Living with Psoriatic Arthritis (PsA)

Loss of attraction


Ever since I came down with PsA, my husband has been caring for me in addition to working and doing the majority of housework. He still loves me but is no longer physically attracted to me. He said he has an obligation to me and that really hurt. I want him to love me for me, not because he promised to do so, so many years ago. We’ve been together for 15 years and he is only 37. He is too young to give up his sex life in my opinion. We haven’t been intimate in a long time. He said he doesn’t want to deal with the complications of that type of relationship (with someone else). I offered because I love him and want him to be happy. I’m pretty much physically unable to have sex and had a total hysterectomy when I was 28 due to severe endometriosis. I never gained back my sex drive after that so I’m not really interested in sex, per se. I do miss the intimacy now. My dad died two years ago and my husband has become my surrogate daddy. That was what I needed for a while, but I want my husband back now. I’m still on the medication trial and error rollercoaster and never feel good.

What can we do to become intimate again? I want him to be fulfilled and happy once in a while. Me, too.


It’s an awfully big question you ask here. I don’t think I can offer any specific advice, even with someone I knew very well I’d find it difficult to hit the right note I think.

It does strike me that there is still a lot of love between you two, I can see that it is how it is expressed that is the problem.

All I can think is that it sounds as if something has changed for you, in a good way, because you say that you no longer feel you need a ‘surrogate daddy’. It sounds as if you’ve woken up, are feeling stronger emotionally, and suddenly want everything to be as it used to be. But I doubt that will happen over night. Perhaps you will have to focus on you a little more and wait and see how things turn out. After all this time in a predominantly caring role, it might be a bit mind-blowing for your husband to suddenly hear ‘I’m ready, come & get me!’. One step at a time maybe?

I came back to add to my post after a bit of thinking … that phrase ‘an obligation’ (to you) … it’s a bit harsh. I guess there’s a thin line between the mean things we all say to our partners sometimes and verbal abuse or control. Go careful. You deserve respect no matter how much help and support you need.


I suggest starting things back up by focusing strictly on him in an intimate situation. You do everything to bring him pleasure. You take pleasure from bringing it to him. Don’t let him try to reciprocate, keep the focus 100% on him. Keep in mind being intimate and being sexual are two different things.

Maybe it’s sexual satisfaction for him. Maybe it’s a massage of some kind. Maybe it’s watching a game with him (and actually watching it and engaging in it!). Maybe it’s going fishing. Maybe it’s letting him pick the movie. Basically you want to shift the focus to him and his needs and way from you and your limitations.

To the best of your abilities, make it all about him. This should help reset your relationship away from caregiving and back to couplehood.



I couldn’t agree with azurelle more; there are so many other ways to be intimate than just sex. Making him feel loved and appreciated and not just your carer can be achieved in so many ways. Communication is key.
That said, relationships don’t always work out, regardless of health problems, so don’t stay in it if it’s not working just because you’re grateful. Life’s too short to be unhappy.


