Sex, pregnancy, children and ankylosing spondylitis (AS)
Sex may be painful if you have inflammation in the sacroiliac joints or lumbar spine, and lack of mobility in the hips can be a problem. Try taking some painkillers beforehand and experimenting with different positions.
Ankylosing spondylitis (AS) can make you feel tired so it’s important that your partner understands how your condition affects you. Good communication is the key to preserving an active sex life and counselling can sometimes be helpful for both partners.
It’s fine to use the contraceptive pill if you have AS, but you should tell your doctor that you take it.
Read more about sex and arthritis.
Usually pregnancy doesn’t present any special problems for the mother or the baby, though the symptoms of ankylosing spondylitis may not ease during pregnancy, as they do in some other types of arthritis. If your spine is very stiff, it may not be possible to have an epidural during childbirth. If your condition makes it difficult to open your legs, it's a good idea to think ahead about the delivery and to discuss with the team at your antenatal appointments whether a Caesarean section might be better for you.
If you're thinking of starting a family, it's very important for both men and women to discuss any medications with your doctor beforehand so that your prescription can be changed if necessary. Some drugs such as methotrexate should normally be stopped several months before trying for a baby. Your doctor can also advise you on which medications are well tolerated during pregnancy and while breastfeeding.
Read more about pregnancy and arthritis.
Will my children develop AS?
If you have AS there's a small chance your children will also develop it. However, the way ankylosing spondylitis runs in families isn't straightforward. If you're thinking of having a baby and are concerned about this, discuss it with your specialist.
Parents with AS sometimes ask if their children should have the HLA-B27 test to see whether they might develop the condition in the future. This isn't recommended as there’s no way of knowing whether a child will develop AS even if they do have this gene.