, it means how often you are in the mood for sex.

The rest of the Wikipedia definition states: “[Libido] is influenced by biological, psychological, and social factors.” Basic sexual drive is biological but the desire for sexual activity is strongly influenced by psychological and social.

The relationship between autoimmune or rheumatoid arthritis and sex drive/libido.

Let’s do a quick recap of some of the factors that negatively impact libido. Of the 12 factors mentioned above (certainly not an exhaustive list but reasonably broad), a person living with RA and chronic pain can easily expect to have 6:

• Chronic illness is defined as any illness that lasts 3 or more months and cannot be prevented by vaccine or cured by medication.
• Pain – RA’s primary symptoms are joint pain, tenderness and swelling, as is the case for many autoimmune diseases
• Fatigue is the second most common RA symptom.
• Depression and anxiety; it’s hard not to be mentally and emotionally impacted by a disease that threatens to negatively impact the rest of your life. See this post.
• Poor self-image. It is no surprise that many of the symptoms of RA affect your self-image – swollen joints, constant pain, inability to continue certain activities etc…

Rheumatoid arthritis (RA) and all autoimmune diseases are chronic illnesses. Any illness that is ongoing with “no cure” will surely impact not just our physical health but also our mental and emotional wellbeing. Is it any wonder that libido may falter when we are diagnosed with RA and other life-altering diseases?

Of course, here at Open to Abundance we know that, while considered incurable by conventional medicine, RA is certainly controllable and can often be sent scurrying into remission with the right lifestyle changes.

The physical symptoms of rheumatoid arthritis and low libido

Pain has a way of reducing life to its bare minimum. When I have constantly achy joints, the thought of intimacy or “bedroom gymnastics” is the furthest thing from my mind, and body! Yes, the experience of sex with RA can reduce the pain but I have to first push through the pain in order to experience the sex. Kind of a chicken and egg situation.

There is a huge difference between being tired and fatigue. Being tired can sometimes be an aphrodisiac, at least, it is for me. (I call it sleepy sex!) Fatigue, on the other hand, leaves me feeling like I got run over by a truck and holding my head up or lifting a fork to my mouth feels overwhelming.

Sex is definitely not happening in the throes of fatigue. Fatigue may be eased by improving sleep (Read this post to learn good sleep habits) but it usually takes more than that and addressing the underlying causes of RA and AD will often reduce fatigue.

The emotional symptoms of rheumatoid arthritis and low libido

As a person diagnosed with depression (another chronic illness) for more than 30 years, the additional onslaught of RA exacerbated my symptoms and added to its impact. Much of the enjoyment of an active sex life is the anticipation of intimacy and depression can make it hard to anticipate pleasure which in turn makes it more difficult to talk yourself into taking action.

Anxiety and worry increase the production of stress hormones like adrenaline that make you feel on edge. When the brain can’t turn off and the body can’t physically relax, enjoying sexual sensations is often more difficult. Many people living with RA and AD deal with ever-present anxiety and worry; how will I maintain a job? What will happen if I cannot pick up my child? Will I ever be able to think properly again?

These never-ending thoughts combined with an overactive immune system negatively impact libido which might lead to further worry – can my relationship survive no sex life?

Imagine my horror when I could no longer lift a pot or do simple cat/cow pose in yoga. I began to hobble when I got out of bed, shuffling like the parody of a centenarian and my once sharp mind became foggy and less alert. And sex? Are you crazy?

As my dreams faded, my body crumbled and my emotions slipped into darker places, my view of myself changed – I began to see myself as a sick person, fragile even; I became a woman who felt useless, unattractive and undesirable.

And the worst part? I blamed myself entirely for all my “issues”; I felt guilty that I had this debilitating chronic illness.

As my self-image shifted so radically, is it any surprise that my libido tanked? I could not understand how or why Tom could even want to make love to such a person.

Why are you telling me all this personal stuff?

It’s easy to talk about joint pain, fatigue, even depression. But talking about sex, or lack thereof, can be difficult and few doctors even bring the subject up, perhaps making us feel that it’s “just me.”

And I want you to know you are not alone. Many of us living with rheumatoid arthritis, chronic pain and autoimmune diseases are going through the same struggles which is why this blog even exists.

Yes, my doctor was a great resource and she changed the trajectory of my life with chronic illness but I felt alone. Yes, I have family members with RA and other autoimmune diseases but they are an ocean away or dead and I felt alone.

I knew no one like me, no one going through the same struggles and it was lonely and frightening. And if I can change that experience for just one person, for you, then something good will have come of my diagnosis and journey back to health.

My dream is to create a community where we can gather to support and care for each other, celebrate the wins and hold space for healing during the challenges.

What about me?

