Background Sexuality is an important dimension of personality and human body, therefore any involvement in this area should be considered as important. Sexual disturbances in rheumatoid arthritis (RA) patients are poorly described in literature. In other chronic conditions studies had shown that sexual disturbances can be common problem in but, sexual dysfunction has a high risk of under treatment because providers frequently do not initiate the conversation with the patient.
Objectives The purpose of this study was to describe sexual disturbances in population with RA and a possible correlation with disease activity in a specialized rheumatology center.
Methods A descriptive cross-sectional study was performed in a specialized clinic dedicated to care patients with rheumatoid arthritis (RA). Data was collected during a two year period at a psychology consultation, through semi-structured interview. Descriptive epidemiology was applied for continuous variables, using measures of central tendency and dispersion for categorical and qualitative variables by averages and percentages. We analyzed bivariate association with Pearson's X2.
Results We included 1398 patients attending to our psychology consultation. Mean age was 55 years ± 8; 80% were female and 20% male. Mean DAS28 was 2.6±1.3, mean HAQ was 1.6±1.6; patients had the disease for an average of 12 years ± 8; 41% of patients had comorbidities associated with non-autoimmune disease, 14% comorbidities related to autoimmune disease; 35% of our patients did not report other comorbidities. Most of patients were married 60%, followed by divorced 19%, single 14% and widowed 7%. Regarding occupation 33% were employees, 25% were housekeepers or retired due to age, 12% were retired due to disabilities, and 3% unemployed. Of the total population 45% had elementary school, 32% high school, 8% college education, 7% graduate education and 7% were illiterate. 17% of patients lived alone. Concerning sexual disorders, 38% reported no to have any sexual activity, 32% reported to have a satisfactory sexual life, 11% dyspareunia,9% had an unsatisfactory sexual life, 5% loss of desire, 3% premature ejaculation and 2% orgasmic decrease. Regarding predisposing factors of sexual disorders 63% of our population did not present any, 11% had insecurity related to the sexual role, 10% inadequate information relating sexuality, 10% infidelity and 6% physical and biological predisposing factors. Regarding precipitant factors of sexual disorders 63% report no to have any, 19% had biological or physical factors, 12% infidelity, 3% inadequate information and 3% insecurity related to de sexual role. There was no statistical association between disease activity and predisposing or precipitant factors.
Conclusions We found that a third of patients with AR have sexual disorders and a high percentage reported not having any sexual activity. Also, it is important to have a multidisciplinary care team for the patient with RA, including a psychologist and a sexologist for managing this kind of illness in order to improve the life quality of patients.
Disclosure of Interest None declared