Background Ankylosing spondylitis (AS) is a chronic, systemic inflammatory rheumatic disease affecting the axial skeleton, but may also affect peripheral joints, tendons and internal organs. This disease which begins in the second or third decade may give rise to significant loss of function and impaired quality of life. Despite the known importance of sexuality as part of quality of life (1), only a few studies have explored this important issue in AS patients.
Objectives To explore sexuality in patients with AS in regard to how satisfied they are with their sexual life and whether the patients think their sexuality is influenced by the disease.
Methods This is a prospective, longitudinal, observational study were patients with established AS seen in the outpatient clinic in three hospitals in the southern and eastern part of Norway, were asked to participate. A broad specter of demographic, clinical data, quality of life data, also including a general questionnaire on sexuality, was collected.
Results Mean (SD) age in the 411 included patients was 44.1 (13.9) years and disease duration 16.9 (11.8) years. 66.6% were men and 89.8% were HLA-B27 positive, 45.0% reported to be ever users of biologics, 92.7% of NSAIDs and 19.7% to be ever users of DMARDs. Mean (SD) values was 3.2 (2.1) for BASDAI, 2.8 (2.2) for BASFI, 3.9 (2.5) for BAS-G, 2.5 (2.0) for BASMI, 0.56 (0.49) for HAQ, 13.7 (12.8) mm/hr for ESR and 8.4 (11.4) mg/l for CRP.
82% reported to have a partner with whom they currently had sex with and 75.8% were reporting to be married or cohabitant.
Among the AS patients 67.8% reported sex and sexuality to be important/very important to be satisfied in daily life. 28.0% reported sexuality to be less important and only 4.2% thought sexuality was not important.
On the question: “how satisfied are you with your sexual life?” 50.4% reported to be satisfied/very satisfied, 23.8% were neither satisfied nor dissatisfied and 25.8% were dissatisfied.
49.5% reported to have had problems with their sexuality, however only 14.1% of the patients had been seeking help to solve the problems. 67.6% of the patients thought their sexual problems were related to their disease, 25.2% in very high degree and 42.4% in some degree.
The main disease related causes of sexual problems were tiredness 32.1%, stiffness 33.1% and pain 34.3%.
Conclusions In this study as many as 49.5% reported to have had sexual problems, and 67.6% thought their sexual problems were related to their AS. The main causes of sexual problems were tiredness, stiffness and pain. The number of patients reporting sexual problems is high in this group this despite disease activity scores and health activity scores which was in the lower range of the scales. More studies are needed to illuminate how sexual life is influenced by AS.
Healey EL, Haywood KL, Jordan KP, Garratt AM, Ryan S, Packham JC. Ankylosing spondylitis and its impact on sexual relationships. Rheumatology (Oxford). 2009 Nov;48(11):1378-81.
Disclosure of Interest K. Hansen Berg: None Declared, A. Prøven: None Declared, E. Almås: None Declared, E. E. Benestad: None Declared, M. Østensen: None Declared, G. Haugeberg Grant/Research support from: Helse Sør-Øst