Arthritis can affect many aspects of your life, including your relationship and sex life. While the physical discomfort can make sex less enjoyable and so lower your desire, there are things you can do.
See also: Seven foods to ease the pain of arthritis
See also: 10 natural ways to ease arthritis pain
Talk to your partner
It is not uncommon for people with a long-term illness to have low self-image, which can lessen your desire to have sex and have an impact on intimacy. If you feel self-conscious about swollen joints or other signs of arthritis, tell your partner. They may not be aware of how you feel and may have their own fears and concerns they want to talk about.
Worrying in silence can make matters worse. Talking, whether it's with your partner, your rheumatology team, or a counsellor, can help put your mind at rest.
Change your routine
Sometimes, making little changes can make a big difference. In the same way that getting your medication right can take trial and error, changing your routine can make it easier to have a fulfilling sex life.
For example, if you find that you're too exhausted then and your pain is worse, try making love in the morning or early evening. Spontaneity is all well and good – but like many things when you have arthritis, you need to plan ahead.
Taking painkillers in the lead up to sex can help. If your joints and muscles are achy, have a warm bath to help you to relax or ask your partner to give you a massage. Before you get started, make sure you have pillows or bean bags for support to hand.
Best sex positions
Durex sex and relationship expert Susan Quilliam advises a side-by-side position, where you both lie facing and with her outer leg raised up and over his waist, means that your bodies are supported.
"Unlike the missionary position where she's underneath, or 'woman on top', it means that neither of you is taking the weight of the other.
"It's also a gentle position, that doesn't take much exertion or acrobatics, and being face-to-face makes it very intimate. The alternative side-by-side position is 'spooning', where she lies in front, he lies behind her and curled round, penetrating. This may not be as romantic but does mean that either of you can reach down and stimulate her clitoris."
Best sexual positions and tips to try
If you one or both of you has had a hip replacement or has problems with kneeling or lying face down, try a standing position. Both partners stand, with the woman resting on furniture at a comfortable height to provide support and balance, while the man enters from behind.
If you're a woman who can't bend your hips or straighten your knees, try lying on your back on the edge of the bed. Your partner then kneels on the floor and enters from in front.
Arthritis Research UK has a list of positions - illustrated with line drawings - suggesting the best positions for various problems.
When dryness is a problem
Arthritis can sometimes lead to a dry vagina, which may make sex uncomfortable. "Added to that, a woman's ability to lubricate drops naturally after the menopause, particularly if she is not using hormonal supplements," says Susan.
If dryness is a problem, Susan suggests using a water-based lubricating gel.
"I'd recommend Durex Play O which not only lubricates but also enhances orgasm. Also, make sure that foreplay is long and arousing to encourage natural lubrication. Plus, keep having sex for as long as you want it - so you don't 'lose it' because you don't 'use it', whether that's with partner sex or pleasuring yourself."
Think beyond intercourse
Sexual fulfilment doesn't have to mean penetration – using sex toys can be a way to enjoy sexual satisfaction and promote intimacy. Most toys can be bought online and delivered discreetly (in plain packaging). Even Boots and some supermarkets now have a range of vibrators.
Susan says: "If you're not used to using one, I would recommend a compact vibrator for clitoral stimulation. Because it's smaller, it can be easier to introduce into your love making."
There will be times when you just don't have the energy or the pain is too much. Try not to place too much pressure on yourself or your partner. Keep talking and sharing your feelings. Many couples find that they become closer by discussing things openly and that their relationship is stronger as a result.