The Effects of Rheumatoid Arthritis

on Sexual Activity & Relationships

Dr Jackie Hill
Original article: 04/04/2006
Reviewed: N/A
Next review due: 04/04/2009

A study carried out by Leeds University has found that many patients with rheumatoid arthritis believed that their disease has negative effects on their relationships and sex lives. Patients attending the Rheumatology Outpatients Clinic at the General Infirmary in Leeds were asked to complete a questionnaire and return it by post. The questions covered relationships with partners, sexual activities, the impact of the disease on sexual activity, the effects of drug therapy on libido, and the extent to which patients felt able to discuss any problems with partners, health professionals and others. Because of the sensitivity of the information, patients were given the option of remaining anonymous. Fifty nine patients returned questionnaires, which was an 80% response. Only 22% of these chose anonymity.

Thirty-five per cent of patients who were in a relationship believed that the disease put a strain on their relationship with their partner. The most common causes were limitations of activities, changes in the balance of the relationship, emotional changes and financial changes. The symptoms of the disease were cited as causing curtailment of activities. For instance, one lady mentioned that fatigue prevented her from going on walks, something she and her husband had greatly enjoyed. Many patients mentioned that they or their partner had become short tempered and lacked patience and this strained the relationship. This was generally caused by the symptoms, such as pain and stiffness.

Forty-four per cent of those who were sexually active believed that their rheumatoid arthritis had changed their relationship with their partner. Again symptoms such as pain, fatigue, dry vagina, difficulty with comfortable positioning, reduced interest and lack of spontaneity were contributing factors. Patients were asked about their sexual ability and the majority considered it to be an important or very important part of their lives. The patients who thought that sex was not important tended to be older, on average they were 69 compared to for those who thought it was important, the average age being 49 years.

Fatigue or tiredness was stated by most patients (59%) as the main reason that impaired love making, but pain and reduced function also contributed. Twenty couples regularly discussed the effects arthritis had on their sexual relationship but 19 patients didn’t feel that they could talk about it with their partner. On the other hand, the majority of patients felt that their partners understood the effects that rheumatoid arthritis had on their sex life. It’s not only patients and partners that feel unable to talk about sex, the majority of patients had never been asked by any health professional about the impact of their arthritis on their sexual lives. Many of these patients had had their arthritis for over 15 years and only three patients had brought up the subject with doctors, nurses or other health professionals. When patients were asked if they felt they would talk to someone if they had a sexual problem, the majority said they felt inhibited. For those patients who felt that they could talk to someone the nurse and the doctor were the professionals most often chosen.

Although patients may have been reluctant to bring up the subject of sexuality with health professionals, they did appear willing to complete and return the questionnaire about their sexuality. This is demonstrated by the fact that 80% of the people who was given the questionnaire completed and returned it.

The result from this research shows that rheumatoid arthritis can affect the patients' relationship with their partners and that sexual activity is difficult for a large minority of patients. The research also shows that ageing does appear to have an impact on the importance the patient places on their sexual ability. We conclude that rheumatoid arthritis impacts on the sexual lives of the large number of patients, and that this is a problem that patients and health professionals are reluctant to discuss face-to-face. However, if problems are to be solved they must be discussed and health professionals should undertake this as a routine part of patient care.