Hugs! I’ve felt very much the same, especially since hitting menopause.
Intimacy is an important part of life for most couples, and when one has chronic illness and pain, that can be difficult to manage even when our natural hormones are still onboard.
The advice others have shared above is great, and through my martial years similar actions on my part have served my marriage well when my own body was just not up for intimacy.
My husband is my partner, and I don’t wish to think of him as my caregiver, and I want him to know I feel he is my partner. My disease progressed slowly, and was never taken seriously by doctors or me at first, therefore I spent many years wondering what was wrong with ‘me’ and like I was a failure at being an equal in our marriage. He’s always had to take up slack, and there were times I felt he resented it, though it was left unsaid if he did.
At this point in our lives, where my abilities are really declining, he reminds me I’d care for him exactly as he’s caring for me if our roles were reversed. Your husband likely recognizes that in your marriage, too.
For your own health and well-being, however, it might help if you look into bio-identical hormone replacement therapy (BHRT) following your hysterectomy. I’ve found endocrinologists are usually the most well versed on this, though some gynecologists are, too. I researched well before even considering hormones.
For me, hitting menopause a few years ago sucked what little interest there was right on out of me. Before, it wasn’t that I had no interest, only that pain always kind of took over (SI joints especially, sigh), and we tend to not go looking for things that pain us.
There are risks to BHRT, and of course you need to understand and be comfortable with them, but since starting them myself, I think they’ve helped my outlook and attitude on life. Loss of hormones can affect so much more than just our interest in sex. I’ll never be an acrobat when it comes to intimacy, but that part of my life no longer feels completely stolen away. Lack of hormones can change the structure and function of the vagina, and atrophy and dryness both may make intimacy painful. BHRT can help change this. I currently have bio-identical estrogen, progesterone, and testosterone prescribed. For hysterectomy patients, progesterone isn’t always in the mix, however, as it is for menopausal patients. I was looking for relief of hot flashes… constant, day and night. Just feeling better all the way around is a bonus.
Finally getting specific treatment for PsA has also helped as I have a bit more relief from the pain now!
Incidentally, my endocrinologist has PsA…
I had no idea when I made the appointment with her.
Whether you consider hormone therapy or not, I hope you find something that helps you to return this normalcy in your marriage and to rediscover the reasons you fell in love in the first place. :two_hearts:


Hard question. Being on the other side of the gender, I am pretty much incapable of sex, due partly to a prostatectomy for prostate cancer, and all the physical pain. My urologist has given me options for being able to maintain an erection, but I know until all the pain, or at least some of the pain, is gone, it would be pointless.

Coming from a counseling and therapist background I would recommend finding a good mariage therapist that both of you can see. They can facilitate getting you two talking.

Just my two cents.


what a great guy for wanting to be there for you. Im single and also sexually unavailable not a great start for a new relationship lol, but you have the foundation for a great long lasting relationship which is so hard to find, i hope u can find a way to make it work


This is an important issue that I haven’t seen discussed here before. But it is one that I am also well aware of. I don’t have a partner, and haven’t had for nearly twenty years (and only then, it was short term). I am happy being single, and can’t think of being anything else. I like my own company. I like the ability to do what I want when I want. It’s just the way I am. There are reasons for that, which are unimportant in the context of this discussion, although there is nothing particularly strange about them.

But I am also in the situation where I haven’t been sexually active, or wanted to be sexually active since the arthritis came along. Not only is it logistically difficult, there are other things that come along with the arthritis - the shapes of bodies change due to immobility, weight gains due to steroids, immobility itself - there are some basic things I can’t do now that I once could. In other words its being self-conscious about these things - along with middle-age to go with it.

Luckily for me, I’ve never really been into it a great deal. Most often than not, I’d rather have a cup of tea or a bit of Victoria Sandwich. But that doesn’t mean I don’t want it to be a possibility, even if it were only within the most basic sexual acts. But at the moment I’m too self-conscious for that to happen, even if there was someone to do it with! On the plus side, the biologics have got rid of the pain in my wrist, which makes solo activity relatively pleasurable again!

Did I really just say that?


Hi there,
Sorry to hear things are difficult for you at the moment.

My 2 cents, what works that I can share:

Communication with your spouse, super important. Your husband is telling you important stuff. I agree with the other posters, some good couple therapy to help untangle whats going on for you both and find the way ahead, whatever that may be. You are both now living with this, it affects you both.
Care giving, can you get a funded carer / home help where you are?. We support and help our spouses, but care giving duties can be bloody hard work and not very sexy, lets be honest. Perhaps some outside help would lighten the load for you both and allow a space for your husband to breathe too.
Sex, honestly, why are toys not talked about more?. Great for everyone, but very handy for those who have mobility or fatigue issues. As a woman, look for Jimmy Jane online. Trust me::wink:. Ask your husband what he might like to try as well, be bold and have fun. I hear you on the meds roller coaster, strike when the iron is hot, or even slightly warm. Some times you have to just show up and do your best, often you may be pleasantly surprised.:grinning:
“Say what you mean, mean what you say, but don’t be mean when you say it.” Words for married people to live by.
Good luck, Melissa.


When you find the solution, let me know! In the same boat here!