Not all scleroderma patients find that their condition negatively affects their sexual well-being. An active sex life also is known to not worsen scleroderma. Many patients lead fulfilling sexual lives.
Some, however, can find that sexual activities affected by their disease and may need to explore different ways of being intimate.
Limited flexibility
Different sexual positions can help a person to overcome the stiffness and movement difficulties caused by tight skin in different areas of the body. Light stretching may help before sex, but should not be done to the point of exhaustion or fatigue.
Occupational and physical therapists, as well as dentists, can help stretch the muscles around the mouth — an opening that may have become smaller due to the disease, so that kissing and oral sex is more comfortable and enjoyable.
Use of sex toys and creams could be avenues to explore for patients unable to bend their fingers comfortably, and who find it difficult to properly touch themselves or their partner.
Pain
Pain may be overcome by using extra pillows under tender areas, taking a warm bath before sexual activity, or by simply engaging in sexual intimacy during times when pain is minimal.
Vaginal dryness
Scleroderma can cause vaginal dryness, which can make sex painful. This can be overcome by using lubricants and local anesthetic jelly to help ease pain. Relaxing can also help to prevent vaginal muscles from tensing and may make sex more enjoyable.
Fatigue
Sexual intercourse is a high-energy activity. It may be helpful for patients to plan ahead with their partners before any sexual activity, so that they can save energy and time encounters for periods of least fatigue.
Lichen sclerosus
Lichen sclerosus is a skin condition that most commonly affects the skin around the genitals and the anus, although it can occur elsewhere. It is characterized by small white patches that become cracked, sore, and itchy. The fragile skin may also bleed and blister.
The condition can occur in those with scleroderma and interfere with sexual intercourse. Scarring and skin shrinkage around the vulva can narrow the entrance of the vagina; in men, patches can form in the tip of the penis or on the foreskin.
Lichen sclerosis is a long-term condition that may have alternating periods of worsening and improvement. Symptoms can be relieved with creams, ointments, and surgery.
Erectile dysfunction and Peyronie’s disease
Scleroderma can cause erectile dysfunction — estimates of its impact range widely from  12 to 81 percent of male patients, because it damages the small blood vessels in the penis, hindering the ability to maintain an erection long enough for intercourse.
Peyronie’s disease is marked by the buildup of scar tissue in the penis, causing men to experience uncomfortable and possibly painful, curved erections. This condition may also lead to erectile dysfunction.
Both erectile dysfunction and Peyronie’s disease are treatable conditions, with  options ranging from oral medication, surgery, penile implants, toinjections.
Pregnancy
Fertility is not affected in scleroderma. However, it is important to discuss the desire to have a child with a physician as several medications used to treat scleroderma may harm the fetus.
Woman may also be advised to wait until their disease stabilizes, to lessen the likelihood of the pregnancy triggering disease worsening.
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Scleroderma News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.