If you watched “Masters of Sex,” the Showtime series on renowned researchers Dr. William Masters and Virginia Johnson, you witnessed vivid scenarios of human sexual response. What you didn’t see onscreen was a couple having sex as the woman struggled with hip arthritis or as the man gingerly worked around recent knee surgery. Even so, these situations play out in many real-life bedrooms, potentially throwing a wrench into intimacy. Whether you’re coping with chronic arthritis or recovering from a joint replacement procedure, you and your partner can still enjoy sex by combining caution and creativity. Here’s how.
[See: Osteoarthritis and Activity: Walking It Out.]
Be direct with health care providers. At any age, if you’re concerned about sex after surgery, ask about it, says Sallie Foley, a sex therapist, sex educator and therapy-trainee supervisor. “Patients need to be saying to the physical therapist and doctor: ‘What are the specific things I can’t do with sexual activity?'” she says. “Because younger professionals — and older ones, frankly — often assume that older adults aren’t having sex. Well, older adults have more time and they have a lot of sex.” That, she says, can take the form of intercourse, mutual masturbation, oral sex and more. As the patient, she advises, be willing to say: “We’ve been talking about my general rehab. Now I want to talk about my sex life. How will this joint replacement affect it?”
Relieve knee pressure. If your joints are riddled with arthritis, your sex life can take a hit. For instance, a squatting position may become impossible. “You can have significant difficulty putting direct pressure on the knee,” says Dr. Matthew Hepinstall, associate director of the Center for Joint Preservation and Reconstruction at Lenox Hill Hospital in New York City. “Positions requiring kneeling can be quite uncomfortable.” Whether you have an older aching knee or fresh knee replacement, you want to go easy on that area.
Support your hips. In her work with couples after surgery, Foley sees many women who’ve had a hip replacement and been told not to move their hips too far apart. The concern, she says, is that the woman might pop the hip joint. A couple used to a missionary position might have to improvise and switch, she says, for instance with the woman on top. Side-by-side sex is another possibility. “Having pillows propped behind a person eases some pressure on lower-back or hip joints,” she adds. “What we a call semi-reclining position.”
Use foam blocks as bolsters. You can look to your local craft store for foam blocks to make sex more comfortable. Propping your leg on a block may help with body alignment and enable positions you couldn’t otherwise manage, Foley says. Or if you’re kneeling, placing soft foam under your knees protects them from the pressure of a harder surface.
Try yoga. For people who’ve undergone knee surgery, gentle yoga is a terrific idea, Foley says. “Yoga [instructors] give great tips on positioning with alternate positions,” she says. When looking for a class, she recommends seeking ones with names such as yoga fundamentals, beginning yoga or restorative yoga. “Restorative yoga moves slowly,” she explains. “They help you with poses and you can say, ‘I need to replicate kneeling, but I can’t put direct pressure on my knee like I used to.'”
[ See: 4 Ways to Stick to Your Physical Therapy ‘Homework.’]
Seek physical therapy. After joint surgery, working with a physical therapist helps you return to normal daily function — and that includes resuming your sex life. Sexual counseling, therapeutic exercise and advice about sexual positions are part of rehabilitation, according to a 2014 study in the journal Sexual Medicine. “Rehabilitation provided by physical therapists may help decrease pain, and facilitate greater self-awareness, self-confidence and improved body image, all of which encourage and affirm optimal sexual health,” the study authors concluded.
Follow post-op guidelines. “I typically recommend that people wait until their incision is well-healed before they start getting hot and sweaty,” Hepinstall says. “With knee replacement, patients can participate relatively quickly.” Their choice of positions might be restricted in the first few weeks, he adds, to give the incision time to mature and heal. With hip replacement, he says, restrictions might last six weeks or so, depending on the surgical approach used. Once past early recovery, Hepinstall says, he’s never had patients complain about sexual function. Instead, every so often, he gets postoperative kudos when patients can resume an activity they’ve enjoyed.
Address pain to improve sex. “Scientific studies support the fact that for people whose sex life is inhibited by joint pain, joint replacement actually improves [it],” Hepinstall says. Hip replacement likely offers the greatest improvement, he says, because bad hips probably interfere with intimacy the most. Surgery or not, lifestyle changes can improve a suffering sex life, Foley says. “If people have not had a joint replacement and their joints are hurting, they’ve got to look at their full lifestyle,” she says. That includes reducing stress, getting enough sleep, eating healthily to reduce inflammation, walking gently and and sometimes just taking a soothing bath.
Ease back gradually. Couples can reestablish their connection a number of ways. Skin-to-skin touching has value in itself, Foley says. “Sometimes I ask people to lie naked side by side and put their hands on each other’s heart. Just to feel the beating of the heart inside the other person. Breathe together. And then begin to explore each other’s bodies and give feedback: ‘This is a great area — it’s not sensitive anymore.’ Or: ‘Gee, my scar’s still sensitive. Can we work around my incision site?” And go ahead and play with sex toys, she suggests — you can order online if you prefer.
[How to Prepare for Hip Replacement Surgery.]
Be sex-plorers. You don’t have to be Masters and Johnson to take a scientific, exploratory approach to sex. “The sexiest thing older adults can do is talk about what they want to try before they go in the bedroom,” Foley says. Once there, she says, the couple can accept that of course the session will be awkward, because they’re trying new positions. “So it’s going in with the attitude: ‘We’re like scientists and we’ll see what works for us now, as opposed to in the past.'”
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Healthy Aging: Sex After Joint Surgery originally appeared on usnews.com
