Sexual Function in Italian Women with Systemic Sclerosis Is Affected by Disease-related and Psychological Concerns

Emotional intelligence: a novel predictor of quality of life in patients with systemic sclerosis

Systemic sclerosis (SSc), a chronic systemic autoimmune disease, affects skin and internal organs compromising organ function and leading to significant morbidity and poor health-related quality of life (HrQoL). This cross-sectional study investigated whether HrQoL is influenced by trait emotional intelligence (TEI). Sixty patients with SSc (Female: 86.67%) completed the socio-demographic characteristics form, TEI Questionnaire Short-Form (TEIQue-SF), and Short-Form Health Survey (SF-36). Sixty healthy controls were also completed the TEIQue-SF. A series of multiple linear regression analyses with correlation matrix was used to analyze SF-36 domains as dependent variables with TEI domains (well-being, self-control, emotionality, sociability) as independent variables. The average age of participants was 57.3 ± 12.9 years with a mean disease duration of 7.7 ± 6.7 years. Patients differed from controls in the sociability domain of TEI. TEI global was found to affect the physical and mental component summaries (p < .001), and all 8 dimensions of the HrQoL (p < .001). Age, disease duration, and gastrointestinal manifestations were negatively associated with various components of SF-36. TEI was positively associated with all dimensions of HrQoL. Understanding the relationship between TEI and HrQoL dimensions is important for the support and empowerment of SSc patients, as well as the establishment and implementation of appropriate psychotherapeutic interventions.

Impact of Chronic Medical Disease on Sexual Function and Other Conditions

Chronic diseases are prevalent and impact sexual health and function. Screening for and managing sexual dysfunction in women with chronic diseases is important to optimize well-being and quality of life. Clinicians should consider the biopsychosocial impact of chronic diseases on sexual health, screen for direct and indirect factors, and identify medications that may cause dysfunction. The authors recommend a multidisciplinary approach to treat sexual dysfunction in women with chronic diseases, including sexual medicine specialists, sex therapists, and pelvic floor physical therapists when indicated. This review provides a practical approach to assessing and managing sexual dysfunction in women with chronic diseases.

The Impact of Systemic Sclerosis on Sexual Health: An Italian Survey

OBJECTIVE

To evaluate the impact of systemic sclerosis (SSc) on vulvovaginal atrophy (VVA) and sexual health in an Italian population.

METHODS

An Italian survey about the prevalence and severity of VVA (on a 0 to 10 scale) and sexual dysfunction (using the Female Sexual Function Index-FSFI) through an anonymous online questionnaire. We investigated couple relationships and intimacy with partners, the predisposition of patients to talk about their sexual problems, physicians' receptivity, and treatment scenarios. Risk factors for VVA symptoms and sexual dysfunction were assessed.

RESULTS

A total of 107 women affected by SSc were enrolled. Of these, 83.2% of women (89/107) complained about VVA symptoms and 89.7% (among sexually active women; 87/97) about sexual dysfunction. Menopausal status did not affect VVA symptoms, while age was the only independent risk factor for sexual dysfunction. About 70% (74/107) of women reported a negative impact of disturbances on intimacy with their partner. A total of 63 women (58.9%) had never discussed their sexual problems and VVA condition with a physician. Lubricants were the only treatment prescribed, and 75% of women would welcome new therapies, even if experimental (62.9%).

CONCLUSIONS

In women with SSc, VVA symptoms and sexual dysfunction are highly prevalent, independently from menopause. In more than half of the investigated women with SSc, we found reluctance to talk about their sexual problems, despite being symptomatic. This should encourage physicians to investigate vulvovaginal and sexual health. SSc patients would welcome the advent of new treatment possibilities for their VVA and sexual complaints.

Multi-Organ System Screening, Care, and Patient Support in Systemic Sclerosis

Systemic sclerosis (SSc) is a heterogenous systemic autoimmune disease of complex multi-organ manifestations with a disease-specific mortality of >50%. The patient journey is fraught with severe, diverse, and diffuse physical impairment, psychological burden, and diminishing health-related quality of life. SSc remains unfamiliar to many clinicians. Delayed/misdiagnosis, inadequate screening, and attention for common complications with potentially preventable disability/death contribute to patients feeling isolated and unsupported. We present actionable standards including screening, anticipatory guidance, and counseling in patient-centered SSc-care emphasizing psycho-social health as the central goal, whereas robust vigilance and efforts to improve biophysical health and survival are imperatives that support this goal.

Prevalence of Sexual Dysfunction in People With Systemic Sclerosis and the Associated Risk Factors: A Systematic Review

INTRODUCTION

The association between systemic sclerosis (SSc) and sexual dysfunction was controversial.

AIM

To explore the impacts of SSc on sexual function, the prevalence of sexual dysfunction in patients with SSc and associated risk factors.

METHODS

A systematic review of all published studies was performed. Studies exploring the association between SSc and sexual function were retrieved from PubMed, Web of Science, and EBSCO. All retrieved papers were selected according to the inclusion and exclusion criteria.

MAIN OUTCOME MEASURE

The impacts of SSc on sexual function, the prevalence of sexual dysfunction in males and females with SSc and associated risk factors.

RESULTS

A total 12 studies were included in this study. The prevalence of sexual dysfunction in SSc males and SSc females were 76.9-81.4% and 46.7-86.6%, respectively. But the direct impacts of SSc on sexual function were controversial. EULAR SSc activity score ≥3, the number of complications ≥2, and the presence of anticardiolipin antibody and anti U1 ribonucleoprotein antibody in males and resistive index (RI) and the systolic/diastolic (S/D) ratio of clitoral blood in females have potential to be SSc-specific risk factors for sexual dysfunction.

