Sex, Intimacy, and Psoriatic Arthritis
Psoriasis causes red, scaly patches on the skin that can be located on all areas of the body and can be painful and itchy, as well as seem unattractive. Psoriatic arthritis causes inflammation, tenderness, and joint pain. These symptoms can lower your self-image and interfere with sexual intimacy.
Everyone wants to feel good. In relationships, people expect to experience closeness, to feel safe and accepted. If you have psoriatic arthritis, you may have experienced discomfort or embarrassment because of the appearance of your skin. The National Psoriasis Foundation reports that nearly a third of people with psoriasis and psoriatic arthritis report their condition interferes with their love life.
Thinking about my self image
Everyone wants to seem comfortable in his or her own skin, but that may have a different meaning to you if you have psoriasis. A chronic skin condition that is subject to flare-ups can cause people to stare or stay away; perhaps making you feel self-conscious, vulnerable, and anxious. Some with symptoms are hesitant to date or engage in sexual relationships fearing rejection or shame.
Having a partner who sees you, the person you are, and not your skin condition is reassuring. Discussing your psoriasis, what it is and how it affects you, is an important step to building trust. Explain that it is not contagious, and you are being treated. Answer any questions, respecting hesitation or uncertainty along the way.
Impact on intimacy
Strong intimate relationships have many facets including emotional and sexual components.2 They change over time. The emotional quotient includes a closeness, physical, and emotional well being. It doesn’t require a physical connection but often includes one.
Sensual feelings and physical needs are part of sexual intimacy. They can include stimulation of multiple senses.
Why does sexual dysfunction occur?
Psoriasis can affect any part of the body. If it is in the genital area, you may experience some difficulty or pain when having sex. This can be because of fatigue, pain from the arthritis, or the location of skin lesions.3 Flaky or itchy psoriatic patches in or around the genitals can occur in thighs, anal and pubic areas, and for men on the penis and scrotum. For women, they can appear in the vaginal area and vulva.
People with psoriasis and psoriatic arthritis have reported diminished sexual satisfaction and function. It’s not just the visual skin condition; depression and anxiety can be contributing factors. A treating dermatologist or rheumatologist can refer you to a specialist to help address both the medical and psychological components of performance issues.
How to improve sexual satisfaction
If you feel self-conscious try taking steps to create an intimate atmosphere. Dim the lights; wear sexy clothing, and other steps to make you feel less self-conscious and more desirable. Talk to your partner about what feels good and what adjustments may need to be made. Talk about what areas are good to touch and others that might make your feel uncomfortable. Explain that these areas may change based on your condition at any given time. Follow your doctor’s instructions on treating the lesions and take care to do things that make sex more comfortable such as using lubricants or condoms.
Sexual satisfaction to some may be simply achieving climax, but for others it may include having a trusting, satisfying relationship that includes emotional comfort and feeling desirable. Let your partner know when it’s a good time and when it’s not. Your sex drive and timing may not be the same as your partner’s - creating challenges. Finding ways to communicate and a variety of ways to satisfy one another will help improve intimacy and make sex more enjoyable for both of you.
Don’t be afraid to discuss your condition with your partner. Explaining how it makes you feel, including any fears or anxiety, can help them to understand why you sometimes appear uncomfortable (hint: it’s not anything they’re doing wrong). This openness generally leads to good sexual health and a closer, more satisfying relationship.
Do you have a sleep disorder (eg. insomnia, sleep apnea, RLS) in addition to your PsA?