Sexual functioning and its correlates in premenopausal married Indian women with systemic lupus erythematosus

Sexual dysfunction among female patients with rheumatic diseases

To demonstrate the burden of sexual dysfunction (SD) among females with rheumatic diseases, we conducted a cross-sectional comparative study in patients with systemic sclerosis (SSc), systemic lupus erythematosus (SLE), and Behçet's syndrome (BS) along with suitable healthy controls (HCs). Age-matched female patients with SSc (n = 50), SLE (n = 49), and BS (n = 54), along with 52 female HCs were included in this study between April and October, 2021. Sociodemographic features were recorded, and psychometric tests, i.e., female sexual function index (FSFI), Beck depression inventory (BDI), body cathexis scale, and marital adjustment test (MAT) were performed. Scale scores were compared, and binary logistic regression was used to identify predictors for SD in the whole group. The total FSFI and body cathexis scores among the patient groups were significantly lower than those of the HCs (p < 0.001). Depression was significantly more frequent in the patient groups. MAT scores did not differ significantly between the study groups. Patients with SSc had the worst scores in each psychometric index, including MAT. Decreased body cathexis score [OR 0.974, 95% CI (0.957-0.991), p = 0.003] and low MAT score [OR 0.937, 95% CI (0.896-0.980), p = 0.005], and being diagnosed with SSc [OR 6.6, 95% CI (1.975-22.498), p = 0.002], SLE [OR 2.7, 95% CI (0.998-7.753), p = 0.050], and BS [OR 2.8, 95% CI (1.100-7.359), p = 0.031], were identified as independent predictors for SD. Body cathexis seems to be the most important independent predictor for SD, and the burden of SD appears heavier in patients with SSc, probably due to poor body image satisfaction.

Current investigation of the high prevalence of sexual dysfunction in female patients with systemic lupus erythematosus: a cross-sectional study

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects women of childbearing age and has been reported to cause sexual dysfunction in women. Although there are articles on sexual function in women with SLE, the number of articles is small, and the factors affecting sexual function in women with SLE are controversial. Based on this, this study aimed to investigate the prevalence of sexual dysfunction in Chinese female SLE patients and to explore the factors that influence it. The study design was a cross-sectional study conducted from December 2023 to April 2024 in the Department of Rheumatology and Immunology of a tertiary hospital in Hefei, Anhui Province. A total of 293 female patients diagnosed with SLE were enrolled using face-to-face questionnaires and online questionnaires. The questionnaire consisted of four parts: general information questionnaire, fatigue severity scale (FSS), depression-anxiety-stress scale (DASS-21), and female sexual functioning index (FSFI) scale. A total of 173 (59.04%) patients had sexual dysfunction, including 251 (85.67%) with decreased libido and 186 (63.46%) with difficulty in sexual arousal. There was a correlation between the patients' total FSFI scores and age (p = 0.028), marital satisfaction (p < 0.001), own education level (p = 0.008), partner's education level (p = 0.003), place of residence (p = 0.039), monthly household income (p < 0.001), family financial satisfaction(p < 0.001), menstrual status (p = 0.003), hormone use (p = 0.021),immunosuppressant use (p = 0.042), disease activity (p = 0.016), FSS score (p < 0.001), stress score (p < 0.001), anxiety score (p < 0.001) and depression score (p < 0.001)were correlated. The results of stepwise regression analysis showed that marital satisfaction (b = 2.011, t = 3.797, p < 0.001), monthly household income (b = 0.854, t = 2.316, p = 0.021), menstrual status (b = 1.218, t = 2.350, p = 0.019), fatigue scale score (b = - 0.069, t = - 2.302, p = 0.022), and depression score (b = - 0.117, t = - 2.910, p = 0.004) were the influencing factors of FSFI total score, and the difference was statistically significant. The incidence of sexual dysfunction in Chinese female SLE patients is high, and medical personnel should pay more attention to patients' sexual problems, to provide theoretical and practical bases for further prevention, treatment, and care of sexual dysfunction in female SLE patients.

Fatigue have impact on the sexual problems in Chinese females with systemic lupus erythematosus

Background

Systemic lupus erythematosus (SLE) might affect all aspects of life including sexual function; previous study indicated that fatigue was the risk factor of sexual dysfunction. The current study aims to investigate the effects of SLE on Chinese mainland female patients’ sexual problems compared with healthy subjects and to investigate the relationship among fatigue, disease parameters, depression, quality of life and sexual problems in Chinese female patients with SLE.

