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Carrillo A, Marengo-Rodríguez D, Ibarra-Velasco-Siles M, Chávez-Barajas MJ, Barrera-Vargas A, Pérez-García LF, Merayo-Chalico J. Addressing the unspoken: sexual dysfunction in men with systemic lupus erythematosus, a call to action for rheumatologists. Sex Med Rev 2024; 12:434-441. [PMID: 38796305 DOI: 10.1093/sxmrev/qeae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION Sexual dysfunction (SD) is highly prevalent and multifactorial; nevertheless, recent research has shed light on a notable phenomenon: male patients with systemic lupus erythematosus (SLE) exhibit an elevated prevalence of sexual function disorders compared with the general population. Despite this recognition, the precise nature and extent of this association remain incompletely understood. OBJECTIVES This comprehensive review aims to clarify the link by providing an overview of the fundamental components of normal male sexual function, delving into the pathogenesis of male SD and exploring the primary factors predisposing male SLE patients to SD. Additionally, the review offers insights into potential screening, diagnostic, and treatment strategies based on the current body of literature. METHODS A meticulous search of relevant literature was conducted using the PubMed and Google Scholar databases. RESULTS Studies exploring the correlation between SLE and SD in both genders have revealed a nearly 2-fold increased risk of SD among individuals with SLE compared with healthy counterparts. Moreover, these studies suggest that male SLE patients may have a higher susceptibility to SD, with reported prevalence ranging from 12% to 68%, compared with 0% to 22% in healthy individuals. Male patients with SLE are influenced by a spectrum of pathological factors, including pharmacological, psychological, and disease-related determinants, which, through their intricate interplay, elevate the likelihood of developing SD. CONCLUSION Healthcare professionals must remain vigilant in understanding the intricacies of human sexuality and its dysfunction, particularly in males with SLE. The objective is to establish effective and potentially standardized methods for promptly diagnosing and optimally managing SD, recognizing its significant impact on the quality of life for males living with SLE. The pivotal role of rheumatologists in initiating discussions about sexual health, diagnosing SD, investigating causes, and implementing tailored strategies is underscored as crucial in addressing this multifaceted issue.
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Affiliation(s)
- Abril Carrillo
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14080 Ciudad de México, Mexico
| | - Daniela Marengo-Rodríguez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14080 Ciudad de México, Mexico
| | - Monserrat Ibarra-Velasco-Siles
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14080 Ciudad de México, Mexico
| | - María José Chávez-Barajas
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14080 Ciudad de México, Mexico
| | - Ana Barrera-Vargas
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14080 Ciudad de México, Mexico
| | | | - Javier Merayo-Chalico
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14080 Ciudad de México, Mexico
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Liu M, Dou J, Wang Q. The effect of systemic lupus erythematosus on sexual function in women: an updated meta-analysis based on cross-sectional studies. Adv Rheumatol 2022; 62:24. [DOI: 10.1186/s42358-022-00257-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/29/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Systemic lupus erythematosus (SLE), a chronic systemic autoimmune disease, often affects different organs and tissues. It can be effectively managed using drugs; however, attention should be paid to the patient’s quality of life. This study aimed to evaluate the effect of SLE on female sexual function based on current literature.
Methods
The PubMed, Embase, and Cochrane Library databases were searched for eligible studies published up to November 9, 2021. This review included all English studies that compared the sexual function between women with SLE and healthy women. A meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results
A total of 367 records were retrieved from 3 electronic databases. Five studies that involved 710 women with SLE and 2059 healthy women were finally included in this meta-analysis. The result indicated a significant decrease (mean difference = − 1.74, 95% confidence interval − 3.14 to − 0.34, p = 0.02) in the total scores of the Female Sexual Function Index in women with SLE, implying that healthy women had better sexual function than those with SLE.
Conclusion
The results of our study indicated that SLE could negatively affect the quality of sexual life in terms of desire, arousal, and pain. Thus, close attention should be paid to the sexual function of women with SLE.
Trial registration: This study was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42021290439).
