Sexual Dysfunction Common, Undertreated in Women With Rheumatoid Arthritis

Sexual dysfunction is common in women with rheumatoid arthritis (RA) and affects all subdomains of sexual function, according to study data published in The Journal of Rheumatology.

Investigators administered surveys that included the Changes in Sexual Functioning Questionnaire-short form (CSFQ-14) to patients with RA (n=203) and healthy controls (n=169). Additional demographic and clinical variables were also assessed, including scores on The Health Assessment Questionnaire-Disability Index and the Clinical Disease Activity Index. Patients with RA had a mean age of 55.2±11.3years, compared with 47.4 ± 11.8 years for controls (P <.0001). Mean disease duration was 12.0±10.1 years.

A significant percentage (47.8%) of patients with RA reported a total CSFQ-14 score of ≤41, indicating female sexual dysfunction, compared with 14.2% of healthy controls (P <.0001). The median CSFQ-14 score in patients with RA was also significantly lower than the median score in healthy controls (42 vs 49 points; P <.0001). After adjusting for age differences between patient groups, patients with RA still had a significantly higher likelihood of female sexual dysfunction compared with healthy controls (odds ratio [OR], 3.04; 95% CI, 1.61-5.75; P =.001). Specifically, RA was significantly associated with mucous membrane dryness (OR, 3.78; 95% CI, 1.90-7.55; P <.0001), which was in turn associated with sexual dysfunction (OR, 5.10; 95% CI, 2.64-9.87). Survey respondents who indicated that RA had harmed their sexuality (31.4%) also reported lack of sexual desire (86%), dryness (25%), and pain during intercourse (14%). Just 6.8% of patients with RA reported using professional support for a sexual problem. Of note, adjustments for disability and activity index scores did not mediate the association between RA and sexual dysfunction.

These data suggest that sexual dysfunction in women with RA may often be underestimated in clinical practice, given the low percentage of patients who sought professional help for a sexual problem. Further research is needed to identify the proper intervention methods for women with RA who report experiencing sexual dysfunction.

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Reference

Puchner R, Sautner J, Gruber J, et al. High burden of sexual dysfunction in female patients with rheumatoid arthritis: results of a cross-sectional study [published online September 1, 2018]. J Rheumatol. doi:10.3899/jrheum.171287