Sex and Intimacy

Reviewed by: HU Medical Review Board | Last reviewed: May 2020 | Last updated: June 2021

AxSpA spectrum conditions can affect various parts of your life, in very personal ways. One of these is sexual dysfunction. Sexual dysfunction can affect both men and women, and can impact quality of life. If you’re experiencing sexual dysfunction, talk with your doctor about it. There are things that can be done to help improve your sexual functioning and quality of life.

How can axial spondyloarthritis affect sex and intimacy?

Sexual dysfunction is a problem that happens during any point of the sexual response cycle that interferes with a person or a couple from being satisfied from sexual activity.1 There are different types of sexual dysfunction, including:1

  • Desire disorders (lack of sexual desire or interest)
  • Arousal disorders (problems with becoming physically aroused during sexual activity)
  • Orgasm disorders (problems with orgasm)
  • Pain disorders (pain with intercourse)

In men, sexual dysfunction can occur as trouble having or keeping an erection or trouble with ejaculation.1 For women, it can present as trouble having an orgasm, problems with vaginal lubrication, or not being able to relax the vaginal muscles to allow penetration.1

What causes sexual dysfunction?

Both physical and psychological reasons can cause sexual dysfunction. There may be psychological stress regarding nerves about sexual performance, relationship problems, body image concerns, or past trauma.1 Physically, there may be physical or medical conditions that contribute to the dysfunction, as well as medication side effects.1

In AxSpA spectrum conditions, including ankylosing spondylitis (AS), chronic musculoskeletal pain, fatigue, depression or anxiety, joint stiffness, lowered libido, and medication side effects may all have an effect on sexual functioning.2 In both men and women with AxSpA spectrum conditions, more disease activity, inflammation, and certain biologic medications resulted in lower sexual quality of life.3 More research needs to be done on women’s experiences of AxSpA spectrum disorders and sexual quality of life.

How is sexual dysfunction treated?

Talk with your doctor about what kinds of symptoms of sexual dysfunction you are having. If they’re related to medications you take for AxSpA spectrum conditions, perhaps you could try a different medication. If things like joint pain or stiffness are interfering with your sexual functioning, physical or occupational therapy can help promote range of motion and reduce stiffness, and your doctor may recommend certain sleeping positions or medications to address the pain and reduced range of motion.

For other kinds of sexual dysfunction, treatment can include medications like hormone shots, creams, or pills; dilators, penile implants, or vacuum devices; sex therapy, behavioral treatments, and education.1 Treatment varies depending on the specific challenges that are presenting with sexual functioning.

If you’re having issues or challenges with sexual functioning, it can feel embarrassing to talk with your doctor about this – and that’s okay. Providers know that sexual activity is a part of life, and just because you have an AxSpA spectrum condition, that doesn’t mean that you have to live with problems with sexual functioning. Once they know what you’re experiencing, they’ll be able to work with you in getting to the root of the issue and finding ways to help restore your sexual functioning and quality of life.

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