By Dr Irwin Lim, Rheumatologist
Barry, a regular reader of this blog, emailed me this week with a range of suggestions for blog posts.
Among those, was a suggestion for me to write about the effect of a disease on a patient's sex life and measures to deal with this.
I emailed Barry saying that I didn't have any particular expertise in the topics he suggested.
I definitely don't have expert knowledge regarding how patients with arthritis deal with their sexuality, either the actual mechanics of the physical act of being intimate or their desire for sex or even, the effects of medication on these.
Since that email, I've been mulling over this topic of sex and intimacy. I must admit it's not something I bring up or try to discuss in a consultation. I doubt many rheumatologists would, but I am happy to be corrected.
The closest I have come to discussing this would be a couple of cases of impotence when we (the patient & I) were wondering if their medication was implicated, and a particular case of a patient with sciatica who was too scared to let her husband know that their intimate moments would flare her pain.
I do mention sex when discussing the need to avoid pregnancy while being on certain medication, with the most common occasion being my spiel before prescribing Methotrexate. But, that's typically in the context of using contraception.
So, it's dawned on me that I've basically not broached the subject of sex and intimacy in any meaningful way with my patients.
Can you share your thoughts or ways you have coped? Has your rheumatologist been better at helping you with this? Where do you go for support/information?Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.