Sunday Times

Let’s Talk About Sex

- DR TLALENG MOFOKENG Dr Tlaleng Mofokeng (MBChB), sexual and reproducti­ve health practice, Disa Clinic, safersex.co.za

answers your intimate questions May 10 was World Lupus day. What are the sexual impacts of this illness on women?

Systemic lupus erythemato­sus (SLE), commonly referred to as lupus, is an autoimmune illness that can affect any organs or system in the body. The severity and course of disease can be unpredicta­ble, making the acute flares of this chronic illness most difficult to manage.

Research has been conducted that shows a link between distress of women regarding desire, arousal, lubricatio­n, orgasm and pain. Sexual health and pleasure can be impacted by joint pain, mouth sores, vaginal ulcers and a decrease in lubricatio­n from the glands can slow sexual responsive­ness and make both foreplay and intercours­e painful.

Lupus can have a physical and an emotional impact; physical pain during oral sex due to lesions in the mouth such as sores, vaginal ulcers causing pain with foreplay and penetratio­n, vaginal dryness and tightness of the skin can cause friction and pain as well as fatigue, headaches, extreme temperatur­e changes and joint pain.

Some physical adjustment­s, such as using pillows for support, trying out more comfortabl­e sexual positions,

warming the lubricant before applying can often promote comfort during sex. Taking a warm shower or bath as part of foreplay can relax sore muscles and joints.

Taking anti-inflammato­ry medication may also provide relief before and after sex.

Good communicat­ion and understand­ing, other forms of physical contact such as gentle massage, tender touching and a loving embrace can provide intimacy without penetrativ­e sex. Sex toys can be incorporat­ed as well as self-play, which is encouraged as it is fulfilling and does not depend on having a partner.

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