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Pelvic floor dysfunctions in women with systemic lupus erythematosus: A cross-sectional study. Int Urogynecol J 2022; 34:1025-1033. [PMID: 35913612 DOI: 10.1007/s00192-022-05310-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/12/2022] [Indexed: 10/16/2022]
Abstract
INTRODUCTION AND HYPOTHESIS As a result of the impairment of the musculoskeletal system, the pelvic floor muscles are likely compromised in women with systemic lupus erythematosus (SLE). We hypothesized that women with SLE would report more symptoms of pelvic floor dysfunction (PFD) and there will be an association between SLE and PFD. METHODS An online cross-sectional survey was conducted. Data were collected on demographic and anthropometric characteristics, PFD (urinary incontinence, nocturia, anal incontinence, genital-pelvic pain/penetration disorder and pelvic organ prolapse) and obstetric history using a web-based questionnaire. The groups were compared using the Mann-Whitney test for quantitative variables and the chi-squared test for categorical variables. The association between SLE and PFD was tested using logistic regression analysis. RESULTS A total of 196 women answered the questionnaire (102 with SLE and 94 healthy controls). Women with SLE reported significantly more urinary incontinence, nocturia, anal incontinence, pelvic organ prolapse and genital-pelvic pain/penetration disorder than the healthy controls (p ≤ 0.05). Women with SLE were 2.8- to 3.0-fold more likely to report genital-pelvic pain/penetration disorder than healthy women. CONCLUSIONS The prevalence of PFD was significantly higher in women with SLE compared to healthy women. Thus, PFD seems to be an important problem in women with this disease. An in-depth investigation of these disorders could contribute to the understanding of how SLE impacts pelvic floor function.
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Zhang L, Wu B, Ye J. Fatigue have impact on the sexual problems in Chinese females with systemic lupus erythematosus. BMC Womens Health 2022; 22:266. [PMID: 35768845 PMCID: PMC9245321 DOI: 10.1186/s12905-022-01854-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Lijuan Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197, Ruijin Er Road, Shanghai, 200025, China
| | - Beiwen Wu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197, Ruijin Er Road, Shanghai, 200025, China.
| | - Junna Ye
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197, Ruijin Er Road, Shanghai, 200025, China.
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Hsu CW, Hsu BB, Koo M, Lu MC. Factors associated with intimacy in female Taiwanese patients with systemic lupus erythematosus: a cross-sectional study. BMJ Open 2022; 12:e055754. [PMID: 35428632 PMCID: PMC9014030 DOI: 10.1136/bmjopen-2021-055754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
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.
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Affiliation(s)
- Chia-Wen Hsu
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Bao-Bao Hsu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Malcolm Koo
- Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien, Taiwan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ming-Chi Lu
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
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Serna-Peña G, Colunga-Pedraza IJ, Villarreal-Alarcón MÁ, Castillo-Torres SA, Abundis-Márquez EE, Reynosa-Silva IC, Galarza-Delgado DÁ. Sexual function in women with systemic lupus erythematosus: a case-control study. Rheumatol Int 2021; 41:1465-1469. [PMID: 34021365 DOI: 10.1007/s00296-021-04895-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/15/2021] [Indexed: 11/26/2022]
Abstract
The effect of systemic lupus erythematosus (SLE) in sexual function is one of the least studied areas. There are few previous studies that investigate sexual function in SLE, and current evidence indicates a negative impact. The main objective of this study is to evaluate sexual function in Mexican women with SLE and compare if sexual dysfunction occurs in a greater proportion than in healthy women. A case-control study with 102 Mexican women between 18 and 60 years, with SLE diagnosis and a control group of healthy women (n = 156) matched by age. They were asked about their sexual life in the last month, and the Female Sexual Function Index (FSFI) self-questionnaire was applied. Variables between groups were compared with Chi-square and Mann-Whitney U test. SLE women had less sexual activity than controls (63.7% vs 77.5%, p = 0.01). Out of the total, the FSFI was applied only to those that had an active sexual life, 65 with SLE and 121 healthy women. Sexual dysfunction (< 26.5 points) was found in 28% women with SLE and in 22% of controls, with no significant differences (p = 0.4). In the SLE group, a worse performance was found in the desire and excitation domains compared to healthy women. SLE women had less active sexual life than healthy women, but no greater sexual dysfunction. However, they performed worse in the desire and excitation domains. This alteration did not show a relation with demographic nor disease-related variables.