Okay, so you’ve been diagnosed with RA or another AD after what may feel like (or be) years of pain, achy joints and fatigue. Throw in some brain fog, depression and life becomes more difficult and challenging.

And then, your libido tanks. Yup, forget low libido; you have no libido.

Take a moment, close your eyes, take a deep breath and hear this truth:

There is good news. (Rheumatoid arthritis and sex are NOT mutually exclusive!)

When you begin the holistic healing journey, it is important to remember that change can take time. Lifestyle shifts produce much slower results than drugs but they have way better side effects:

You will find info about yoga and toxins on this blog. You can learn how to improve your diet and sleep, use essential oils and meditation to improve your RA symptoms. By addressing the body holistically, it begins to heal in supportive and nurturing ways and you will begin to notice a reduction in your symptoms. Some will be almost immediate (like when I gave up gluten and could do cat/cow pose) and others more slowly (I re-began my daily 4-habits and my depression slowly lifted.)

Tips to enjoy sex with RA

As you shift to a new way of eating, sleeping, thinking and being, you are likely to see an increase in your libido and sexual desire.

Natural aphrodisiacs

Did you know that watermelon is nicknamed the “natural Viagra”? Who knew something as simple and delicious as summer’s favorite fruit would be so rich in citrulline (relaxes and dilates blood vessels)?

Chocolate, saffron and oysters are also potentially aphrodisiac foods though studies are somewhat ambiguous on their effectiveness.

Supplements that may address your rheumatoid arthritis and low libido issues include:

• Maca – it comes in powder form and can be easily (and deliciously) used in smoothies. Take 2-3 grams Maca daily for 1-3 months.
• Tribulus terrestris. Learn more at WebMD.
• Asian Ginseng is believed to revitalize the whole body, not just the sexual organs.

Relationship building

Like any major life stressor, chronic illness can disrupt a relationship; one person feels pretty crappy most of the time and the other may feel helpless and unable to “fix the problem”. Whatever the reason, when your relationship hits a bump, sex, or lack thereof, is often an early symptom. Instead of trying to fix the symptom, let’s find other ways to improve our relationships.

Spend time together. No really! Real time together – no phones, no TV, no kids, no other distractions.

Do something novel. Have you ever been to a glass blowing or cooking class together? What about enjoying a couple’s massage or yoga class?

We recently enjoyed a photo shoot with the talented Emmy Gaines of Celebrate Again which was much more than a photo shoot. She prompted us to remember moments we laughed together, express why we cherish each other and share our dreams for the future. It was one of the most intimate experiences I have ever spent with my husband.

Find other ways to physically connect

I know my mind immediately jumps to sex when I hear the word intimacy and libido but sex is just one element of an intimate relationship. And we needed to learn this profound lesson. The great news is that it is really fun practicing all sorts of other ways to deepen our relationship and the new practices tend to improve our sex lives also.

We took to enjoying lingering kisses in the hallway, kitchen and garage whenever we passed each other. We now hold hands on the couch while watching TV, we give each other foot massages and spoon ourselves to sleep. What ways can you bring back touch to your relationship?

Rethink the sexiness of spontaneous sex

Where does the belief that “good sex should be spontaneous” come from? I could lay blame on any number of TV shows, films, books and magazines but does it matter? The truth is, sex does not have to be spontaneous to be thrilling. In fact, the anticipation of planned sex can be a wonderful aphrodisiac.

In order to enjoy sex with RA, you may need to do a little extra planning. When do you typically feel the best? When do your achy joints and fatigue have minimum impact? Schedule sex for those times. And use the time between now and then to practice foreplay connecting, using one of the suggestions above.

Take advantage of when you are in the mood

Now that we’ve discussed scheduling sex, when you’re living with RA, know that you should definitely take advantage of the times when you do feel in the mood. Even if it happens to be Tuesday evening and you have a presentation at work tomorrow. Who knows, maybe the experience will enhance your performance!

One thing I have noticed – the more I practice Kegel exercises, the more my libido improves – double bonus!!

The simplest way to learn how to do a Kegel is to practice while peeing. Clench your pelvic floor muscles tight in order to stop the flow of urine. Hold 3-5 seconds, then release. Repeat 5 times each time you pee during the day (or whenever you remember.)

Experiment with new positions

Now that you are living with RA, you might find your body does not move the same way as in the past or that certain sexual positions are no longer comfortable or enjoyable. It is essential to remain open to novelty – try new positions and see what works for you and your new body.

Final thoughts

Yes, the relationship between rheumatoid arthritis and sex and low libido can be a challenging conversation to have with your partner or your doctor but if you want sex to be part of your RA Warrior life, then you owe it to yourself to give the matter some attention.

I hope this article has inspired you to take action.

If you have a photo of you and your partner that you would like to share here, please let me know. I’d love this article to feature your success story.