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Sex and Intimacy

Reviewed by: HU Medical Review Board | Last reviewed: March 2023

Chronic pain and stiffness can make it difficult to maintain intimate relationships. If you have axial spondyloarthritis (axSpA), you may find that your symptoms make it hard to be physically close to your partner. This can lead to distance in your relationship and some tough conversations. But by talking openly with your partner, you can help keep your relationship strong despite the challenges.1

How can axSpA affect sex and intimacy?

AxSpA can make it difficult to maintain close relationships, both physical and emotional. Activities that require being close to someone, like sex, might become harder due to the pain and fatigue caused by axSpA. Also, the drugs used to treat axSpA can have side effects that affect intimacy.1

Some other ways axSpA can impact sexual function include:1,2

  • Decreased mobility or the ability to move around freely
  • Changes in sex drive
  • Problems with arousal or achieving orgasm
  • Increased anxiety, stress, or depression

Treating axSpA to improve sex and intimacy

For people with axSpA, managing pain and stiffness can be done through a combination of treatments. Drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and biologics can help reduce inflammation and pain.3

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Some people also find that changing their lifestyle helps them manage their axSpA symptoms. Changes might include:3

  • Exercising regularly
  • Eating healthy foods
  • Managing stress
  • Practicing relaxation

Seeing a physical or occupational therapist can help you gain range of motion and flexibility. This might make sex more comfortable and less painful.1,3

Talk to your doctor about seeing a physical or occupational therapist if you do not already see one. If problems with your mental health are affecting your sex life, ask your doctor for a referral to a mental health professional.1,3

Enjoying sex when you have axSpA

Having axSpA does not mean you cannot enjoy sex. Listen to your body and your symptoms, and try the following tips.

Manage your symptoms

If your axSpA symptoms are under control, you will be more likely to enjoy intimacy. Your pain or stiffness might not always be at the same level, but there are things you can do to help control your symptoms and pain. It might help you feel better if you keep track of your symptoms and find ways to manage them.4

Get and stay active

Engaging in physical activity can be tough for people with axSpA due to chronic pain and stiffness. But staying active can help manage symptoms and make you feel better. Exercise can:5

  • Ease joint pain
  • Make you happier
  • Make you stronger
  • Give you more energy
  • Help you sleep better

Feeling better physically has a positive impact on your mental health. And being stronger might make having sex easier.5

Try different positions

Experiment with different sexual positions. Exploring ways to be comfortable and sexual at the same time can help reduce pain and stiffness and make it easier to connect in a physical way. Also, finding ways to ease discomfort by using pillows or cushions as support can help to create a more enjoyable experience. Take the time to discover what works best for both you and your partner.1

Redefine intimacy

Intimacy is not just about physical contact. It is also about showing love and care through actions like romantic gestures or talking. Touch is an important way to connect. Massage, cuddling, or holding hands can make the connection special. Toys can help you feel new sensations while still feeling comfortable.1

Intimacy goes beyond intercourse. Choosing how you want to show your intimate connection is personal and up to you and your partner.1

The takeaway

Healthy and fulfilling intimate and sexual relationships can be achieved when you have axSpA. It is okay to take it slow or take time to rest and manage your symptoms. Even in the best relationships, living with a chronic illness like axSpA can sometimes make things more difficult.1

Showing respect for yourself and how you want to be treated can help. Remember that axSpA does not define who you are. Be open and honest with your partner, even if the conversation might be tough. Together, you can embrace a new normal in your relationship and explore ways to create a lasting connection.1