Sexual function in Italian women with systemic sclerosis is affected by disease-related and psychological concerns

J Rheumatol. 2013 Oct;40(10):1697-705. doi: 10.3899/jrheum.121540. Epub 2013 Sep 1.

Abstract

Objective: In patients with systemic sclerosis (SSc), sexual function is somewhat impaired. Our aim was to evaluate sexual function in women with SSc in comparison to controls, and to investigate the association with sociodemographic and disease characteristics, and physical and psychological variables.

Methods: Forty-six women with SSc and 46 healthy women were assessed for sociodemographic characteristics and gynecological development and administered the Female Sexual Function Index (FSFI), Medical Outcomes Study Short Form-36 (SF-36), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale, Coping Orientation to Problems Experienced-New Italian Version, and Functional Assessment of Chronic Illness Therapy-Fatigue Scale. Patients were also assessed for disease duration and subset, Female Sexual Function in SSc, Hand Mobility in Scleroderma test (HAMIS), Cochin Hand Functional Disability Scale, Mouth Handicap in Systemic Sclerosis Scale (MHISS), Disability Sexual and Body Esteem Scale (PDSBE); and fist closure, hand opening, and mouth opening.

Results: In patients with SSc, only FSFI desire subscale score was significantly lower (p = 0.035) versus controls. Total FSFI score, similar to controls, was related with Medical Outcomes Study Short Form-36 mental component, HAQ (p = 0.022), MHISS (p = 0.038), and HAMIS (p = 0.037). In SSc, the main factors independently associated with sexual functioning were vaginal dryness [regression coefficient (B) = -0.72; p < 0.001], PDSBE (B = 0.42; p = 0.001), and HADS depression scale (B = -0.23; p = 0.035). Together, these variables explained 70% of the variance in the FSFI total score.

Conclusion: In SSc, sexual function, although not different from controls, is influenced by specific disease-related and psychological concerns. Thus it should be included in patient evaluations and assessed in daily clinical practice.

Keywords: FEMALE SEXUAL FUNCTION INDEX; QUALITY OF LIFE; SEXUAL ABILITY; SYSTEMIC SCLEROSIS.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Anxiety / diagnosis
  • Anxiety / psychology
  • Depression / diagnosis
  • Depression / psychology
  • Disability Evaluation
  • Disabled Persons / psychology*
  • Female
  • Humans
  • Italy
  • Libido / physiology*
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Quality of Life / psychology*
  • Scleroderma, Systemic / psychology*
  • Self Concept
  • Severity of Illness Index
  • Sexual Behavior / psychology*
  • Stress, Psychological / diagnosis
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires