Hi all,
A “touchy” subject here but thought I would raise it and see who is brave enough to comment lol. I am finding it difficult to be intimate with my partner due to SI joint and hip pain both during and after sex. It saddens me because I’m only 29 and my partner is so loving and supportive and I really want to be able to enjoy sex and I don’t want him to feel bad for hurting me. I am hoping things will improve once my PsA is under control, but it’s dampening the mood in the meantime 
it’s difficult enough with the extreme fatigue that comes with the PsA I’m thinking I won’t be alone in this problem… Has anyone else had PsA affect your sex life and then Eventually your relationship? We have such a strong relationship and I don’t want our lack of sex life to become an issue…
I have hip pain that sometimes impacts sex, but find that it is usually worse after, so I just deal with the pain. The fatigue is more of an issue. It's more that my husband doesn't want to approach me as he doesn't want to pressure me. So more often than not I initiate, which is fine too.
You would think it would have an impact on our relationship, but we've never had an extremely active sex life, so it's not a huge impact. But I'll also point out that your sex life need not be limited to intercourse, and you may find many other ways to connect, with intercourse being a lesser part.
hello there I believe in unconditioanly love so very much I know with the psa when it came out of remission about a year or so ago I married a wonderful man he hurt his back real bad and was out of work for about 3 months before my arthritis hit me full force it came back with avengence had to go on std and then after 6 months I got approved for disability the intimate part of our relationship was not happening as much I stood beside my husband took care of him cause that is what you do but when I got bad he started to change he could not handle what was happening to me I am a firm believer that when to people make that comment to one another in sickness and in health threw the bad and good that you don't turn and walk away from all of that not real true unconditional love It depends on how strong that bond is being intimate is important but I guess maybe I look at it to as there are some out there that cannot be intimate in that way hugs are priceless and being touched and kisses are their only means guess maybe it depends on the love between 2 people.A love that strong is far and few between now a days but they r out there hope this helped and good luck have a great day
I have inverse psoriasis in that region. There absolutely isn’t any fun until that’s clear.
My husband has a much higher sex drive than I do, for a variety of reasons, pain being one of them. I have huge issues with SI joint, hip, and back pain. He and I have a deal. Before bed I take my meds and melatonin, he brings me a hot pack for my back, and I go to sleep. When he comes to bed, if he's in the mood, he snuggles up to me to see if I am, too. I either elbow him, grumble at him, and roll over and go back to sleep, or things go in his favor. LOL I'm usually relaxed enough and pain-free enough that it isn't painful during sex. If it starts getting painful, I'm not shy about telling him to hurry up. There are also things we do to please each other without penetration, sometimes saving that until the last second to avoid causing me too much pain. We are actually more intimate now than we were before my huge PsA flare that led to my diagnosis a few years ago.
Thank you all for replying, it’s great to have someone to talk to about this, women who are in the same boat. I am very lucky that my partner is very understanding and caring and doesn’t push the issue… I guess that makes me love him even more and I want to have sex! Lol most of the time I just get sore hips afterwards but sometimes we have to stop because my si joints or hips are really hurting… That being said, I’m grateful I don’t have the inverse psoriasis like some - that must be horrible and I feel for you! I guess we all get affected in various ways. Thanks so much for talking girls, it’s nice to have people to talk to about such a personal topic and I really appreciate your candidness to keep me at ease xox
According to that Hannah Montana girl, Kellr84, you are only months away fro being over the hill anyway so why worry.
It has affected the desire to want to. My husband will try to touch me and the desire to respond is not there. However, if I don't turn away his advances, lol, everything turns out good. I thought the meds would affect things but it doesn't. My problem is not having the desire to. My SI joint bothered me for a couple of years. Terrible pain. It didn't really affect me during sex though. It turns out mine was actually the piriformis. I had an injection to the sciatic nerve which relieved it. You are really young. I am 42 so my sex life is normal, I think. PsA does dampen the mood. When I am hurting I definitely would rather be left alone. My meds are really controlling the pain for me. My fatigue is getting much better. When I first started meds I felt pretty bad. You may be able to talk to your rheumatologist about your meds or using something to help the sexual aspect. I hope things get better for you. I have worried about the sexual side myself. My husband and I have always had a good intimate relationship. I don't want the PsA to destroy it.
I have a lot to say on this topic! I've had PsA since before I became sexually active, so it's ALWAYS been part of my life. This post is very into TMI territory, so skip if you don't want your eyes to melt out :)
I've also been with my husband for 21 years (we met at age 20 in college). I have some things that work for us, and different things work at different times. I'll share and take or leave whatever you like.
First, there are some resources out there on sex and arthritis. One position for intercourse that rests the lower back and hips, is for the woman to be laying on her back, the guy at a right angle, laying on his side, with just the hip area lining up and the woman's legs over the guy's hips. The woman does not need to open her hips for this position. It's sort of like she is sitting on a chair, but the guys lap is the chair. There are also disability guides for using toys that are hands free if your hands hurt, easy hold toys, pillows to support the body, other positions for various sore spots, etc. Search out this information, and try some of the things. If you don't have kids or housemates, you may find the sofa, a certain chair, or someplace else to be more comfortable for sex than a bed.
Because I am intermittently exhausted and / or in pain, I always let my husband know if sex is even a possibility (ie, I'm the initiator of the conversation 99% of the time). We have about the same sex drive (pretty average, I'd say), and he never wants to pressure me, so this works out great. I am VERY up front, and he's used to it after 20 years. I say something like "do you want to have sex in an hour? If so I need to take some pain meds" (or whatever I need to do). For me, the endorphins from sex make me feel better. For the first couple of years it was tough for my boyfriend then husband to understand that even though I couldn't get out of bed all day from pain and swelling, I was still down for having sex because it helped with the pain. It's really counterintuitive to the healthy spouse, that someone in that much pain would want to have sex. Their frame of reference is pain=don't do anything until you feel better. But when you never GET better, working sex in whenever possible is necessary. This won't work out though if the spouse EVER pulls the "you had energy to have sex and now you can't do X?"
I don't want to harp on "communication is key!" but my husband and I have to speak very clearly and openly about sex with each other. I can ask if he wants to have sex, but give him the information that my hands are very sore and I won't be able to touch him much and he can make the decision if he is in the mood for that type of sex or not. Or I can tell him I'd like to but it's going to have to go quick because I have no energy, or that I'm going to need lots of time because of the meds I'm on make my body slow to respond. Really really open communication. If you're not used to this it can be very awkward feeling. But the rewards of a good intimate relationship are worth it.
Sex doesn't have to be mostly about intercourse, or even INCLUDE intercourse. This may be a helpful approach if intercourse is painful or difficult to recover from. Things like mutual masturbation, oral sex, even just being there when your partner masturbates, massages, toys, role-play, sharing erotica, lingerie, basically anything that is enjoyable to two people, but leaves intercourse off the table can be GREAT for those times when you don't want intercourse for whatever reason.
Another issue I'm going to talk about is orgasms. I have been on and off meds that reduced or completely wrecked my ability to orgasm. Antidepressants, being on a lot of pain meds, etc. It can be a sticking point in a relationship if one partner feels that the other partner's inability to orgasm makes them feel like they aren't doing a good job in bed. Again, communication is key. I still enjoy sex with my husband in these situations, but it was tough to make him understand why. Turns out I can get most of the endorphin response, the relaxation, increased flexibility, etc. regardless of orgasm, and I had to let my frustration go. That was the hardest part, letting MY frustration with intermittent med-induced anorgasmia and learning to enjoy everything else.
The last thing that I'm going to recommend for someone with PsA is to masturbate regularly (whatever regularly means to you: once a month or once a day). You get pain relief, you don't have to put forth the effort with a partner, you can do it at a time of day that is the best for you when you don't have a partner available, it keeps your libido from dropping dead, and keeps all those systems in working order. If your hands hurt, there are plenty of toys out there to help, for both men and women.
Very informative, Marietta. Great job! Thank you.
Thanks, Marietta.
My husband and I have always been very close and love our physical intimacy. I have also had to be more communicative with him. He stopped initiating sex when I stared having problems. I really missed that because it makes me feel so good to have his attention and to know that he desires me. I made it clear that he needed to stop worrying about “bothering” me. Its never a bother. Sometimes it has to be a quickie, sometimes it has to be very gentle with a gentle massage of whatever hurts first. I am lucky that he listens to what I need and makes it happen. That said, the frequency is less than I would like, but I make sure that it happens once a week.
Thanks. After I wrote it I was having 2nd thoughts LOL!
mom5 said:
Very informative, Marietta. Great job! Thank you.
Thank you so much Marietta!! That was very helpful!! You made some really great points there 
I’m so so glad you were happy to share I need to definitely make more effort on my behalf and make time for us to be intimate. I raised the topic because I have noticed I was turning down my partners not so subtle hints more and More in the last month as I have been so tired and in so much pain it’s not fair on him when I shut him down, it hurts his ego and sometimes he even says I’m not giving him enough affection. Our relationship is great, he is my best friend but I need to also remember he is my lover. It’s so great to have a girlie chat xox
Thank you so so much Sybil for coming forward and sharing this 
I cringed after I wrote this post but I thought I wouldn’t be alone in this problem mariettas advice below is amazing, check it out! Hope you are feeling ok xox Kelly
sybil said:
Well I’ve had to psyche myself up to say this, but for me the problem is near-total libido collapse. I don’t suffer from the really painful joints that plague some, but not being as limber as I was doesn’t help.
As I’m past the menopause this could be the reason, lack of hormones does diminish desire I’m sure, but somehow I think that PsA and / or the drugs I take are more to blame. On another forum I read some young mens’ tales of woe in this respect & they were told that Mtx can wipe out libido.
It’s yet another loss that saddens me. I’m glad you raised this subject though.
Thanks Stoney yes, that is very true
Stoney said:
I have hip pain that sometimes impacts sex, but find that it is usually worse after, so I just deal with the pain. The fatigue is more of an issue. It’s more that my husband doesn’t want to approach me as he doesn’t want to pressure me. So more often than not I initiate, which is fine too.
You would think it would have an impact on our relationship, but we’ve never had an extremely active sex life, so it’s not a huge impact. But I’ll also point out that your sex life need not be limited to intercourse, and you may find many other ways to connect, with intercourse being a lesser part.
Yes very true, just holding each other is nice too and touching one another
howdydoodee said:
hello there I believe in unconditioanly love so very much I know with the psa when it came out of remission about a year or so ago I married a wonderful man he hurt his back real bad and was out of work for about 3 months before my arthritis hit me full force it came back with avengence had to go on std and then after 6 months I got approved for disability the intimate part of our relationship was not happening as much I stood beside my husband took care of him cause that is what you do but when I got bad he started to change he could not handle what was happening to me I am a firm believer that when to people make that comment to one another in sickness and in health threw the bad and good that you don’t turn and walk away from all of that not real true unconditional love It depends on how strong that bond is being intimate is important but I guess maybe I look at it to as there are some out there that cannot be intimate in that way hugs are priceless and being touched and kisses are their only means guess maybe it depends on the love between 2 people.A love that strong is far and few between now a days but they r out there hope this helped and good luck have a great day
Lol @ lamb! Did she say 30 is over the hill? Lol
tntlamb said:
According to that Hannah Montana girl, Kellr84, you are only months away fro being over the hill anyway so why worry.
I'm so glad I could help! My spouse and I have had SO many years to deal with this issue. In some ways it was easier having this issue from the start, we have always had to be great communicators around sex or we would both be miserable. It's such a difficult issue to discuss anyway, and add in health issues that most people don't understand (see every post on this board about relatives and friends who 'don't get it'), and it can be a recipe for problems. It can be so very lonely and we feel like we are the only one having these troubles. When we are partnered and have PsA we have so many things to deal with. It's nice when sex can be a refuge and a connection instead of one more stressor.
