Background Chronic joint diseases impair the quality of life. This occurs not only by the deformity generated, but also by the pain and disability produced by them (1, 2). There are a limited number of studies on joint diseases and sexuality (3, 4). Besides, many lack a control group and do not explore the different areas of sexuality(1-4).
Objectives To describe the prevalence of sexual dysfunction (SD) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PA). To compare the results obtained between the two diseases and a healthy population. To analyse the factors associated with SD in the 3 populations.
Methods Cross-sectional observation study. Patients diagnosed of PA (CASPAR criteria) and RA (EULAR/ACR 2010 criteria), followed in outpatient Rheumatology offices of two different university hospitals of the same geographical area, were consecutively included. The following variables were collected: (age, gender, year of diagnoses, perceived health, marital status, level of education, employment situation and the annual level of income), as well as (history of depression and active treatment of mental health disease). The results were compared against healthy individuals, acting as a control group. Only adult patients, of any sexual orientation, were included. The CSFQ-14 questionnaire, which evaluates changes in sexual function due to the disease or its medication, was applied. This questionnaire studies 4 different domains in both genders (pleasure, desire, arousal, orgasm and pain during orgasm) and in addition, it evaluates orgasm completion in women and erection in men. A regression model was created to estimate the influence of the collected variables on the obtained results.
Results 188 patients were included (52.7% women and 47.3% men); 72 of them were diagnosed of PA and 27 of RA. Moreover, 30.43% of the patients with PA, 48.15% of the patients with RA and 5.88% of the control group had scores on the CSFQ-14 test in the SD range.
SD was found related to being diagnosed of PA and RA (p < 0.001), age (p < 0.001), employment status (p < 0.001) and the annual level of income (p = 0.002). On the CSFQ-14 test, men had a mean score 7.5 points higher than women, although this score decreased to 6.15 points in men with PA. Furthermore, patients with PA and RA had a mean score 8.2 points lower than the control goup. All of the domains of the CSFQ-14 questionnaire were negatively affected by having PA or RA (p < 0.001). The estimated odds ratio of having SD was 8.7 times higher in patients diagnosed of PA and 10 times higher in patients diagnosed of RA.
Conclusion Patients with RA or PA have a deteriorated sexual life when compared to a healthy population. This detriment affects all of the domains of the sexual sphere (pleasure, desire, arousal and orgasm). As shown in previous studies, age, gender, perceived health, employment situation and economic status, are related to the risk of suffering from SD. Therefore, these factors must be considered when attending this area of our patient’s health. The CSFQ-14 questionnaire provides a complete approach to sexual health and can be a tool for the management of chronic joint diseases.
References Hill J, Bird H, Thorpe R. Effects of rheumatoid arthritis on sexual activity and relationships. Rheumatol Oxf Engl. 2003 Feb;42(2):280–6.
van Berlo WTM, van de Wiel HBM, Taal E, Rasker JJ, Weijmar Schultz WCM, van Rijswijk MH. Sexual functioning of people with rheumatoid arthritis: a multicenter study. Clin Rheumatol. 2007 Jan;26(1):30–8.
Kurizky PS, Mota LMH da. Sexual dysfunction in patients with psoriasis and psoriatic arthritis--a systematic review. Rev Bras Reumatol. 2012 Dec;52(6):943–8.
Zhao S, Li E, Wang J, Luo L, Luo J, Zhao Z. Rheumatoid Arthritis and Risk of Sexual Dysfunction: A Systematic Review and Metaanalysis. J Rheumatol. 2018 Oct;45(10):1375–82.
Disclosure of Interests None declared
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