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Female patients with Sjögrens syndrome may experience sexual distress
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Vaginal dryness and dyspareunia are common in women with Sjögren’s syndrome, and patients may be hesitant to discuss their concerns with a physician, according to researchers from the University of Groningen in the Netherlands.
Forty-six women with Sjögren’s syndrome (SS) were surveyed along with 43 age-matched, healthy women. No differences were seen between groups in menstrual status, relationship status or education level, but patients with SS used NSAIDs more frequently and were less likely to have paid employment status.
Surveys included the 19-item Female Sexual Function Index (FSFI), with questions related to arousal, desire, lubrication, orgasm and satisfaction, and the 12-item Female Sexual Distress Scale (FSDS), which covered the period of time during the prior 4 weeks. Disease activity was measured using the European League Against Rheumatism Sjögren’s Syndrome Disease Activity Index (ESSDAI) and Patient-Reported Index (ESSPRI). Other surveys included the Multifunction Fatigue Inventory (MFI), Hospital Anxiety and Depression Scale (HADS), Maudsley Marital Questionnaire (MMQ) and the RAND 36-item Health Survey (RAND-36).
Statistical analysis of variables included t-test, Mann-Whitney U-test, chi square test and Fisher’s exact test to compare differences between the groups. Subanalyses excluded participants who were not sexually active in the prior 4 weeks and adjusted for menstrual status.
The overall FSFI and its subscores for arousal, desire, lubrication, orgasm and pain were significantly lower in patients with SS compared with healthy participants (20.6 vs. 30.3), and fewer were sexually active in the prior 4 weeks (76% vs. 93%), according to the researchers.
Of sexually active participants, more patients with SS had impaired sexual function (56% vs. 27%). Frequent symptoms included vaginal dryness and dyspareunia.
Sexual dysfunction and sexual distress in patients with SS were associated with higher self-reported SS symptoms measured with the ESSPRI and included fatigue, depressive symptoms, relationship dissatisfaction and lower mental quality of life. ESSDAI scores were less correlated with sexual function, according to the researchers.
Multivariate regression analysis showed depression was the most predictive of sexual dysfunction and correlated with FSFI scores.
The majority of patients with sexual dysfunction rarely discussed their symptoms with their rheumatologist.
“The sexual health of patients with rheumatic diseases is often neglected, as both patients and physicians may find it difficult to address sexual complaints, partly because effective treatment options are not yet available,” Jolien F. van Nimwegen, PhD candidate and lead study author, said in a press release. “However, by simply acknowledging and discussing these complaints, rheumatologists can help patients cope with their sexual problems. If necessary, patients can be referred to a gynecologist or sexologist.” – by Shirley Pulawski
Disclosures: The authors report no relevant financial disclosures.
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