Effects of rheumatoid arthritis on sexual activity and relationships

Living with a disease such as rheumatoid arthritis (RA) is not at all easy, one finds oneself facing it in everyday life with fluctuating phases; days in which it seems to have “won” in the morning and days when the disease is in an acute phase, in which even the most banal “gesture” like tying shoes or wearing jeans seems complicated and impossible…. in short, living with this pathology has implications on various aspects of life: sentimental, working and daily.

59% of RA patients the intimate relationship with their partner is more problematic; this is especially true with a disease such as RA as it is a chronic, systemic, painful and potentially debilitating inflammatory condition.

Healthcare professionals, in some cases, play a central role in the care of rheumatology patients by providing holistic care, but sexuality remains an area that many feel unable to discuss [2]. This is unfortunate, as sexuality is an important aspect of most people’s lives.

Sexuality has been described as an essential part of the whole person, an integral part of the human being, including the total sense of self, and is linked to the quality of life of the individual [5].

It is a complex aspect of human life, which includes much more than the act of sexual intercourse, a crucial part of an individual’s personal identity, and therefore important in all stages of health and illness

In 1936 Freud described the distinction between sex and sexuality thus: “sex is something we do, sexuality is something we are” [6].

Research to date suggests that some patients experience problems within relationships and this occurs more frequently if the disease occurs within a more stable relationship [11].

Some studies have focused on their frequency. Among these, a lower frequency in sexual intercourse, orgasms and a demand for sexual desire in females has been demonstrated following the onset of RA [13].

The correlation between the deficiencies of the reported aspects is to be found in the loss of physical function, fatigue and pain.

The greater the level of pain, physical disability and depression, the greater the effect on sexuality, regardless of gender.

Among the largest and most valid studies conducted to date, that of Oxford University Press has emerged.

The inclusion criteria in the scientific study admitted patients over the age of 18 with a positive diagnosis of RA, recruiting a total of 74 patients.

These patients were given a self-administered questionnaire, allowing the latter the opportunity to remain anonymous.

The questionnaire consisted of a mixture of open and closed questions including 5 domains: patient-partner relationship; sexual relationship and sexual activity; impact of disease symptoms; impact of drug therapy; and communication.

All participants, informed of the content, were asked to complete the questionnaire at home and return it in a prepaid envelope; none of them refused.

Upon completion of the test, of the 74 questionnaires; 59 (80%) were returned, two were left blank and some patients had not answered all questions.

From the analysis of the answers, the researchers identified how most of the patients responded by describing in the open questions the manifestation of physical symptoms during intercourse with their partner.

Fatigue was the most frequently mentioned problem, followed by pain and impaired physical function.

In summary, the study shows that RA has an impact on patients’ sexual relationships and activities; the prescription of a correct pharmacological treatment could represent an aid in this sense, since the correct prophylaxis could reduce and improve the inflammatory aspects of the patient.

It is therefore of fundamental importance to identify the correct drug for the right patient.

iCareX  adopts an individual-centric approach in helping patients with RA to better understand and characterize their disease. With the exploRA test, the uniqueness of the gene expression of each individual is analyzed in order to obtain the correct drug therapy with medical support.




  1. Irwin R. Sexual health promotion in nursing. J Adv Nurs 1997; 25: 170–7.


  1. Wells D. Caring for sexuality in health and illness. Edinburgh: Churchill Livingstone, 2000.


  1. Freud A. The ego and mechanisms of defense. London: Hogarth Press, 1936.


  1. Le Gallez P. Rheumatoid arthritis: effects on the family. Nurs Stand 1993; 7: 30-4.


  1. Yoshino S, Uchida S. Sexual problems of women with rheumatoid arthritis. Arch Phys Med Rehabil 1981; 62: 122–3.
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