Autoimmune Disease Affecting Your Intimacy? Try This — Transcript

If you're living with arthritis, an autoimmune disease, or a disease that can cause chronic pain, your sex life can be severely affected. In this video, I will discuss how different forms of arthritis or autoimmune diseases affect your sex life. And I also discuss if sex is going to help with your pain. And I will also share five tips that will help you improve your sexual life despite suffering from an autoimmune disease.

Let's begin. Hi, I'm Dr. Diana Girnita, a board-certified rheumatologist who diagnoses and treats people with autoimmune diseases. Autoimmune diseases like rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, scleroderma, and Sjogren's syndrome can significantly affect your sexual life and the relationship that you have with your partner. A 2023 study revealed that more than 60% of women with autoimmune diseases suffer from sexual dysfunction, and many patients suffer in silence.

For instance, women with inflammatory arthritis like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, can experience chronic pain, joint limitations, and sleep deprivation, leading to mood changes like anxiety, depression, and ultimately impacting their relationship.

Lupus patients may also face mood swings, severe headaches, increased skin sensitivity, or skin changes that can make them feel uncomfortable to undress in front of their partner.

Vaginal dryness can also be bothersome for women with Sjogren's disease, making sex uncomfortable or even painful, often leading them to avoid intimacy with their partner. Now, similarly, women with scleroderma may also face challenges because of skin tightening, oral and genital tract fibrosis, and vaginal dryness also causing discomfort during sex.

A 2015 survey showed that 72% of patients with low back pain had sex less frequently, and 70% found sex less satisfying. 61% said that their pain made relationships more difficult to maintain. Now, men with autoimmune diseases are also affected as many of them suffer from erectile dysfunction. Conditions like type 1 diabetes, rheumatoid arthritis, lupus, and multiple sclerosis can cause damage to their nerves or blood vessels leading to erectile dysfunction.

Now, interestingly, 50% of men with erectile dysfunction are at higher risk for heart attacks, potentially due to ongoing inflammation from autoimmune diseases, which can increase the risk for atherosclerosis, heart disease, and erectile dysfunction. Then, fatigue, depression, anxiety, and the lack of motivation associated with autoimmune diseases can further decrease the desire for sexual intimacy.

Who wants to engage in sex when they are feeling drained of energy or they're anxious or depressed? Many of my patients will tell me that they feel guilty that their partner is unsatisfied or they don't understand them. Many of my single patients, they also tell me that their symptoms affect their interest in meeting other new people.

Who wants to get dressed and head to a date when they feel awful? Even the medications that are used for treating autoimmune diseases such as glucocorticoids or steroids, immunosuppressants, or SSRIs for depression can cause a decrease in libido. However, studies have shown that maintaining an active sexual life is beneficial for patients with arthritis and chronic pain.

Sex induces pleasure and increases endorphins and oxytocin in your body. Those are the hormones that make you feel good. It is also shown that you will feel more connected with someone during a time that you might actually feel alone. Here are the five tips to improve your sexual life despite suffering from an autoimmune disease.

Number one, keep the communication open. Communicating with your partner is crucial when one partner or both have limitations caused by autoimmune diseases. Now, deep conversations can improve connections without sex. Tell your partner about what are your physical boundaries and where are your limitations today. For example, say something like, "My joints hurt today too much to have sex, but we can kiss." And that can help increase your partner's understanding of where you are when it comes to sex.

Communicate your needs often. Tell your partner how they can provide for you. If you need a hug or if you're craving something like physical touch, like holding your hands. In turn, ask them about what they need as well.

Number two, plan ahead to achieve successful intimacy. It is best to plan ahead for intimacy around the times of the day that are better for your symptoms. For example, if you are suffering from rheumatoid arthritis, waking up feeling achy and stiff in the morning, it is not the best time of the day. So, plan your intimacy moments for later in the day when you feel better.

If you suffer from pain, stiffness, weakness, and muscle spasms, then experimenting with different sexual positions can also be helpful. Number three, lubricate, lubricate, and more lubricate. Since vaginal dryness is a huge problem in a lot of autoimmune conditions, especially in patients suffering from Sjogren's, rheumatoid arthritis, or even scleroderma, investing in a good quality lubricant is going to be a must. It can help with relieving the discomfort caused by dryness, and it can make the sexual encounter more pleasant. Also, discuss with your OB/GYN if hormone replacement therapy is going to be helpful for you. Many females of menopause would be a candidate for estrogen creams, for example, but you need to discuss these options with your doctor. You can also listen to my podcast Thriving with Arthritis, where together with my guest, an expert in menopause, Dr. Prabhakar, I discuss more about this topic.