CLINICAL IMPLICATIONS

Clinicians need to pay more attention to the impacts of SSc on sexual function of patients especially in those with risk factors.

STRENGTHS & LIMITATIONS

Systematically explored the prevalence of sexual dysfunction in SSc males and females, and the risk factors of sexual dysfunction for SSc were explored innovatively. However, there were some limitations in included studies prevented exploring the impacts of SSc on sexual function deeply.

CONCLUSION

Sexual dysfunction may be an important symptom of SSc, many risk factors may be associated with sexual dysfunction in males and females with SSc. Gao R, Qing P, Sun X, et al. Prevalence of Sexual Dysfunction in People With Systemic Sclerosis and the Associated Risk Factors: A Systematic Review. Sex Med 2021;9:100392.

Measuring the impact of systemic sclerosis on oral health-related quality of life in a UK population

BACKGROUND

The objective of the present study was to identify the impact of systemic sclerosis (SSc) upon oral health-related quality of life (OHRQoL) of affected individuals resident in the UK.

METHODS

A total of 100 patients and their partners or carers were invited to complete questionnaires regarding the impact of SSc on quality of life and psychological well-being using valid and reliable patient-reported outcome measures (OHIP-14, MHISS, OIDP, MDAS and HADS). A total of 50 patients with SSc and 18 partners or carers who acted as controls returned the completed questionnaires. Statistical analyses were performed for comparisons of different variables.

RESULTS

All the mean scores of OHIP-14 (SSc [16.5 ± 12.4] Vs controls [6.06 ± 7.6, p = 0.001]) and MHISS components were significantly higher in patients than those of control group (SSc [21.26 ± 12] Vs controls [4.8 ± 7.3, p < 0.0001]). Majority of OIDP mean scores were significantly worse in patients compared with controls [SSc (10 ± 8.7) Vs controls (1.72 ± 3.4, p < 0.0001)]. The mean of total MDAS [SSc (11.7 ± 5.3) Vs controls (9.5 ± 4.4)] and HADS scores were higher in patients compared to controls (SSc depression [4.8 ± 3.3] and anxiety [6 ± 4.6] Vs controls [3.7 ± 3.1] [4.7 ± 3.9]).

CONCLUSIONS

Although the present study is limited by the low response rate and its cross-sectional design, present results highlighted that systemic sclerosis has a negative impact on OHRQoL of the affected individuals; hence, the evaluation of associated psychological impact including anxiety and depression symptoms is needed to better understand, monitor and evaluate the disease comorbidity in patients with SSc.

Systematic Review of the Impact of Inflammatory Arthritis on Intimate Relationships and Sexual Function

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.

The impact of systemic sclerosis on health-related quality of life assessed by SF-36: A systematic review and meta-analysis

OBJECTIVE

The purpose of this meta-analysis was to systematically review the literature to evaluate the impact of systemic sclerosis (SSc) on the health-related quality of life (HRQoL) assessed by the Medical Outcomes Short-Form-36 questionnaire (SF-36).

METHODS

A systematic literature search was performed on PubMed, Web of Science and Embase until April 2017 to obtain eligible studies. Random effect model was performed to summarize the scores of each domain. Scores from the SF-36 questionnaire were used as the outcome measurements, and mean differences with 95% confidence intervals were calculated.

RESULTS

In total, seven studies were eligible for inclusion criteria, comprising 795 SSc patients and 1154 healthy controls. The SF-36 questionnaire score of each domain (physical function, role physical function, emotional role function, vitality, mental health, social function, body pain, general health) was lower in SSc patients than in healthy controls, meanwhile, physical component scale (PCS) and mental component scale (MCS) scores were all lower in patients with SSc than in healthy controls. Likewise, pooled mean scores of PCS and MCS ranged from 31.20 to 52.80, 37.40 to 68.30, respectively. Additionally, the score of PCS was lower than that of MCS in SSc patients.

CONCLUSIONS

This meta-analysis showed that SSc patients had lower HRQoL than healthy controls, and SSc had negative influence on the HRQoL of patients. This indicates that clinical workers should pay more attention to SSc patients' HRQoL, so as to improve global health of patients with SSc.

The clinical relevance of sexual dysfunction in systemic sclerosis

Systemic sclerosis is a chronic multi-organ autoimmune disease, leading to important clinical and psychological implications. Among organ complications, sexual dysfunction is a major issue for both male and female gender, with high prevalence and great impact on quality of life, although frequently not addressed by both clinicians and patients. While erectile dysfunction is the most common cause of sexual problems in males, genital tract and general physical changes are major contributors to sexual impairment in females. This review presents current state of the art on this topic, discussing published data on presentation, evaluation and therapeutic options.

Psychosocial Aspects of Scleroderma

Patients with systemic sclerosis (SSc; also called scleroderma) have to cope with not only the physical impacts of the disease but also the emotional and social consequences of living with the condition. Because there is no cure for SSc, improving quality of life is a primary focus of treatment and an important clinical challenge. This article summarizes significant problems faced by patients with SSc, including depression, anxiety, fatigue, sleep disruption, pain, pruritus, body image dissatisfaction, and sexual dysfunction, and describes options to help patients cope with the consequences of the disease.