Sexual dysfunction prevalent in RA and PsA patients

According to a Spanish study, patients with rheumatoid arthritis and psoriatic arthritis have a markedly deteriorated sexual life compared with a healthy population.

The CSFQ-14 standardised questionnaire was used by all participants

Although previous studies hinted at a higher frequency of sexual dysfunction in RA and PsA, most studies were of low quality regarding the study design. “Most studies lack a control group,” said Dr Carlos Valera-Ribera (Doctor Peset University Hospital, Spain). Therefore, he and his team performed a cross-sectional observational study, in which patients diagnosed with PsA and RA were compared with a control group of healthy individuals. Included were 188 adult patients of any sexual orientation in 2 different university hospitals.

The researchers collected different variables, including age, gender, year of diagnosis, perceived health, marital status, level of education, income, history of depression, and treatment for mental health disease. All participants completed the 14-item Changes in Sexual Functioning Questionnaire (CSFQ-14), a standardised questionnaire used to evaluate changes in sexual function due to disease or medication in 4 different domains: pleasure, desire, arousal, and orgasm. A regression model was created to estimate the influence of the collected variables on the obtained results.

Dysfuntion was experienced in 48.15% of RA, 30.43% of PsA and 5.88% of control group patients

Of the 188 participants (52.7% women), 72 had a diagnosis of PsA and 27 of RA. They were compared with 89 healthy individuals matched by age (mean 48 ± 12.5 years). More than half of the participants assessed their own health as “good” or “very good”. Interestingly, 77.7% had a personal history of depression, which did not correlate significantly with sexual dysfunction. In contrast, age, employment status, and level of income were associated with the risk of sexual dysfunction, consistent with earlier findings from studies including patients with rheumatic diseases.

Around 80% of the participants were in a relationship. Nearly half of patients with RA (48.15%) experienced sexual dysfunction compared with 30.43% in the PsA group and only 5.88% in the control group. All the domains of the CSFQ-14 questionnaire were negatively affected by being diagnosed with PsA or RA (P<0.001). In general, men were more severely affected. The odds ratio of sexual dysfunction was 8.7 times higher in PsA patients and 10 times higher in RA patients.

Dr Valera-Ribera concluded that sexual health must be considered a holistic part of care. The CSFQ-14 is a valuable tool for the management of sexual health in people with rheumatic diseases.

1. Valera-Ribera C, et al. Impact of chronic joint diseases on the sexual sphere with regard to a healthy population: a multicenter study. OP0139, EULAR 2022, 1–4 June, Copenhagen, Denmark.