Background Rheumatoid arthritis (RA) may affect all aspects of life including sexual functioning.The percentage of arthritic patients who experience sexual problems ranged in various studies from 31% to 76%.The reasons for disturbing sexual functioning are multi-factorial and comprise disease-related factors as well as therapy.It can occur before, during and after sexual activities, and can affect sexual health in different perspectives.

Objectives The aim of our study is to evaluate the impact of the RA in sexual function and its associated factors.

Methods This is a cross-sectional and descriptive study during a period of the year 2016, including 37 patients followed in the department of Rheumatology in Mahdia Tunisia. All patients were diagnosed with RA based in ACR 1987/EULAR 2010. We evaluated for each patient the sexual quotient (QS). It is a validated scale which estimates the degree of satisfaction of the sex life.

Results The age of the RA patients (32 females/5 males) ranged from 21 to 76 years. The mean age was 53.1±12 years. The mean duration of the disease was 11±10 years [1–34]. The mean number of tender joints was 13.2±9.6 and swollen joint was 5.9±7. The mean DAS28 was 5.5±1.5 [2.9–8.2] and HAQ was 1.6±0.9 [0–2.8]. 51.3% of patients had specific joint deformations, 83.8% had radiologic involvement and 29.7% had osteoporosis.

The biologic analysis showed that the mean ESR was 45±27.1 and the CRP was 13.7±25.3. Rheumatoid factors were positive in 37.8% of cases, the ACPA were positive in 32.4% of cases. 81.1% of RA patients were treated by methotrexate and 13.5% were treated by biologic treatments.

The mean sexual quotient was 50.25±20.8 [6–87.5]; only 8.1% of patients had a great sexual life (QS between 80 and 100), 16.2% expressed some sexual satisfaction (QS between 60 and 80), 21.6% had a mild sexual life (QS between 40 and 60), 18.9% presented a disappointing sexual life (QS between 20 and 40) and 35.4% didn't have any partner.

Our study showed a significant correlation between the duration of the disease and the alteration of the sexual quotient, but no correlation with the clinical and biological parameters of RA.

Conclusions We conclude that only 24.3% of our RA patients had satisfaction in their sexual life. This alteration of the sexual quotient was found to be correlated with the duration of the disease.

This fact may be explicated by the disability, fatigue and pain caused by this chronic inflammatory disease. This relation should be confirmed by future studies.

References

1. Antonio G Tristano, Impact of rheumatoid arthritis on sexual function, World J Orthop 2014 April 18; 5(2): 107–111.

2. Abdo J. Sex Med. 2007;4:382–389.

3. Kraaimaat FW, et al, Intrusiveness of rheumatoid arthritis on sexuality in male and female patients living with a spouse. Arthritis Care Res 1996; 9:120–125.

References

Disclosure of Interest None declared