Sexual Dysfunction and its Determinants in Male Patients with Rheumatoid Arthritis

Sexual and reproductive health while living with rheumatoid arthritis: The impact of the disease stage on patient perspectives

BACKGROUND

Rheumatoid arthritis (RA) is one of the most prevalent rheumatic diseases that harms all aspects of patients' lives, including sexual and reproductive health (SRH), often neglected in patients' care. The study aimed to explore the sexual and reproductive experiences of Mexican outpatients with RA from a narrative perspective.

PATIENTS AND METHODS

From July 2020 to October 2021, 30 adult patients with RA from the Department of Immunology and Rheumatology outpatient clinic of a national referral center for rheumatic diseases had in-depth interviews audiotaped, transcribed, and analyzed using a thematic analysis approach. Results are presented in a descriptive and interpretative manner and integrated into a theoretical model for the topic understanding.

RESULTS

Five intertwined major themes emerged: I) RA onset: Absence of SRH contents, II) Healthcare for RA: Emerging SRH contents, III) RA's impact: Proliferation of SRH contents, IV) Coping with the process of living with RA: SRH-related strategies, and V) The impact of the COVID-19 pandemic on patients' experiences: Increased SRH burden. SRH contents emerged through these major themes (but at RA onset), mostly when inquired and mainly when narrating the RA impact and coping. Patients identified that RA affected their couple dynamics, sexual function, and reproductive project. The SRH care was considered relevant but limited and focused on reproductive contents. It worsened during the COVID-19 pandemic. We proposed a theoretical model where patients' SRH experiences are embedded across their RA biography and integrated with the RA impact and the copy with the disease process. These intertwined experiences were also evident during the COVID-19 pandemic, which challenged participants' biopsychosocial resources.

CONCLUSIONS

The sexual and reproductive experiences narrated by the RA outpatients concerning their disease-related biography showed that even when the SRH appeared as not prioritized at the disease onset, it was widely expressed during the process of living and coping with the disease and was additionally affected by the COVID-19 pandemic.

Evaluation of sexual dysfunction and its predictive factors in female and male patients with rheumatoid arthritis

Background

Rheumatoid arthritis (RA) is a common disabling joint disease affecting both males and females. Sexual dysfunction (SD) is a common association with RA. The aim of this work was to study the prevalence and predictors of sexual dysfunction in male and female patients with rheumatoid arthritis.

Results

The mean age of female patients was 32.1 years and 39.7 years for males. The prevalence of sexual dysfunction was higher in RA female patients than controls, 62.1% versus 41.2% respectively (P ≤ 0.05). The prevalence of global sexual dysfunction was higher in RA male patients than controls, 63.8% versus 47.5% respectively (P ≤ 0.05). Predictors of sexual dysfunction in female RA patients were the number of children, BMI, disease duration, DAS score, HADs-D score, HAQ score, VAS score, joint deformity, and the number of drugs. Predictors of sexual dysfunction in male RA patients were age, disease duration, DAS score, HAQ score, VAS score, and the number of drugs.

Conclusion

SD is prevalent in RA patients. Disease activity, pain, depression, and disturbed quality of life affect nearly all domains of sexual functions in female and male patients.