Inflammatory arthritis may impact sexual function
medwireNews: Findings from a systematic review suggest that sexual dysfunction is common among both men and women with inflammatory arthritis (IA), highlighting the importance of including sexual health in the routine management of rheumatic disease.
Andrew Briggs (Curtin University, Perth, Western Australia) and co-authors analyzed data from 55 studies (89% quantitative) with patient numbers ranging from eight to 1272, most commonly involving people with rheumatoid arthritis (29%) or ankylosing spondylitis (29%). Median disease duration was 3.3–19.0 years.
As reported in Arthritis Care & Research, findings from the quantitative studies demonstrated that sexual dysfunction was more prevalent among male and female patients with IA relative to controls without arthritis.
The most frequently reported measure of male sexual function was the International Index for Erectile Function (IIEF). In all seven studies using this measure, mean IIEF scores among IA patients were 25 points or lower, indicating erectile dysfunction. IA patients also had significantly lower average IIEF scores relative to controls in the six studies making this comparison.
Similarly for women, mean Female Sexual Function Index (FSFI) scores were at or below the threshold for sexual dysfunction (26.55 points) in all 15 studies reporting these scores, and people with IA had significantly lower mean FSFI scores than controls in most of the studies.
Analysis of the qualitative studies provided further insight into the impact of IA on sexual function and intimate relationships. For example, Briggs and team report that sexual function was affected by pain, fatigue, reduced desire, and erectile dysfunction among IA patients, in addition to factors that impact the general population such as stress. They also found that intimate relationships “tended to transition towards a more caring and less physical nature” among IA patients, particularly during disease flares.
These findings provide “consistent evidence […] highlighting an association between IA and [the] impacts on intimate relationships and sexual function for both genders,” write the study authors.
They caution, however, that the studies included in the systematic review were of “varying methodological quality,” and that estimates tended “to be crude and [were] not adjusted for potential confounders.”
The team concludes: “As sexual health is an important component of wellbeing, raising clinician and patient awareness of sexual dysfunction associated with IA could facilitate the provision of more holistic care.”
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