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Affiliation(s)
- Griselda Serna-Peña
- Rheumatology Division, "Dr.José Eleuterio Gonzalez" University Hospital, Autonomous University of Nuevo León, Av. Gonzalitos No. 235 Nte. Col. Mitras Centro, 64460, Monterrey, N.L. C.P., Mexico
| | - Iris Jazmín Colunga-Pedraza
- Rheumatology Division, "Dr.José Eleuterio Gonzalez" University Hospital, Autonomous University of Nuevo León, Av. Gonzalitos No. 235 Nte. Col. Mitras Centro, 64460, Monterrey, N.L. C.P., Mexico
| | - Miguel Ángel Villarreal-Alarcón
- Rheumatology Division, "Dr.José Eleuterio Gonzalez" University Hospital, Autonomous University of Nuevo León, Av. Gonzalitos No. 235 Nte. Col. Mitras Centro, 64460, Monterrey, N.L. C.P., Mexico
| | - Sergio Andrés Castillo-Torres
- Neurology Division , "Dr.José Eleuterio Gonzalez" University Hospital, Autonomous University of Nuevo León, Monterrey, Mexico
| | | | - Ileana Cecilia Reynosa-Silva
- Internal Medicine Division, "Dr.José Eleuterio Gonzalez" University Hospital, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Dionicio Ángel Galarza-Delgado
- Rheumatology Division, "Dr.José Eleuterio Gonzalez" University Hospital, Autonomous University of Nuevo León, Av. Gonzalitos No. 235 Nte. Col. Mitras Centro, 64460, Monterrey, N.L. C.P., Mexico.
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The impact of Sjӧgren's syndrome on the quality of sexual life of female patients in the UK: a controlled analysis. Rheumatol Int 2021; 42:1423-1429. [PMID: 33688999 PMCID: PMC9287246 DOI: 10.1007/s00296-021-04830-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/02/2021] [Indexed: 11/25/2022]
Abstract
Mucosal dryness and dyspareunia are symptoms that may significantly affect women with primary Sjӧgren syndrome (pSS). We investigated whether vaginal dryness is correlated with sexual function, and the impact may have on the quality of life (QoL) and mental health well-being in pSS patients. Ethically approved comparative cross-sectional study was designed to assess sexual function using the Female Sexual Function Index (FSFI) in 65 pSS female patients vs 62 sex-matched controls. The effect of vaginal dryness and fatigue on sexual function was investigated. Vaginal dryness was correlated with oral dryness estimated by salivary flow rate and the Clinical Oral Dryness Score to investigate whether genital dryness is indicative of general mucosal dryness in pSS. Validated questionnaires were used to investigate the effect of sexual function on QoL and mental health well-being. The number of sexually active pSS participants was significantly less than in the control group (28/65 vs 42/62, p < 0.05). The sexual function was significantly impaired in the pSS group (mean FSFI = 19 vs 28.3, p < 0.05). There was no significant association between self-reported vaginal dryness and oral dryness or sexual function. The open-ended questions showed that the most troublesome symptom reported by pSS patients was oral dryness (43%, n = 28/65) followed by fatigue (31%, n = 20/65). Sexual dysfunction had a negative impact on QoL and the mental health well-being of pSS patients in all aspects, especially on the quality of social life (β = 0.7, p = 0.02). Addressing sexual dysfunction can potentially improve the QoL of pSS patients significantly, especially their social well-being.
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Jin Z, Yang C, Xiao C, Wang Z, Zhang S, Ren J. Systemic lupus erythematosus and risk of sexual dysfunction: A systematic review and Meta-Analysis. Lupus 2020; 30:238-247. [PMID: 33210559 DOI: 10.1177/0961203320974081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
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.
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Affiliation(s)
- Zhao Jin
- Department of internal medicine, China-Japan Friendship Hospital, Beijing, China
| | - Cong Yang
- Department of internal medicine, China-Japan Friendship Hospital, Beijing, China
| | - Chu Xiao
- Department of internal medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Zizhen Wang
- Department of internal medicine, China-Japan Friendship Hospital, Beijing, China
| | - Suxin Zhang
- Department of internal medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Jie Ren
- Department of internal medicine, Peking University Third Hospital, Beijing, China
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Dorgham D, Haggag HM, Attia DH. Sexual dysfunction in Egyptian females with systemic lupus erythematosus: a cross sectional study. Lupus 2020; 29:1085-1094. [PMID: 32605530 DOI: 10.1177/0961203320935518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Sexual dysfunction in systemic lupus erythematous (SLE) patients is an important issue to be tackled. We aimed to study the prevalence of sexual dysfunction in SLE women and detect its association with depression, functional disability and quality of life. METHODS This study included 94 SLE females. Ninety-eight control females agreed to participate. Patients and controls answered a written form of the Arabic version of the Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI), Health Assessment Questionnaire-Disability Index (HAQ-DI) and Short Form 36 (SF-36). Disease activity and damage were assessed using the SLE Disease Activity Index and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. RESULTS The frequency of sexual dysfunction was similar in the patients and control groups (77.7% versus 82.7%) while the BDI, HAQ-DI and SF-36 scores were significantly worse in SLE patients. SLE patients with and without sexual dysfunction differed in neither disease characteristics nor disease activity and damage indices. The FSFI showed a strong positive correlation with SF-36, and strong inverse correlations with BDI and HAQ-DI in the patients group while it had a weaker positive correlation with SF-36 and no correlations with the other two indices in the control group. CONCLUSION No significant difference was found in the prevalence of sexual dysfunction between SLE patients and controls. Sexual dysfunction in SLE patients is mostly related to depression, poor functional status, increased pain, poor health perception and bad quality of life. Neither disease activity nor damage contributes significantly to sexual dysfunction in lupus females.
