Background/Purpose: Systemic sclerosis (SSc), or scleroderma, is a chronic, multi-system, connective tissue disorder characterized by thickening and fibrosis of the skin and internal organ involvement. Approximately 80% of patients are women, with highest onset rates between ages 30-60. Common problems include pain, fatigue, pruritus, body image distress, depressive symptoms, and general disability. Reduced sexual activity and impaired sexual functioning are also common among women with SSc and, in addition to age and marital status, are associated with disease severity and symptoms. To date, however, no studies have compared the rates of sexual activity and impairment of women with chronic medical disease to general population data. Thus, the objectives of this study were to 1) determine the rates of sexual activity and sexual impairment, stratified by age and marital status, for a SSc sample and a female population sample, 2) identify the odds of sexual activity and sexual impairment for women with SSc compared to the population sample, controlling for age and marital status, 3) identify the domains of sexual function (desire, arousal, lubrication, orgasm, and pain) most closely related to impairment in SSc compared to the general population, and 4) assess the association between sexual domain scores and sexual satisfaction in SSc versus the general population.

Methods: Female SSc patients from the Canadian Scleroderma Research Group Registry were compared to females from a UK population sample. SSc patients were asked whether they had engaged in sexual activities with a partner in the past 4 weeks. Sexually active patients completed a 9-item version of the Female Sexual Function Index (FSFI) and an item on sexual satisfaction. Women from the UK completed the FSFI as part of a study on female sexual dysfunction. Multivariate logistic regression analyses were used to assess the independent association of sample group with sexual activity and impairment status. Analysis of covariance was used to assess differences in sexual domain scores in both samples, controlling for total FSFI scores. Pearson’s correlations were used to assess the association between sexual domain scores and sexual satisfaction.

Results: Among 730 women with SSc, 296 (41%) were sexually active, 181 (61%) of whom were sexually impaired. Among 1,498 women in the population sample, 956 (64%) were sexually active, 420 (44%) of whom were impaired. Adjusting for age and marital status, women with SSc were significantly less likely to be sexually active (OR=0.34, 95%CI=0.28-0.42) and significantly more likely to be sexually impaired (OR=1.88, 95%CI=1.42-2.49), compared to women from the general population. Adjusting for total FSFI scores, women with SSc had significantly worse lubrication and pain scores than women in the general population. All domains were substantially more highly correlated with satisfaction among women with SSc compared to population sample women.

Conclusion: This study highlights that sexual functioning is a problem for many women living with scleroderma and that it is associated with pain and poor lubrication, two known problems for women with SSc.

 

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/sexual-activity-and-sexual-functioning-among-women-with-systemic-sclerosis-compared-to-women-from-a-population-sample/