RA & Chronic Conditions | Sex & Romance After 50

Dr. Gail Saltz Sex and Romance After FiftyWelcome to our Q&A with renowned expert Dr. Gail Saltz,  a psychiatrist, columnist, best-selling author, and television commentator.

For women in midlife, romance and sexuality can be  difficult when chronic conditions like Rheumatoid Arthritis complicate the mix.  Dr. Saltz has become a trusted resource in  the  conversation surrounding the impact of rheumatoid arthritis (RA) and other chronic conditions on romantic relationships. She is currently a dating and intimacy expert on New Way RA™  with news anchor and host Deborah Norville.

Q. Your expertise is – well – unique. How did you come to study the effects of Rheumatoid Arthritis and other chronic conditions on romantic relationships?

A. I am a psychiatrist and have a specialty in sex therapy, hence much of my work is about helping people with difficulties in their relationships and sexual lives. The fact is that many people struggle with chronic illnesses that impact their relationships and their sex lives. Rheumatoid arthritis often presents in women in their 20’s, 30’s or 40’s which is a population I see a lot of. These women are still trying to find a relationship or are often navigating a new marriage and they find their disease is creating real obstacles. Many of these obstacles are psychological in that it is a matter of how their illness makes them feel and that is what we try to work on.

Q. RA can affect people of all ages…are the psychological effects more pronounced for women who are in the throes of menopause? Are there any resources that people living with RA can utilize to learn more about managing RA and living with the condition?

A. Chronic pain, fatigue and self consciousness all effect how you feel about yourself as a partner, how you see your body and how you interact with someone you are being intimate with. Questions like “When do I tell him that I have rheumatoid arthritis?” or “Will he reject me if I can’t keep up with him?” and even “How do I make sex fun and passionate when I feel self conscious about my body and positioning?”  These fears can keep women from either starting a relationship, being really emotionally available in a relationship or communicating openly.

I have just participated in an episode of New Way RA , an online talk show about living with rheumatoid arthritis. In this show I  talk in more detail about how one can date and make the most of any current relationship if they are living with RA. Also there are episodes that talk about nutrition, style for clothing, treating and overall living with RA. It can be found at NewWayRA.com. Also participating in the show are real women living and thriving with RA.

Q. What other factors affect healthy emotional and sexual relationships as women age?

A. Perimenopause often causes mood fluctuation, particularly irritability. Many women feel sad around menopause because it signals aging, loss of ability to have children, midlife. This is true for all women. So add to that an illness that by itself can make a woman feel depressed due to chronic discomfort and fears already about aging with an illness and it can really cause some women to struggle with depression. That being said, many women before and during menopause do not have a problem with their mood and fair pretty well. Probably one of the biggest factors is how well you feel you cope with your Rheumatoid arthritis.

Q. What is the first step a woman should take in recognizing and coping with the discomfort and fear of intimacy under these conditions?

A. Many factors affect how a woman feels about her sexuality as she ages. They range from old myths she may believe passed on from her family about older women being entitled to enjoy sex and being sexy, to the health and communication of her current relationship, to medications she may be on that can effect sexuality, to really knowing herself as a sexual and emotional being and feeling good about that.

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