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There are also IUDs that people can use.” Some people with lupus develop a negative self-image because of disease-related weight gain or rashes, which make them feel less attractive.

“I have an extremely negative body image because I gained 70 pounds due to prednisone use for lupus, but my husband tells me he loves me just as I am and finds me sexy,” says Laurie Cook of Jamaica, N. “We make love three or four times a week, and although I'm in pain a lot, we're careful to keep our physical love alive and recognize the importance of this fine part of life.” Telling your partner how lupus has changed your self-image may help.

For instance, having sex in the missionary position gives some women with lupus hip pain.

Others have vaginal dryness or very sensitive skin.

And that's on top of the day-to-day responsibilities that come with having a chronic illness, as well as the routine tasks of life. There are things you can do to make it more satisfying and keep that part of your relationship alive.

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“The happiest relationship I had was with a man who happened to need a lot of sleep and who respected my needs.” Lupus is more common in women than in men.“Some lupus patients are very sensitive; the skin rips easily, and they get very irritated,” Rose says.“Water-based lubricants help with friction and vaginal dryness, and they work with condoms.” Being in touch with your body can help you figure out when the moment is right, says Marisa Zeppieri-Caruana of Fort Lauderdale, Fla., a lupus patient who serves on the board of the Lupus Foundation of America's Southeast chapter.“Reviewing your medication list with your physician or a pharmacist may help,” Jolly says.“They can print out a list of possible side effects, and in some cases, trying a different medication could be an answer.” Some women with lupus may feel reluctant to have sex because they're unhappy with their birth control options, since it's commonly believed that all lupus patients should avoid birth control pills.

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