When addressing how to deal with joint stiffness, pain and fatigue, which can make intercourse more challenging for both men and women, Dr. Dikranian suggests trying different sexual positions because some may be more comfortable than others. Also, it may work better to have intercourse in the evening rather than the morning, because joints may be less stiff at that time. To cope with pain, a patient may want to take medication to help it subside before being intimate with a partner. Practical measures, such as taking a warm shower or using massage as part of intimacy to help loosen joints, may also be beneficial.
Dr. Dikranian adds that his advice for discussions about intimacy issues with gay or lesbian patients is the same, because the challenges for heterosexual and homosexual patients are similar.
Other Resources
If an appointment doesn’t allow enough time to fully discuss an intimacy-related issue, perhaps an ancillary staff member, such as a nurse practitioner, nurse educator, therapist, counselor or social worker, can address their concerns. Rheumatologists may also want to point patients to a patient advocacy group, printed resources or websites, such as Arthritis.com. The ACR also has online resources for patients and caregivers.
The bottom line: At minimum, a rheumatologist should initiate a conversation with their patients and ask if they have any intimacy issues. “Keep conversations nontechnical and on par with patients’ understanding. Provide resources and referrals to other providers who can spend more time on the topic or give more practical, specific advice,” Dr. Dikranian concludes.
Karen Appold is a medical writer in Pennsylvania.
