The constant pain and fatigue associated with lupus may make it difficult to cope with the physical and emotional aspects of sex. In addition, some medications used to treat lupus can cause problems. Some of these drugs may decrease your sex drive. Other drugs may lessen sexual arousal or make it difficult to achieve an orgasm.

Some people with lupus also have a condition known as Raynaud’s phenomenon. Exposure to cold causes spasms in the small blood vessels of the finger and toes. This reduces blood flow and may cause fingers and toes to turn white or blue and numb. During sex, the flow of blood increases to the genital area and decreases to other areas of the body, including the fingers. This can cause the numbness and pain of Raynaud’s phenomenon to occur.

Other problems also can interfere with sexual activity, such as oral and genital sores, vaginal dryness, and yeast infections. You may feel less attractive because of skin rashes that are difficult to control.

Your partner may not understand the changes in your desire, the fact that you may feel unattractive, or the physical problems you are experiencing. He or she may think you are no longer attracted to him or her. On the other hand, you may feel your partner is avoiding you, when he or she is trying to be sensitive to your needs and is afraid of hurting you or causing you more pain during sexual contact.

These issues may be hard for you to talk about. However, a mutual willingness to have open and honest discussions with your partner can play an important part in understanding the issues that are affecting your relationship. If the two of you cannot resolve your problems together, seek help from your doctor, nurse, or a counselor experienced in working with people who have lupus.

Caring For Yourself

• Keep a healthy attitude about yourself. Being positive can play an important part in maintaining your sexuality.
  
• If you notice a change in sexual desire after starting a new medication, tell your doctor or nurse.
  
• Ask your doctor if he or she can prescribe an anti-inflammatory or pain medication that you can take before having sex.
  
• Be sure you are well rested. Consider taking a nap just before sexual activity.
  
• Relax and ease some of the pain with a warm shower or bath just before sexual activity.
  
• If you have Raynaud’s phenomenon, increase circulation to your fingers and toes by taking a warm bath before sex. Raising the temperature in the bedroom will also help.
  
• If you have vaginal dryness, use a water-based personal lubricant during sex.
  
• If you have a vaginal yeast infection, call your doctor so that he or she can prescribe the medication you need. Yeast infections are easily treated.
  
• If some physical problems make certain sexual activity difficult, don’t be afraid to explore with your partner other ways to achieve mutual pleasure and satisfaction.