Methods

A total of 128 female SLE patients (mean age: 43.65 ± 7.13 years) and 121 healthy female controls (mean age 43.59 ± 6.57 years) were included in this cross-sectional study. All data were collected consecutively by face-to-face questionnaires from January 2021 to December 2021. SLE patients completed questionnaires for demographic or clinical variables, the 10-cm Visual Analog Scale for pain, the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) for disease activity, the multidimensional fatigue inventory (MFI) for fatigue, the patient health questionnaire-9 (PHQ-9) for depression, the Female Sexual Function Index (FSFI) for problems, and the Short Form 12 health survey for quality of life. Independent sample t-test, Mann–Whitney U-test, Chi-square test, and forward stepwise binary logistic regression model were used to analyze these data.

Results

Our results showed that the prevalence of female sexual problems was 78.9% in SLE patients, which was significantly higher than the controls (56.7%; p < 0.05). The results found that having child (OR 23.04; p < 0.000), age (OR 1.11; p = 0.002), DMARDs usage (OR 0.04; p = 0.004), MFI total score (OR 1.06; p = 0.006), and disease duration (OR 1.16; p = 0.043) were the potential risk factors of female sexual problems by forward stepwise binary logistic regression.

Conclusion

The present study reported that female sexual problems was more common in Chinese SLE female patients compared to controls. Having child, age, DMARDs usage, fatigue, and disease duration had great impacts on female sexual problems in Chinese SLE patients. Rheumatologists and nurses should pay close attention to SLE female patients’ sexual problems, especially those having no child, older age, not using DMARDs, fatigue, or long disease duration by health education or other methods to improve their sexual problems, and ultimately improve SLE patients’ quality of life.

Factors associated with intimacy in female Taiwanese patients with systemic lupus erythematosus: a cross-sectional study

OBJECTIVE

The aim of this study was to investigate the association of demographic factors, clinical manifestations and disease activity of systemic lupus erythematosus (SLE) with intimate relationships in female patients with SLE.

DESIGN

This was a cross-sectional study based on questionnaires.

SETTING

This study was conducted at a regional teaching hospital in southern Taiwan from April to September 2019.

PARTICIPANTS

Adult patients with SLE recruited from the outpatient rheumatology clinics of the study hospital.

PRIMARY OUTCOME MEASURE

Disease-specific quality of life assessed using the Lupus Quality of Life questionnaire (LupusQoL).

RESULTS

A total of 243 female patients with SLE were enrolled. The results of the multiple linear regression analysis indicated that the independent factors associated with a higher score in the intimate relationships domain of the LupusQoL included the age group under 40 years (p=0.001), education level of college or above (p=0.005), being employed (p<0.001), a better self-reported health status (p=0.012) and a lower SLE-Disease Activity Score (SLE-DAS) score (p=0.010). In addition, the intimate relationships domain was significantly and independently associated physical health (p=0.001), fatigue (p=0.006) and burden to others (p=0.002) domains of the LupusQoL.

CONCLUSIONS

Physicians should be vigilant regarding the intimate relationships aspect of the health-related quality of life in female patients with SLE, especially in those who are older, unemployed, have a low educational level, poor self-reported health status, higher SLE-DAS, fatigue, and feeling of burden to others.

Quality of life measures in Systemic Lupus Erythematosus: A systematic review

In this study we systematically investigated the health-related quality of life (HRQoL) tools, which have been most often used over the last five years to evaluate the QoL in patients with systemic lupus erythematosus (SLE), focusing on their items and applications. A detailed literature search was conducted: the inclusion criteria were as follows: 1) studies including at least 50 patients; 2) studies including at least 25 patients with SLE; 3) quality of life testing with validated measures. The systematic review was based on 119 studies for a total of 32,449 SLE patients and 3092 controls. A total of 35 different patients-reported quality of life measures, applied in cohorts of patients with SLE, were retrieved with the 36-item Medical Outcome Short Form (SF-36) (63 studies of 119 =52.95%), Lupus Quality of Life (LupusQoL) (17 studies =14.3%) and Lupus Patient-Reported Outcome (LupusPRO) (12 studies =10%) being the most commonly used tools. Overall, this systematic review of the literature indicated that quality of life in patients with SLE appears to be poor and generally lower compared to both the general population and patients with other chronic conditions, as was shown by a few studies that used SF-36 and LupusPRO. The use of HRQoL scoring in SLE is gaining increasing interest and is used both in randomized controlled trials and in real-life. Future efforts are needed to improve the understanding of the impact of the disease burden on quality of life from the patient’s perspective.

