London, United Kingdom—More than one-third of patients with rheumatoid arthritis (RA) who are still sexually active experience sexual dysfunction. And yet, this topic is rarely, if ever, addressed in discussions with rheumatologists, according to the investigators of a study presented at the 2016 European League Against Rheumatism Annual Congress.
“Sexuality is an important dimension of an individual’s personality, and sexual problems can have a seriously detrimental impact on a couple’s relationship,” stated the study’s co-investigator, Pedro Santos-Moreno, MD, Director, Biomab, Centre for RA, Bogota, Colombia. “It is therefore rather surprising that up until now, very little quality research on sexual disturbances in patients with RA has been published in the literature, bearing in mind how common the problems are.”
“The true percentage of patients with sexual dysfunction is probably closer to 50% in the real world,” he added.
The descriptive, cross-sectional study included 1298 patients with RA (1048 women, and 250 men), with an average age of 55.1 years. Forty percent of women reported having no sexual activity, whereas 60% reported that they did. Of the women who were sexually active, only 60% found it satisfactory. Thirty percent of men reported having no sexual activity; of the 70% who were sexually active, 50% found it satisfactory.
Overall, 36% of the women and 34% of the men reported having sexual problems that included lack of desire, dissatisfaction with their sexual life, dyspareunia, orgasmic dysfunction, and premature ejaculation.
The investigators explored precipitating, predisposing, and maintenance factors that could be related to sexual dysfunction in patients with RA.
Precipitating factors for sexual dysfunction were infidelity (33% of women, and 6% of men), insecurity in sexual role (32% of women, and 16% of men), and biological or physical causes (17% of women, and 3% of men). The following predisposing factors were reported in women and men, respectively: image changes (14% and 21%), infidelity (13% and 7%), loss of attraction (1.4% and 10%), and anxiety in 2% of both sexes.
“We also saw a strong correlation between no sexual activity and high disease activity as reported on the [Disease Activity Score 28],” Dr Santos-Moreno said.
“We consider it essential to have a psychologist with expertise in sexual function available to our patients,” he explained. “At our center, we see about 4000 patients with RA per year, and every patient must be seen by a psychologist 3 times a year.”
Dr Santos-Moreno suggested that future avenues of research include studying the effectiveness of specific psychotherapeutic interventions for sexual disorders.
Villarreal L, Santos-Moreno P, Bello J, et al. Precipitating, predisposing and maintenance factors associated with sexual disorders in patients with rheumatoid arthritis. Presented at: 2016 European League Against Rheumatism Annual Congress; June 8-11, 2016; London, United Kingdom. www.abstracts2view.com/eular/view.php?nu=EULAR16L_OP0308-HPR-A&terms=. Accessed July 18, 2016