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Affiliation(s)
- Dalia Dorgham
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hisham M Haggag
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Doaa Hs Attia
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Restoux LJ, Dasariraju SR, Ackerman IN, Van Doornum S, Romero L, Briggs AM. Systematic Review of the Impact of Inflammatory Arthritis on Intimate Relationships and Sexual Function. Arthritis Care Res (Hoboken) 2020; 72:41-62. [PMID: 30941870 DOI: 10.1002/acr.23857] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To systematically review evidence of the impact of inflammatory arthritis on, or association of inflammatory arthritis with, intimate relationships and sexual function. METHODS Ovid Medline, Ovid PsycINFO, Ovid Embase, and EBSCO CINAHL databases were searched. Two independent reviewers selected articles, extracted data, and conducted manual searches of reference lists from included studies and previous reviews. The quality of evidence was assessed using standard risk-of-bias tools. RESULTS Fifty-five eligible studies were reviewed. Of these, 49 (89%) were quantitative, 5 (9.1%) were qualitative, and 1 (1.8%) used a mixed-method design. Few quantitative studies were rated as low risk of bias (n = 7 [14%]), many were rated as moderate (n = 37 [74%]) or high risk (n = 6 [12%]). Quantitative study sample sizes ranged from 10 to 1,272 participants, with a reported age range 32-63 years. Qualitative study sample sizes ranged from 8 to 57 participants, with a reported age range 20-69 years. In studies reporting the Female Sexual Function Index, all inflammatory arthritis groups demonstrated mean scores ≤26.55 (range of mean ± SD scores: 14.2 ± 7.8 to 25.7 ± 4.7), indicating sexual dysfunction. In studies reporting the International Index of Erectile Function, all inflammatory arthritis groups reported mean scores ≤25 (range of mean ± SD scores: 16.0 ± 5.3 to 23.8 ± 7.0), indicating erectile dysfunction. Key qualitative themes were impaired sexual function and compromised intimate relationships; prominent subthemes included inflammatory arthritis-related pain and fatigue, erectile dysfunction, diminished sexual desire, and sexual function fluctuations according to disease activity. CONCLUSION Sexual dysfunction appears highly prevalent among men and women with inflammatory arthritis, and increased clinician awareness of this impairment may guide provision of tailored education and support.
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Affiliation(s)
| | | | | | | | - Lorena Romero
- Alfred Medical Research and Education Precinct, Melbourne, Victoria, Australia
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Pinto B, Grover S, Dhooria A, Rathi M, Sharma A. Sexual functioning and its correlates in premenopausal married Indian women with systemic lupus erythematosus. Int J Rheum Dis 2019; 22:1814-1819. [DOI: 10.1111/1756-185x.13675] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/22/2019] [Accepted: 07/14/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Benzeeta Pinto
- Department of Internal Medicine Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Sandeep Grover
- Department of Psychiatry Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Aadhaar Dhooria
- Department of Internal Medicine Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Manish Rathi
- Department of Nephrology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Aman Sharma
- Department of Internal Medicine Post Graduate Institute of Medical Education and Research Chandigarh India
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Wang Y, Zhao R, Gu C, Gu Z, Li L, Li Z, Dong C, Zhu J, Fu T, Gao J. The impact of systemic lupus erythematosus on health-related quality of life assessed using the SF-36: a systematic review and meta-analysis. PSYCHOL HEALTH MED 2019; 24:978-991. [PMID: 30943791 DOI: 10.1080/13548506.2019.1587479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Yilin Wang
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
| | - Rui Zhao
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
| | - Chaoyu Gu
- School of Medicine, Nantong University, Nantong, China
| | - Zhifeng Gu
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Liren Li
- Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong, China
| | - Zhenyu Li
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
| | - Chen Dong
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
| | - Jinjin Zhu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
| | - Ting Fu
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Jianlin Gao
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
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High Prevalence of Sexual Dysfunction in Women with Rheumatic Diseases: A not Recognized Health Domain. SEXUALITY AND DISABILITY 2018. [DOI: 10.1007/s11195-018-9542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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14
