We all like to think we’re invincible and will live forever. But the reality is that as we age, our physical and mental health, including sexual health, also deteriorates. Having rheumatoid arthritis — or any illness — shouldn’t change your identity. Even your sexual identity. So why aren’t we talking more about sex, especially when it can be a pain reliever?

According to Reviews in Obstetrics and Gynecology, the prevalence of sexual dysfunction among women is estimated to be between 25 and 63 percent. In postmenopausal women, that number is even higher, with rates between 68 and 86.5 percent.

That’s a lot of women.

And they’re also probably the same women who resonated with the Emmy-nominated Netflix show “Grace and Frankie.” Sure, it’s hilarious to watch two older women boldly addressing their sexual needs — to the horror of others. But these titular characters also wonderfully exemplify women we love: our grandmother, our mother, a great aunt, a friend, a mentor — even ourselves in the near to far future.

And that connection has also started a wonderful conversation around chronic pain and self-love, a prevailing issue for older women.

Women are about three times more likely to have rheumatoid arthritis (RA). That’s why we engaged with real women with RA — and a sexologist — to help us analyze the Ménage à Moi from “Grace and Frankie” and whether or not it would actually help.

It may seems a little awkward having the conversation, but like Grace and Frankie, someone has to start it. And statistically, it’s not going to be your doctor.

So let’s get started.

Show re-cap
Grace (Jane Fonda) used a vibrator that required so much effort, she got a case of carpel tunnel syndrome. Inspired, she collaborates with Frankie (Lily Tomlin) to design a vibrator that accommodates older women with limited mobility, chronic pain, and rheumatoid arthritis.

This is probably the feature to most stand out of the proposed vibrator. The soft gel sleeve grip allows for women with RA to hold it with more comfort, especially if the knuckle and finger joints are swelling. And, let’s face it — a comfy, soft gel grip is a plus for anyone!

Vibrators with glow in the dark, light-up on and off buttons can be extremely helpful for women with RA, who may also experience blurred vision and sensitivity to light. Mariah Leach, a RA blogger at From This Point. Forward., recommends that these buttons be touch sensitive as well, because of the RA finger pain that may come with pushing buttons.

While we’re talking about being high-tech, replacing tiny batteries can be challenging for those with hand and wrist pain. Carol Queen, a sexologist for Good Vibrations, a woman-founded sex toy shop in San Francisco, also recommends including a rechargeable option.

The effects of a chronic pain condition can also substantially impact levels of sensitivity in the genitals too. “Having multiple speed settings, as many vibrators already on the market do, would be a tremendous help,” Queen says about the Ménage à Moi. She suggests adding a variety of speeds, from low, medium, high, higher, and highest, so that every woman can find her own comfort zone.

A vibrator tip that changes angles easily is appealing but RA has so many variabilities that not all women will respond in the same way. Thankfully, there are different fixes for this.

“A positioning pillow that holds a vibrator in place and allows women to lean against it, for example, or if a woman is interested in inserting the vibrator, a harness might be the way to go,” suggests Queen, who’s also founder of the Center for Sex and Culture. Kirsten Shultz, who blogs at Chronic Sex, mentions the idea of riding the vibrator if using hands or wrists is too painful.

Everyone agrees that large print is desirable for a range of women, especially those with Sjogren’s syndrome, which can cause dry eyes and make reading difficult.

While we haven’t found anything with all the features of the “Grace and Frankie” vibrator on the market, Schultz recommends sex toys from Fun Factory. Their products are made of silicone or rubber and not hard plastic. Queen found a few vibrator models at Good Vibrations with a cushy gel feel, along with many models that have controls that light up. Some are even app-controlled so gripping won’t be an issue after initial placement.

Extra advice for tipping off the edge

Whether insertion is part of the plan or not, Queen recommends lubricant for more comfort. This can help vaginal dryness, which is a side effect of Sjogren’s, other chronic pain conditions, and medications.

Leach seconds this recommendation, noting that lube helps quicken the pace of activity, especially when she’s mentally exhausted but still interested in sex. She also uses lube, vibrators, and other enhancements during sex with her partner.

Using the term “enhancements” also helps create a distinct mindset about sex toys. These toys aren’t making statements about you (or your partner’s) performance, body, mental, or physical state. It’s just added fun for increased pleasure.

According to Leach, many women with RA feel that they don’t deserve to call attention to their sexual health. They believe they should be happy enough with being able to handle the side effects. But Leach emphasizes: “Sex is a part of quality of life, and we deserve to care about it no matter what else is going on.”

Really, it isn’t. Leach reported that on a study by the American College of Rheumatology, they found that 96 percent of rheumatology healthcare professionals considered sexuality a relevant topic in rheumatology care, but a whopping 71 percent seldom or never raised the topic with their patients.

Sexual health is still part of your overall health. And when you consider how advanced technology, science, and medicine can get, it doesn’t make sense to suppress your sexual needs in the name of chronic pain. Especially when sexual arousal and pleasure can be a pain reliever to help manage pain.

Marty Klein, PhD told AARP that, “Sex involves gentle, range-of-motion exercise, which minimizes pain and inflammation. It also releases endorphins, the body’s natural pain relievers. Sex strengthens the muscles around the joints, which helps support them. And its mood-elevating, which likewise helps alleviate pain.”

And as both Grace and Frankie have shown, you don’t always need a partner for sex. Self-love is just as important. It’s also a way for women to direct their own sexual activity. The tools we use help satisfy this desire.

In regards to two-way communication, those in the medical field who want to help their clients feel comfortable enough to open up, can do so by addressing basic barriers to judgment-free health care. It can be as simple as adopting the cliché: “Show, don’t tell.”

Talk about it

  • Don’t hesitate to bring up issues of sexual side effects of your chronic pain.
  • Open communication is key with your partner to maintaining a healthy sex life.
  • Frank two-way communication will increase mutual trust with your physician.

For example, adopting gender-neutral medical forms can help people feel welcome even before meeting with the doctor in-person. Not only does a gender-neutral form show LGBTQ clients that they’re welcome, it also shows the amount of care and respect the healthcare center has for all clients. This small yet inclusive change can make all clients feel more comfortable with disclosing any problems during checkups, such as sexual side effects.

No one needs to settle for a life without sexual activity, not due to age, and especially not because you have a chronic illness. Chronic pain and illnesses have already asked a lot of our bodies, and sexual health doesn’t need to be a part of this compromise. Thank goodness for increasing options for self-love and enhanced sex.

Stephanie Schroeder is a New York City-based freelance writer and author. A mental health advocate and activist, Schroeder published her memoir, “Beautiful Wreck: Sex, Lies & Suicide,” in 2012. She’s currently co-editing the anthology HEADCASE: LGBTQ Writers and Artists on Mental Health and Wellness, which will be published by Oxford University Press in 2018 or 2019. You can find her on Twitter @StephS910.