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Explore resources to help you understand and manage psoriatic arthritis.
Psoriatic Arthritis Handbook
Intimacy, Reproductive Health and Family Life
How will psoriatic arthritis affect me?
RELATIONSHIPS AND SEX
Psoriatic arthritis can present a number of challenges in a relationship, namely:
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reduce your enjoyment of sex and other activities you share with your partner;
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affect your mood and self-esteem;
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impact your ability to contribute to household and family related duties;
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lead to financial worries if your condition affects your ability to work.
Although your relationship may change because of psoriatic arthritis, you should remember that most couples go through phases in their relationship that are more or less positive, depending on a number of factors such as stress, work-life balance, or other health conditions.
Talking to your partner about any changes or challenges you may be facing is a great way to improve communication in the relationship and arrive at solutions to please both of you.
If you are not in a relationship and worry about how your condition may affect your prospects of finding a romantic partner, especially if you have visible signs of the condition, keep in mind that most relationships develop gradually and that shared interests are more important than physical considerations.
While sex will not make your psoriatic arthritis worse, it can sometimes be painful when you move an affected joint. Besides the physical aspect, psoriatic arthritis may decrease your sex drive, affect your self- confidence, or make you feel less attractive.
Psoriatic arthritis can sometimes lead to a dry vagina, and thus to uncomfortable sex. If this is the case, water-based lubricants can help you and/or your partner. Oil-based lubricants may irritate your skin or damage condoms.
To help you overcome difficulties with sex, you should:
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talk openly with your partner about your physical and/or emotional concerns;
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keep active as physical exercise can help you strengthen your muscles and support your joints;
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take painkillers approximately one hour before having sex to minimise pain;
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try different positions and use cushions, pillows, or furniture to support your body;
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remember that there are multiple ways to achieve sexual satisfactions, such as kissing, caressing, mutual masturbation, oral stimulation, or even sex aids such as vibrators.
FERTILITY, PREGNANCY, AND BREASTFEEDING
If you are planning to start a family, you should discuss your treatment plan with your rheumatologist, as some medications are not safe in pregnancy. It is completely normal to feel concerned about the effect of your condition on your ability to start a family.
People with arthritis may take slightly longer to become pregnant. It is best to try for a baby when your condition is not very active.
There is a genetic contribution to psoriatic arthritis, that is, the presence of certain genes makes a person more likely to develop the condition. However, this is not a strictly hereditary condition. There are many factors involved in the development of psoriatic arthritis, not just the genes inherited from parents. Therefore, in the vast majority of cases the chances of passing it on to your children are relatively low.
FERTILITY
In women, there is no evidence to support that psoriatic arthritis affects fertility (51). However, a recent study indicated that untreated inflammatory arthritis, such as psoriatic arthritis, may decrease male fertility (52).
In both women and men, fertility does decrease with age or may be affected by other health conditions.
Therefore, some people living with psoriatic arthritis will need fertility treatments.
If your psoriatic arthritis is under control, there should be no problem to initiate fertility treatments. Discuss any plans for fertility treatments with your rheumatologist. They can offer specific advice, review your treatment plan, and liaise with the medical team responsible for your fertility treatment.
PREGNANCY AND BREASTFEEDING
Discuss your plans to start a family with your rheumatologist so that your treatment plan can be adjusted. If you become pregnant unexpectedly, talk to your rheumatologist as soon as possible.
All women get aches and pains during pregnancy. As the baby grows, you may feel additional strain on some of your joints, especially on your hips and knees.
While there is not a lot of information on the effects of pregnancy in psoriatic arthritis, studies have shown that the majority of women living with rheumatoid arthritis experience some form of symptom improvement during pregnancy. However, some women will have a flare after giving birth.
Psoriatic arthritis usually does not affect delivery and you can still give birth through your vagina. If you are considering a caesarean, you should discuss this with your doctors (rheumatologist and obstetrician). It may be necessary to stop some of your medications before the surgery.
You should continue anti-rheumatic drugs that are safe in pregnancy during pregnancy and breastfeeding. This will reduce your chances of any complications during pregnancy and will make flares less likely after giving birth.
Many mothers feel sad, tearful, or anxious in the first two weeks after having a baby. However, if these symptoms last for longer or start later on, you may have post-natal depression, which affects 1 in 10 women after giving birth. It is important to seek medical help if you feel this way.
Remember that you are not alone. If you need extra support, please speak to your GP or Health Visitor. More information can be found below:
NHS Mental Health Services
NHS Postnatal Depression