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Living with systemic lupus erythematosus in the developing world. Rheumatol Int 2018; 38:1601-1613. [DOI: 10.1007/s00296-018-4017-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 03/19/2018] [Indexed: 12/15/2022]
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Yin R, Xu B, Li L, Fu T, Zhang L, Zhang Q, Li X, Shen B. The impact of systemic lupus erythematosus on women's sexual functioning: A systematic review and meta-analysis. Medicine (Baltimore) 2017; 96:e7162. [PMID: 28682869 PMCID: PMC5502142 DOI: 10.1097/md.0000000000007162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND A number of studies have reported the relationship between women's sexual problems and systemic lupus erythematosus (SLE). However, the results are contradictory. The objective of this paper was to explore the impact of SLE on women's sexual function. METHODS PubMed, Web of Science, CNKI Scholar, VIP and WanFang databases were searched up to April 2017. Studies evaluating the impact of SLE on women's sexual function with the use of Female Sexual Function Index (FSFI) scoring system were included. Statistical analyses were executed using version 5.0 Review Manager statistical software. Data were pooled using a fixed or random effects model according to heterogeneity. RESULTS A total of 2 identified studies matched the inclusion criteria, reporting on a total of 236 patients with SLE. No significant difference was observed between SLE patients and healthy controls on desire (P = .24; MD = -0.44 [-1.17, 0.29]), arousal (P = .12; MD = -0.39 [-0.89, 0.11]), lubrication (P = .17; MD = -0.53 [-1.28, 0.23]), orgasm (P = .27; MD = -0.27 [-0.75, 0.21]), satisfaction (P = .25; MD = -0.10 [-0.27, 0.07]) and pain (P = .17; MD = -0.50 [-1.22, 0.22]), except for total FSFI (P = .001; MD = -1.24 [-1.97, -0.50]). CONCLUSION SLE has some influence on women' sexual function. However, further studies of a larger population of female patients are required to further evaluate the mechanism by which SLE affects sexual function.
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Affiliation(s)
- Rulan Yin
- Department of Nursing, The Second Affiliated Hospital of Nantong University
- Nursing School of Nantong University, Nantong, Jiangsu, P.R. China
| | - Bin Xu
- Nursing School of Nantong University, Nantong, Jiangsu, P.R. China
| | - Lin Li
- Nursing School of Nantong University, Nantong, Jiangsu, P.R. China
| | - Ting Fu
- Nursing School of Nantong University, Nantong, Jiangsu, P.R. China
| | - Lijuan Zhang
- Nursing School of Nantong University, Nantong, Jiangsu, P.R. China
| | - Qiuxiang Zhang
- Nursing School of Nantong University, Nantong, Jiangsu, P.R. China
| | - Xia Li
- Nursing School of Nantong University, Nantong, Jiangsu, P.R. China
| | - Biyu Shen
- Department of Nursing, The Second Affiliated Hospital of Nantong University
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Souza FHCD, Araújo DBD, Silva CA, Miossi R, Abdo CHN, Bonfá E, Shinjo SK. Analysis of sexual function of patients with dermatomyositis and polymyositis through self-administered questionnaires: a cross-sectional study. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57:134-140. [PMID: 28343618 DOI: 10.1016/j.rbre.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 08/29/2016] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION To date, there are no descriptions in the literature on gynecologic and sexual function evaluation in female patients with dermatomyositis (DM) and polymyositis (PM). OBJECTIVE To assess sexual function in female patients with DM/PM. PATIENTS AND METHODS This is a monocentric, cross-sectional study in which 23 patients (16 DM and 7 PM), with ages between 18 and 40 years, were compared to 23 healthy women of the same age group. Characteristics on sexual function were obtained by applying the questionnaires Female Sexual Quotient (FSQ) and Female Sexual Function Index (FSFI) validated for the Brazilian Portuguese language. RESULTS The mean age of patients was comparable to controls (32.7±5.3 vs. 31.7±6.7 years), as well as the distribution of ethnicity and socioeconomic class. As for gynecological characteristics, patients and healthy controls did not differ with respect to age at menarche and percentages of dysmenorrhea, menorrhagia, premenstrual syndrome, pain at mid-cycle, mucocervical secretion, and vaginal discharge. The FSQ score, as well as all domains of the FSFI questionnaire (desire, arousal, lubrication, orgasm and satisfaction), were significantly decreased in patients vs. controls, with 60.9% of patients showing some degree of sexual dysfunction. CONCLUSIONS This was the first study to identify sexual dysfunction in patients with DM/PM. Therefore, a multidisciplinary approach is essential for patients with idiopathic inflammatory myopathies, in order to provide prevention and care for their sexual life, providing a better quality of life, both for patients and their partners.