DUALITY OF LIVING WITH SYSTEMIC LUPUS ERYTHEMATOSUS: FLUCTUATING BETWEEN “GOOD DAYS” AND “BAD DAYS”

ABSTRACT Objective: to learn the perception of individuals with Systemic Lupus Erythematosus about living with the disease. Method: an exploratory and descriptive research study, of a qualitative nature, carried out with 26 individuals undergoing treatment at the rheumatology outpatient clinic of a university hospital in southern Brazil. The data were collected in the period from February to July 2019, by means of semi-structured interviews that were audio-recorded and subjected to the thematic modality of content analysis. Results: a category entitled: “Fluctuating between good and bad days in living with Systemic Lupus Erythematosus”, composed of two subcategories that portray that living with Lupus is something unstable/fickle, emerged from the results. This is because, as a result of the periods of remission and exacerbation of the signs and symptoms of the disease, the patients experience a paradox of constant oscillation between ups and downs. Conclusion: it was learned that individuals with Lupus perceive that living with the disease is marked by an oscillation between good days and bad days, which are related to periods of remission and exacerbation of the manifestations of the disease, respectively.

Systemic lupus erythematosus and risk of sexual dysfunction: A systematic review and Meta-Analysis

OBJECTIVE

To systematically review and summarize the available literature regarding the association between systemic lupus erythematosus (SLE) and sexual dysfunction (SD) in both sexes.

METHODS

We retrieved relevant studies from the following databases: PubMed, Embase,Cochrane Library, and Web of Science. Two reviewers independently reviewed the studies in our sample, assessed their validity, and extracted relevant data. Sensitivity and subgroup analyses were performed to distinguish sources of heterogeneity.

RESULTS

Our search resulted in a sample of eight eligible studies, which involved 758 patients in the SLE group and 1724 individuals in the control group. The pooled RR for the increased risk for SD compared to those in the control group was 1.80 (95%CI 1.12-2.87). Subgroup analysis by sex revealed that males (pooled RR = 2.98, 95%CI 2.41-3.68) had a higher risk of SD compared to females (pooled RR = 1.56, 95%CI 0.99-2.48). Females with SLE had significantly lower values in FSFI compared to the healthy individuals (WMD=-0.224, 95%CI -0.441 to -0.078). Age of participants and the quality of studies might influence the results.

CONCLUSIONS

Our meta-analysis suggests that SLE is significantly associated with an increased risk of sexual dysfunction. It is of great urgency to implement for active interventions that aimed to treat or prevent SD among SLE patients.

Age at diagnosis and health-related quality of life are associated with fatigue in systemic lupus erythematosus patients: Data from the Almenara Lupus Cohort

OBJECTIVE

To define the factors associated with fatigue in Mestizo patients with Systemic Lupus Erythematosus (SLE).

METHODS

This is a cross-sectional study of SLE patients from a single center cohort. Visits were performed every six months. For these analyses, the first visit between October 2017 and December 2018 was included. Demographic and clinical characteristics as well as treatment were recorded at every visit. Fatigue was ascertained with the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-FT), Health-Related Quality of Life (HRQoL) with the LupusQoL, disease activity with the Systemic Lupus Erythematosus Disease Activity Index -2 K (SLEDAI-2K), and damage with the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology damage index (SDI). Prednisone use was recorded as current daily dose. Immunosuppressive drugs and antimalarial use were recorded as current, past or never. Univariable and multivariable analyses were performed using linear regression models. For the multivariable analyses, model selection followed a backward elimination procedure.

RESULTS

Two hundred and twenty-six patients were evaluated. The mean (SD) age at diagnosis was 35.6 (13.1) years, 211 (93.4%) were female; and disease duration was 11.0 (7.3) years. The mean SLEDAI and SDI were 2.4 (3.5) and 1.3 (1.5), respectively. The mean FACIT-FT was 33.1 (10.8). On the multivariable analysis, age at diagnosis and some domains of HRQoL (physical health, emotional health and fatigue) remained associated.

CONCLUSIONS

Age at diagnosis is negatively associated with fatigue whereas HRQoL domains like physical health, emotional health and fatigue are positively associated with fatigue.