Is arthritis putting a chill on your love life?Learnhowto rekindle the fireand why it’s worth the effort.
Joint pain and arthritis-related issues can forcenew approaches to sexual intimacy. Motivationtends to deteriorate along with mobility. Researchindicates that it’s common for sexual activity toebb as discomfort and stiffness increase, saysMaureen K. Watkins, an assistant professor ofphysical therapy, movement and rehabilitationsciences at Northeastern University in Boston.
Not only can sex can be painful for patients, but合伙人可能会因为害怕造成伤害而退缩。Sexual activity is often considered an essentialpart of a well-balanced life and, thus, worth redefiningand committing to, say health care professionalsand people living with these conditions. That’s especially true when partnersare also caregivers – a healthy sex lifehelps prevent the relationship fromcentering around the disease.
Also, physical intimacy has a hormonalupside: Sexual satisfaction releases pain–mitigatingendorphins and, according toa small study conducted by neuroscientistBarry R.Komisaruk, PhD, it also canblock pain. “Vaginal or cervical stimulationhas a pain-blocking action, withor without orgasm,” saysKomisaruk,professor of psychology at RutgersUniversity. “It works against headachepain, arthritic pain, menstrual cramps.”
However, the physical and psychologicalbenefits of sex are often overlookedby medical professionals.
Advice & Assumptions
Though 61 percent of patients reportthat their conditions affect intimacy,only 12 percent ofrheumatologistsdiscuss intimacy with their patients,according to a study published in 2014in theWorld Journal of Orthopedics.
This is gradually changing as morepeople in their 40s and 50s get jointreplacements,says MatthewHepinstall,an attending orthopedic surgeonand associate director of the Center forJoint Preservation and Reconstructionat Lenox Hill Hospital in New YorkCity. “It’s typically younger patientswho bring it up.”
It’s probably up to you to broach thesubject with your doctor or your physicalor occupational therapist. That includesdiscussing and demonstrating the biomechanics,understanding the daily factors– as both the disease and its remediescan sap energy and enthusiasm – andhow to collaborate with your partner.
“How do you have fun? How do youwork things out with your partner? It’sabout exploring together how you canbe an active participant,” says KimSteinbarger, who has had rheumatoidarthritis since her early 20s and isdirectorof clinical education for thephysical therapy department ofHusson缅因州班戈的一所大学。
Energy & Expectations
Talking with your partner about yourexpectations, disappointments andhopes for intimacy is an essential componentof figuring out the logistics,saysSteinbarger.
Patients often tell her thatfatigueis a bigger barrier than specific jointissues. “Any time you’re compensating,it takes energy,” saysSteinbarger, whohas found that understanding beginswith ongoing communication aboutenergy management.
“It can be difficult for a partner who’snot affected to understand that this issomething you have to plan,” she says.“We all want to be spontaneous, but youmight want to conserve your energyduring the day to have a good night. It’s not romantic, but it’s a reality.”
Together, map your respective dailyrhythms to determine where energyand enthusiasm intersect, recommendsEmily Barr, an associate professor ofoccupational therapy at NebraskaMethodist College in Omaha. If you startslowly in the mornings but your staminaramps up in midday, that could framediscussions about when to set the stagefor romance. Owning the sex scheduleas a couple is essential for breaking outof the caregiver-patient dynamic.
The Biomechanics of Love
Still, even the best intentions can stall ifthe logistics can’t support your mutualambition. Exactly how is this going tohappen, and for how long, and at whatlevel of intensity? Different positionsput different demands on each partner.
Skin conditions, scars and joint disfigurementare unwrapped as intimacyintensifies, and those moments can bedisheartening for those who are self–conscious,says Barr. Many concernscan be alleviated with a frank discussion与你的伴侣。And a trustedphysical or occupational therapist(they’ve seen it all) can provide tipssuch as modified positions or applyingheat to vulnerable joints.
A good time to broach the topic withyour doctor and therapists is whenreviewingyour goals for a drug regimen,surgery or physical or occupational therapy.
Define sex as an activityon yourlist of “daily living tasks,” like walking,gardening and other lifestyle goals, saysNicholas Frisch, MD, anorthopaedicsurgeon with AscensionCrittentonHealth in Rochester, Michigan.
Sketch out your situation to directthe conversation: Do you want to resumea robust and adventuresome sex lifeor is your goal a gradual restoration ofcloseness with a lifelong partner?
Frame sex as you would any other physicalactivity, outlining your definition ofsuccess in terms of intensity, frequencyand emotional and social context.
Gillian Hawker, MD, chair of thedepartmentof medicine at the Universityof Toronto, recommends taking acue from workout routines for managingpain during sex. What works for yourworkout – warming up, respectingyour range of motion, expecting tohave some post-activity TLC – is likelyan equally successful strategy for sex.
Ask your physical or occupationaltherapist to includestrengthand balanceexercises to help you stay in preferredsexual positions longer and with moreconfidence. Barr even coaches (fullyclothed) patients and their partnersthrough the biomechanics of recommendedsex positions.
Experimenting with a variety ofpositionswill likely be necessary,especiallyafter surgery – that meanspositions that respect the range ofmotionprescribed by doctors.
Author:Joanne Cleaver
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