Sexual Function and Intimacy Impaired in Inflammatory Arthritis

By Will Boggs MD

May 08, 2019

NEW YORK (Reuters Health) - Patients with inflammatory arthritis (IA) report significant impairments in sexual function and intimate relationships, researchers from Australia report.

"Clinically, these data suggest that due consideration to sexual health in people with IA is needed," Dr. Andrew M. Briggs of Curtin University in Perth told Reuters Health by email. "Typically, sexual function and intimacy are rarely addressed in clinical practice, probably due to the sensitivity of the topic. Our data suggest that in order to provide holistic care and address issues that are of likely importance to patients, then sexual function and intimacy may be important to address for some."

Sexual function in patients with IA can be affected by disease activity, psychological distress related to the disease and/or side effects from pharmacological management.

Dr. Briggs and colleagues investigated the impact of IA on intimate relationships and sexual function in their systematic review of 50 quantitative and five qualitative studies from around the world.

In 15 studies that reported Female Sexual Function Index (FSFI) scores, all patient groups had mean scores indicating the presence of sexual dysfunction, the team reports in Arthritis Care and Research, online April 3.

Similarly, in seven studies that reported International Index for Erectile Function (IIEF) scores, all patient groups had mean scores indicating erectile dysfunction.

In studies with control groups, FSFI and IIEF scores were consistently worse in patients with IA than in controls.

In other studies, impaired sexual function was more consistently reported by patients with IA, compared with controls, including degree of sexual or erectile dysfunction; prevalence of sexual dysfunction; prevalence of patients engaging, initiating, and avoiding intercourse and foreplay; satisfaction with sexual life; and such individual domains as desire, masturbation, fantasies, orgasm, and so on.

Qualitative studies reported that sexual function was affected by pain, reduced sexual desire, erectile dysfunction and fatigue, along with the same stressors that affect the general population (stress, education, and other general life concerns).

Intimate relationships often transitioned towards a more caring and less physical nature as the importance of sexual intercourse declined, especially during disease flares.

Women often reported feeling pressured to maintain a normal sex life despite the sexual dysfunction associated with IA, and poor body image reduced sexual desire in both men and women and restricted people from finding partners.

"There is evidence of sexual dysfunction and potential for relationship strain among people with IA, in both genders," Dr. Briggs said. "Having looked at these cohort studies, we now need to better understand how sexual dysfunction develops, i.e., the temporal relationships with therapy, disease duration, and disease severity, in order to better meet patients' needs."

The researchers reported funding from UBC Australia and AbbVie Australia.

SOURCE: https://bit.ly/2ZoQZEK

Arthr Care Res 2019.

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