Enjoying better sex after a joint replacement

Enjoying better sex after a joint replacement

Read about the author Samantha Evans

With many older people living longer and enjoying good sex lives, some are affected by osteoarthritis which can limit mobility and be very painful. Many people give up sexual activities because of pain and restrict movement in their joints, which can have a negative impact upon their sexual relationship.

However, joint replacement surgery can increase movement and decrease pain, enabling people to resume their sexual relationships.

A study conducted by Dr Rodriguez, an orthopaedic surgeon at Lenox Hill Hospital, New York (2013) found that over 90% of participants who underwent a total hip replacement (THR) or total knee replacement (TKR) experienced improved sexual function.

The study involved asking 147 patients under 70 years scheduled for THR or TKR surgery to complete three questionnaires. Of the 147 people asked, 65% completed all three questionnaires.

The group of patients consisting of 68 men and 78 women with a mean age of 57.7 years were asked to complete questionnaires prior to undergoing joint replacement, at 6 months post operatively and at 1 year post operatively.

Prior to surgery, of the 67 % who reported sexual problems due to physical mobility:

  • 67% experienced pain
  • 39% experienced stiffness
  • 49% had reduced libido
  • 14% were unable to maintain a suitable position for sex due to the pain or limited mobility
  • 91% of respondents reported psychological issues related to osteoarthritis which included general decrease in well being (91%) and reduced sexual self image (53%).

Following surgery after a suitable period of recovery, 90% of respondents reported overall improved sexual function, with slightly higher rates after THR than TKR, and females reporting more improvement after THR than men.

  • 42% reported increased libido
  • 41% experienced longer intercourse duration
  • 41% had sexual intercourse more frequently.
  • 84% reported improvement in their general well being
  • 55% had an increase in their sexual self image.

The benefits of having joint replacement surgery are huge to sexual health and pleasure, in addition to improving both mental and physical health and well being through exercise. The ability to take exercise helps to promote and improve your positive body image.

Sadly, 16% felt the THR and TKR had adversely affected their sexual activity as they were worried about damaging their new joint.

Healthcare professionals need to ensure that the information given out post operatively includes when to resume sexual activity and ways in which you can enjoy sex without worrying about damaging your new joint.

Tips to help you

When can I resume sex?

As with any surgery, you need to allow time for the wound to heal and for the tissue surrounding the new joint to form. Generally, surgeons advise 4-6 weeks. Some people resume sexual activity before this time if they feel comfortableand they are not putting strain on the new joint, others wait longer.

Working with a physiotherapist, they can offer you advice about suitable positions too.

Take your time

Having sexual intercourse may not be as spontaneous as it was but by taking time to plan what you are going to do and how, will enable you and your partner prepare for sexual activity.

You may discover that your partner is more worried about causing you pain during sex than you are so tell your partner what you can and cannot do, halting sex if it feels uncomfortable or painful and experiment with a variety of positions- you’ll soon find one that works for you!

Take your pain medication at least 1 hour before having sex to ensure that you remain pain free, but don’t take anything too strong which might mask pain during sexual intercourse, indicating a problem.

Stretching before having sex will help you become more flexible, enabling you to get into different sexual positions.

Experiment with different positions

Everyone is different so you will need to explore what positions work for you both. Following surgery, you should receive advice from a physiotherapist regarding what positions you can use and what to avoid until your joint replacement is completely healed. Go at your own pace, starting slowly to begin with, then build up your movement, the more confident and comfortable you feel.

Following a TKR, sexual activity can resume as normal, but if you are worried about putting weight on the knee, try other sexual positions such as lying on your back or side, sitting on the side of the bed or standing up, slightly bent over, supported by the bed or a chair.

After THR, there is a possibility of dislocating the joint within the first few months of surgery, therefore using other sexual positions is advised. Any positions that involve excessive bending, twisting or pressure should be avoided as well as any position which may cause you to lose balance and fall over.

Get comfortable

Getting comfortable when having sexual intercourse is important, so use plenty of pillows, rolled up towels and cushions or invest in specially designed furniture such as wedges and bedrolls to support your feet, legs or knees to help keep your joint within a safe range of motion. If you lie on your side, keep the side with the repaired joint on the bottom.

Great sex without intercourse

If full penetrative sex isn’t possible, try sex without intercourse which can be just as satisfying and fun to do.

Sex isn’t just the act of penetration but also includes oral and mutual masturbation using hands, mouth or sex toys, such as vibrators or male masturbators, intimate massage using sexual lubricants, reading and watching erotica and incorporating light bondage, such as a blindfold, silky ties or feather ticklers into your sex play.

Whatever you do, don’t give up on sex. Ask your doctor or physiotherapist about positions that are suitable for sex. You may not be swinging from the chandeliers yet (but who is?) but you will hopefully discover new ways and sexual positions to enjoy the best sex ever.