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Affiliation(s)
| | - Daniel Brito de Araújo
- Universidade Federal de Pelotas, Faculdade de Medicina, Departamento de Clínica Médica, Pelotas, RS, Brazil; Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
| | - Clovis Artur Silva
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brazil
| | - Renata Miossi
- Universidade de São Paulo, Faculdade de Medicina, Serviço de Reumatologia, São Paulo, SP, Brazil
| | | | - Eloisa Bonfá
- Universidade de São Paulo, Faculdade de Medicina, Disciplina de Reumatologia, São Paulo, SP, Brazil
| | - Samuel Katsuyuki Shinjo
- Universidade de São Paulo, Faculdade de Medicina, Disciplina de Reumatologia, São Paulo, SP, Brazil.
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Análise da função sexual de pacientes com dermatomiosite e polimiosite através de questionários autoaplicados: um estudo transversal. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2016.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Lin CT, Liu XN, Xu HL, Sui HY. Menstrual Disturbances in Premenopausal Women with End-Stage Renal Disease: A Cross-Sectional Study. Med Princ Pract 2016; 25:260-5. [PMID: 26907185 PMCID: PMC5588400 DOI: 10.1159/000444879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 02/22/2016] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To evaluate menstrual disturbances and sex hormonal status in premenopausal women with end-stage renal disease (ESRD). SUBJECTS AND METHODS The study consisted of 184 patients with ESRD treated with one of four treatment modalities (46/modality): conventional hemodialysis (CHD), continuous ambulatory peritoneal dialysis (CAPD), nocturnal hemodialysis (NHD) and renal transplantation (RT). Blood samples were collected to determine sex hormone levels. Sociodemographic and clinical data were collected from medical records. A questionnaire was administered to analyze menstrual patterns, and the final analysis included 46, 43, 40 and 36 patients in the CHD, CAPD, NHD and RT groups, respectively. RESULTS The overall prevalence of menstrual disturbances was 64.2% for all four treatment modalities (RT: 50%; NHD: 55%; CAPD: 72.1%, and CHD: 76.1%). Serum prolactin levels were significantly lower (p < 0.01) in the NHD (25.1 ± 10.9 ng/ml) and RT (13.4 ± 5.1 ng/ml) groups than in the CHD group (55.2 ± 10.8 ng/ml). Serum progesterone levels were significantly higher (p < 0.01) in the NHD (25.7 ± 8.3 nmol/l) and RT (30.1 ± 5.9 nmol/l) groups than in the CHD group (17.7 ± 7.3 nmol/l). Moreover, the hormonal status (follicle-stimulating hormone, luteinizing hormone and testosterone) was much closer to normal in the NHD and RT groups compared to the other two groups. CONCLUSIONS In this study, successful transplantation and NHD partially improved the symptoms of menstrual disturbances. Therefore, we recommend that further studies are necessary to confirm our finding in ESRD patients.
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Affiliation(s)
- Chong-Ting Lin
- Department of Hemodialysis Room, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Xi-Ning Liu
- Department of Hemodialysis Room, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Hong-Lei Xu
- Department of Hemodialysis Room, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Hui-Yan Sui
- Department of Radiology, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
- *Hui-Yan Sui, Department of Radiology, Yantai Hospital of Traditional Chinese Medicine, No. 39 Xingfu Road, Zhifu District, Yantai 264000 (PR China), E-Mail
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Priori R, Minniti A, Derme M, Antonazzo B, Brancatisano F, Ghirini S, Valesini G, Framarino-dei-Malatesta M. Quality of Sexual Life in Women with Primary Sjögren Syndrome. J Rheumatol 2015; 42:1427-31. [DOI: 10.3899/jrheum.141475] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2015] [Indexed: 01/22/2023]
Abstract
Objective.To assess the quality of sexual life of women with primary Sjögren syndrome (pSS) and to identify its correlations with disease activity and damage, quality of life, and mood disorders.Methods.The quality of sexual life of 24 women with pSS was assessed with the Female Sexual Function Index (FSFI). Twenty-four healthy women, matched by age and hormonal status, were enrolled as controls. Mood disorders and quality of life were investigated using the Hospital Anxiety and Depression Scale (HADS) and the Medical Outcomes Study Short Form-36. Patients underwent a gynecological visit with vaginal pH measurement, cervicovaginal swabs, and Pap smears. Disease activity and damage were assessed by the European League Against Rheumatism Sjögren syndrome disease activity and damage indexes.Results.Patients with pSS showed a pathological mean FSFI score (19.1 ± 7.33) significantly different from controls (p = 0.004), both in menstruating women (p = 0.006) and in menopausal women (p = 0.03). Major differences between the 2 groups were detected in dyspareunia (p < 0.005), lubrication (p = 0.006), desire (p = 0.004), and arousal (p = 0.018). The FSFI score was inversely correlated with age (p = 0.008) and anxiety HADS (p = 0.031). No early anatomical changes, swabs, and Pap smear alterations were revealed in patients with pSS; however, vaginal pH was higher than normal in premenopausal patients (6.0 ± 0.77).Conclusion.Both premenopausal and postmenopausal women with pSS have a worse sexual quality of life. We reported a greater prevalence of dyspareunia that is statistically significant when compared with controls. The FSFI could be a useful tool to assess this topic, but has been neglected in the care of patients with pSS heretofore.
