RA and erectile dysfunction

[Chezjay]

I’m new to the forum and have had RA diagnosis since early 2022. Methotrexate was prescribed which I take weekly.

I find this mostly makes joint pain ok.

I have recently noticed (November ‘23) issues in the bedroom whereby interest is lost or erections seem weaker. Is this common in men?

I’m also not sure if there is change to colour around the edge of penis tip or if I’m imagining things.

Looking online it shows as a very rare side effect of methotrexate.

But also does show as a link to vascular issues if not psychological.

I will update my Rheum team about this today and ask what extra screening/monitoring I should /could be having.

I only have appts every 6months at the moment, and they don’t feel that beneficial. Very “in/out keep taking drugs as normal”.

[MadBunny]

It's a good idea to discuss it with your rheum team or GP , as there may be another underlying cause, other than the mtx.

Did you know there is a men's health site on HU, where you might be able to get some advice , too ?

I think 6 monthly checks are the norm . Are you having regular blood tests ?

[Chezjay in reply to MadBunny]

Yep having regular bloods to ensure liver function. Mentioned it to rheumatologist nurse yesterday and they said to speak to GP etc. but they will consider drug change if it’s continuing and so on… so not really the decisive action on what to do next. I’m seeing them in Feb so will bring it up again

[MadBunny in reply to Chezjay]

It might be worth contacting the GP before then, in case it isn't related to the mtx. Hope you get some answers soon.

[wilbertjellyfish]

Mtx can cause infertility in men from my vague memory but apologies, im not a man to give first hand experience. Definitely tell your rheumatologist and or GP as they are pretty experienced dealing with people on mtx.

[Scottishlad]

I haven't noticed any effect after about 15 years on MTX.

[RAGuy]

I would contact your RA team immediately. It may be rare but so are you, there is only one of you! Of course, you should also talk to your GP but enough patients have reported this for it to be listed.

Remember, you are the expert on you

[Chezjay in reply to RAGuy]

I have, and RA Nurse was not very concerned and said to bring up within my next appointment…

I am seeing my GP today so will log it there also, incase this is something the RA team think is managed by someone else.

Would be nice to have it all managed and connected centrally!

[RAGuy]

I agree completely. There are apps in development to do that but meanwhile be assertive. Not easy, I know, I have been there with side effects that have later been listed!

It is easy for your team to ignore the less likely causes and you do need to check the cardio vascular possibility with your GP (from my experience). However, you could insist your consultant is made aware if it continues to worry you. Stress about it WILL make your RA worse. Good luck and be strong

[oldtimer2]

Problems with erections and with lack of interest can be re-inforcing each other - if you have noticed some lack of a good erection, that worries you "Will it happen next time?" and that makes it more likely to happen. I hope you can discuss this with your partner and that perhaps some extra stimulation and no pressure 'to perform' will help with that. Also becoming a 'patient' in the relationship can be a problem in itself as the pattern of one one partner being more assertive is a common one, and if you have tended to be the lead partner, your 'patient' role may affect this. Discussion between the partners helps to resolve this and you should be able to find and receive perhaps more stimualtion to compensate, or whatever will help between the two of you.

The next person to discuss it with is your health care team. Reduction in blood flow due to cardiovascular issues is the commonest problem as you get older and that should be checked out. Side effects from medication cannot be ruled out and you should look at all the medication you are taking together with your health care team.

Be careful about seeking help from the internet - you may receive images and 'advice' that you wouldn't welcome! This might be a good source to start with: sexwise.org.uk/about-us