In your case, when you've been turning down your husband's advances because of fatigue and pain, it might be tough, but try to be VERY upfront. Explain that emotionally you'd like to have sex, but you are having pain / fatigue, and you both need to work out what is going to work to get sex to happen that evening (or morning, afternoon, whatever). Most guys are problem solvers, and are eager to come up with helpful solutions :)
It can even be nice to have an hour or whatever until your meds start working / heating pad loosens muscles / etc, all that time you're both thinking about how you are going to have sex soon. It helps get your minds in the right place, and things go better than making a snap decision and then getting in bed and finding you've stiffened up after 5 minutes and are miserable. Who knew sitting around with a heating pad could be exciting?! LOL
Also, take advantage of any spontaneous time periods when you DO feel good. If you want more intimacy with your spouse it can be nice to use that short window of time for sex instead of getting something done around the house (and other times you'll both decide that thing around the house is more important than sex :)
PS: don't underestimate a sizzling look, a small kiss, and saying "I *really* wish I could have sex with you right now, but my body won't cooperate". Sometimes just *knowing* you desire your partner, even if you can't physically act on it at all, helps :)
Very true, I need to let him know I do want to do it, rather than him thinking I’m just not interested… You have been so great Marietta, thank you xoxox
Marietta said:
I’m so glad I could help! My spouse and I have had SO many years to deal with this issue. In some ways it was easier having this issue from the start, we have always had to be great communicators around sex or we would both be miserable. It’s such a difficult issue to discuss anyway, and add in health issues that most people don’t understand (see every post on this board about relatives and friends who ‘don’t get it’), and it can be a recipe for problems. It can be so very lonely and we feel like we are the only one having these troubles. When we are partnered and have PsA we have so many things to deal with. It’s nice when sex can be a refuge and a connection instead of one more stressor.
In your case, when you’ve been turning down your husband’s advances because of fatigue and pain, it might be tough, but try to be VERY upfront. Explain that emotionally you’d like to have sex, but you are having pain / fatigue, and you both need to work out what is going to work to get sex to happen that evening (or morning, afternoon, whatever). Most guys are problem solvers, and are eager to come up with helpful solutions
It can even be nice to have an hour or whatever until your meds start working / heating pad loosens muscles / etc, all that time you’re both thinking about how you are going to have sex soon. It helps get your minds in the right place, and things go better than making a snap decision and then getting in bed and finding you’ve stiffened up after 5 minutes and are miserable. Who knew sitting around with a heating pad could be exciting?! LOL
Also, take advantage of any spontaneous time periods when you DO feel good. If you want more intimacy with your spouse it can be nice to use that short window of time for sex instead of getting something done around the house (and other times you’ll both decide that thing around the house is more important than sex
PS: don’t underestimate a sizzling look, a small kiss, and saying “I really wish I could have sex with you right now, but my body won’t cooperate”. Sometimes just knowing you desire your partner, even if you can’t physically act on it at all, helps
Hi, The athritiscare.org.uk site has a pdf booklet which you can download. I just typed in arthritis and sex life into search. It covers alot of areas to do with relationships including diagrams of positions which may be more comfortable…we have had great fun trying them out " Well baby do you fancy a bit of number 4" lol 
But seriously they do put out some good information on a variety of topics including lack of desire.
The key for me is communication, as long as you don’t let your intimacy fall by the way side and talk about how you feel you will work out your own ways.
Recently I had cooked my partner his favourite dinner, we had the house to ourselves, I was, shall we say, saucily dressed. But I fell asleep in front of the tv My partner didn’t wake me he sat with me after eating his dinner and washing up, and let me wake by myself…it didn’t matter Id fallen asleep he loves me and we had a nice night…at least by sleeping I recovered some ‘spoons’