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Body Image Disturbances Have Impact on the Sexual Problems in Chinese Systemic Lupus Erythematosus Patients. J Immunol Res 2015; 2015:204513. [PMID: 26090484 PMCID: PMC4451262 DOI: 10.1155/2015/204513] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 11/20/2014] [Indexed: 02/07/2023] Open
Abstract
SLE might affect all aspects of life including sexual functioning; previous study found that body image disturbance (BID) was the most powerful predictors of impaired partner relationships and sexual function. The current study investigated the relationship among disease parameters, quality of life, the psychological status, BID, and sexual problems in Chinese patients with SLE. A self-report survey design was administered to 168 SLE patients and 210 healthy individuals. Our results showed that 86 (55.1%) SLE patients reported impaired relationships with a sexual partner or partners, and 100 (64.1%) patients reported impaired sexual function which were significantly higher than the control group (31.6%, 35.7%, rep.). Age, marital status, depression, and BIDQ were the most powerful predictors of impaired partner relationships, while BIDQ3 and education, disease activity, and depression were the most significant causes of impaired sexual function. The study for first time reported Chinese SLE patients had sexual problems and BID was associated with sexual problems. So, early detection and interventions might not only rehabilitate the patients and their loved ones, but also improve overall health outcomes and reduce the direct and indirect costs of their medical care.
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The impact of primary Sjögren’s syndrome on female sexual function. Rheumatology (Oxford) 2015; 54:1286-93. [DOI: 10.1093/rheumatology/keu522] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Indexed: 01/19/2023] Open
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Morales MG, Rubio JLC, Peralta-Ramírez MI, Romero LJH, Fernández RR, García MTC, Navarrete NN, Centeno NO. Impaired sexual function in women with systemic lupus erythematosus: a cross-sectional study. Lupus 2013; 22:987-95. [DOI: 10.1177/0961203313500370] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective The objectives of this paper are to compare sexual function and distress in women with systemic lupus erythematosus (SLE) and in healthy controls; to determine the association between disease characteristics, quality of life, psychopathology and sexual function; and to compare sexual function and distress of women according to age (reproductive and nonreproductive-age women). Methods We conducted a cross-sectional study of 120 participants; 65 women had SLE (aged 18–65), and 55 were healthy, age-matched controls. The assessment included the Female Sexual Function Index (FSFI), Symptom Checklist-90-Revised (SCL-90-R), Short Form 36 health survey (SF-36), socio-demographic characteristics and the Systemic Lupus International Collaborating Clinics (SLICC) and SLE Disease Activity Index (SLEDAI) in SLE patients only. Results Of 65 eligible patients with SLE, 61 (94%) responded; of 55 control subjects, 53 (96%) responded. The FSFI total score and subscale scores for desire, arousal, lubrication, orgasm and pain were significantly lower in patients with SLE. More somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid ideation, psychoticism, the Positive Symptom Total (PST), Positive Score Discomfort Index (PSDI), the use of psychotropic drugs, general health, vitality, social function, emotional role and mental health were significantly associated with changes in the patient group’s sexuality. Multivariate analysis indicated that depression, PSDI and vitality were the variables significantly associated with low sexual function in patients with SLE. Conclusions Women with SLE reported significantly impaired sexual function compared with healthy controls. Impaired sexual function was associated with somatization, obsessive-compulsive behavior, interpersonal sensitivity, depression, hostility, paranoid ideation, psychoticism, PST, higher scores in the PSDI subscale, vitality, social functioning and mental health. These results indicate that, in daily practice, inquiring about sexuality and quality of life and screening for psychopathology are important for every patient with SLE, irrespective of their clinical characteristics.