Number four, explore alternatives to sexual intimacy. Intimacy is so much more than sex. Any emotional and physical bonding such as hand-holding, kissing, a gentle massage, hugging, or cuddling boost the release of oxytocin from your brain, which will make you feel loved. Engage in together time more deeply. Avoid distractions and increase the eye contact. Maybe plan for a tech-free date when you are putting the phones away and you are turning off all the screens. In this way, you can focus on your partner, making you both feel more seen and more heard.

Number five, see a sex therapist. Seeing a sex therapist can be a great way to address intimacy issues and sexual dysfunction and to get tips on having sex with a chronic illness. If you feel like your intimacy struggles, work with a sex therapist by yourself or as a couple. Now, the sex therapist can help you learn how to communicate your needs, your desires, and also your boundaries.

Therapy can also help you with anxiety or resentment surrounding sex and intimacy, which may actually stem from your physical symptoms or past experiences. A trained therapist can work with you to explore sexual positions that could be possible for you and make you feel good despite suffering from an autoimmune disease. Coping with an autoimmune disease is complicated, and it can affect your sexual life. I hope this video helps you see that you are not alone, that there are other men and women like you experiencing difficulties in their sexual life. This is a gentle reminder that you can still have intimacy and sex when you feel able to while living with an autoimmune disease. Talking to your partner and continually exploring each other and dancing back and forth between each other's needs and wants is the key to solve this issue. If you want to learn more about autoimmune diseases and the signs and symptoms, you should watch this video on my channel. Until the next time, stay curious, stay healthy, and get informed. Thank you. [Music] rheumatologistoncall.com

Communicate your needs often. Tell your partner how they can provide for you. If you need a hug or if you're craving for something like a physical touch like holding your hands. In turn, ask them about what they need as well.

Number two, plan ahead to achieve successful intimacy. It is best to plan ahead for intimacy around the times of the day that are better for your symptoms. For example, if you are suffering from rheumatoid arthritis, waking up feeling achy and

stiff in the morning, it is not the best time of the day. So, plan your intimacy moments for later in the day when you feel better.

If you suffer from pain, stiffness, weakness, and muscle spasms, then experimenting with different sexual positions can also be helpful. Number three, lubricate, lubricate, and more lubricate. Since vaginal dryness is a huge problem in a lot of autoimmune conditions, especially in patients

suffering from Sjogren's, rheumatoid arthritis, or even scleroderma, investing in a good quality lubricant is going to be a must. It can help with releasing the discomfort caused by dryness, and it can make the sexual encounter more pleasant. Also, discuss

with your OB/GYN if hormone replacement therapy is going to be helpful for you. Many females of menopause would be a candidate for estrogen creams, for example, but you need to discuss these options with your doctor. You can also

listen to my podcast Thriving with Arthritis, where together with my guest, an expert in menopause, Dr. Prabhakar, I discuss more about this topic.

Number four, explore alternatives to sexual intimacy. Intimacy is so much more than sex. Any emotional and physical bonding such as hand-holding, kissing, a gentle massage, hugging, or cuddling boost the release of oxytocin from your brain, which will make you feel loved. Engage in together

time more deeply. Avoid distractions and increase the eye contact. Maybe plan for a tech-free date when you are putting the phones away and you are turning off all the screens. In this way, you can focus on your partner, making you both

feel more seen and more heard. Number five, see a sex therapist. Seeing a sex therapist can be a great way to address intimacy issues and sexual dysfunction and to get tips on having sex with a chronic illness. If you feel like your

intimacy struggle, work with a sex therapist by yourself or as a couple. Now, the sex therapist can help you learn how to communicate your needs, your desires, and also your boundaries.

Therapy can also help you with anxiety or resentment surrounding sex and intimacy, which may actually stem from your physical symptoms or past experiences. A trained therapist can work with you to explore sexual position that could be possible for you and make

you feel good despite suffering from an autoimmune disease. Coping with an autoimmune disease is complicated, and it can affect your sexual life. I hope this video help you see that you are not alone, that there are other men and women like you

experiencing difficulties in their sexual life. This is a gentle reminder that you can still have intimacy and sex when you feel able to while living with an autoimmune disease. Talking to your partner and continually exploring each other and dancing back and forth between

each other's needs and wants is the key to solve this issue. If you want to learn more about autoimmune diseases and the signs and symptoms, you should watch this video in my channel. Until the next time, stay curious, stay healthy, and

get informed. Thank you. [Music] rheumatologistoncall.com