Sexual dysfunction common in patients with inflammatory arthritis
Sexual dysfunction is highly prevalent among men and women with inflammatory arthritis, with diseases-related factors impacting fluctuations in sexual function and reduced sexual desire, according to data published in Arthritis Care & Research.
“Sexual health and family planning are important considerations not only for individuals living with [inflammatory arthritis] but also for the health practitioners who treat them, yet these issues are rarely comprehensively addressed in clinical practice,” Laura Restoux, BPT, of Curtin University in Perth, Western Australia, and colleagues wrote. “Earlier research has shown that 36% to 70% of people with rheumatoid arthritis experience impaired sexual health associated with their disease, however, the majority have not discussed this with a health professional.”
“The impact of [inflammatory arthritis] on sexual health has been investigated previously, however systematic reviews published to date have important limitations,” they added, stating that other studies have focused on women’s sexual function only, and have been disease-specific without including contemporary evidence.
To evaluate the effects of inflammatory arthritis on sexual function and intimate relationships, Restoux and colleagues conducted a systematic literature review of quantitative and qualitative studies that included both men and women who had been diagnosed with a variety of specific conditions. Searched databases included Ovid Medline, Ovid PsycINFO, Ovid EMBASE and EBSCO CINAHL.
The researchers focused their search on studies of patients aged 16 years and older with diseases including, but not limited to, RA, seronegative arthritis, systemic lupus erythematous, systemic scleroderma and sclerosis, ankylosing spondylitis, psoriatic arthritis, connective tissue disease, vasculitis, Sjogren’s syndrome, spondyloarthritis, autoimmune arthritis and juvenile idiopathic arthritis. In addition, the researchers sought out studies in which participants with inflammatory arthritis expressed concerns, thoughts, beliefs and opinions regarding their condition’s impact on their intimate relationships and sexual function.
The researchers identified 55 eligible studies for inclusion in their final analysis. These included 49 quantitative and five qualitative studies. Sample sizes ranged from 10 to 1,272 participants in quantitative studies, and from 8 to 57 participants in qualitative studies.
According to the researchers, among studies that reported Female Sexual Function Index score, all inflammatory arthritis groups demonstrated mean scores of 26.55 or lower, denoting sexual dysfunction. In studies that reported International Index of Erectile Function scores, all groups with inflammatory arthritis diseases reported mean scores of 25 or less, which indicates erectile dysfunction.
Comments from patients with inflammatory arthritis conditions, collected in qualitative studies through interviews and focus groups, expressed themes of impaired sexual function and compromised intimate relationships. Major subthemes included diseaserelated pain and fatigue, erectile dysfunction, diminished sexual desire and changes in sexual function based on disease activity.
“Sexual dysfunction is prevalent in female and male populations diagnosed with various forms of [inflammatory arthritis],” Restoux and colleagues wrote. “Sexual dysfunction in [inflammatory arthritis] is associated with pain, reduced sexual desire, erectile dysfunction, fatigue and mobility restrictions. As sexual health is an important component of wellbeing, raising clinician and patient awareness of sexual dysfunction associated with [inflammatory arthritis] could facilitate the provision of more holistic care.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.