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Affiliation(s)
| | | | - MI Peralta-Ramírez
- Faculty of Psychology, University of Granada, Spain
- Neuroscience Institute “Federico López Neyra,” Spain
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Rosato E, Barbano B, Gigante A, Aversa A, Cianci R, Molinaro I, Quarta S, Pisarri S, Afeltra A, Salsano F. Erectile Dysfunction, Endothelium Dysfunction, and Microvascular Damage in Patients with Systemic Sclerosis. J Sex Med 2013; 10:1380-8. [DOI: 10.1111/jsm.12110] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Daleboudt GMN, Broadbent E, McQueen F, Kaptein AA. The impact of illness perceptions on sexual functioning in patients with systemic lupus erythematosus. J Psychosom Res 2013; 74:260-4. [PMID: 23438719 DOI: 10.1016/j.jpsychores.2012.11.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 11/04/2012] [Accepted: 11/06/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Sexual problems are common in patients with chronic illnesses. However, few studies have investigated problems with sexual functioning in patients with systemic lupus erythematosus (SLE). The present cross-sectional study assessed the influence of SLE on sexual functioning and its associations with illness perceptions and medical and socio-demographic characteristics. METHOD The study included 106 SLE patients who used at least one immunosuppressive agent to control their SLE. Sexual functioning was measured using the Physical Disability Sexual and Body Esteem and the Medical Impact Scale from the Sexual Functioning Questionnaire. Patients' illness perceptions were assessed using the Brief Illness Perception Questionnaire. RESULTS 49.1% of patients agreed that their SLE had a negative influence on their sexual functioning. In addition, treatment for SLE seemed to play an important role in the negative impact on sexual functioning. Patients' illness perceptions were more important predictors of sexual functioning than medical and socio-demographic characteristics. SLE patients appear to report a lower sexual functioning than patients with other chronic illnesses. CONCLUSION SLE in general and immunosuppressive treatment for SLE specifically have a negative influence on sexual functioning. Patients' illness perceptions appear to play a more important role in the negative impact on sexual functioning than medical characteristics such as disease activity. The high prevalence of sexual problems highlights the need to more frequently address and aim to improve sexual functioning in patients with SLE. Patients may benefit from methods such as illness perception modification and coping style interventions to reduce their sexual problems.
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Affiliation(s)
- Gabriëlle M N Daleboudt
- Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands.
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Armstrong AW, Follansbee MR, Harskamp CT, Schupp CW. Psoriasis and sexual behavior in U.S. women: an epidemiologic analysis using the National Health and Nutrition Examination Survey (NHANES). J Sex Med 2012; 10:326-32. [PMID: 23171046 DOI: 10.1111/jsm.12003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Although sexual behavior is an integral part of most adults' overall well-being, this aspect of psoriasis patients' quality of life is rarely explored. AIM The aim of this study is to assess the relationship between psoriasis and sexual behavior in U.S. women. METHODS We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006. Our study focuses on responses to the dermatology and sexual behavior questionnaires of the NHANES. MAIN OUTCOME MEASURES This study examines the association between psoriasis and sexual behavior in U.S. women with regard to sexual orientation, age of first sexual encounter, number of sexual partners, and frequency of unprotected sex. RESULTS A total of 3,462 women provided responses to their psoriasis status: 2,753 (80%) women were heterosexual and 709 (20%) were nonheterosexual. Among them, 2.7% reported a physician-given diagnosis of psoriasis. On multivariate analyses, psoriasis was not associated with differences in sexual orientation (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.62-2.01). Among nonheterosexual women, multivariate analysis revealed a lower number of lifetime female sexual partners in women with psoriasis (rate ratio [RR] 0.11, 95% CI 0.04-0.33, P = 0.001). Among heterosexual women, no significant differences existed between those with and without psoriasis in age of first sexual encounter (weighted difference -0.54 years, 95% CI -1.27 to 0.19), number of lifetime male sexual partners (RR 1.19, 95% CI 0.69-2.06), or number of lifetime male oral sex partners (RR 0.72, 95% CI 0.40-1.29). Heterosexual women with psoriasis had 1.13 times more unprotected sex (RR 1.13, 95% CI 1.02-1.24, P = 0.03) compared with those without psoriasis. CONCLUSION Psoriasis is associated with a significantly reduced number of sexual partners in nonheterosexual women. Psoriasis may differentially impact sexual behavior based on sexual orientation in women.
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Affiliation(s)
- April W Armstrong
- Department of Dermatology, University of California Davis, Sacramento, CA 95816, USA.
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