ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1637

Sexual Function in Married Indian Women with Systemic Lupus Erythematosus

Benzeeta Pinto1, Sandeep Grover2, Manish Rathi3 and Aman Sharma4, 1PGIMER, CHANDIGARH, India, 2PGIMER, Chandigarh, India, 3Department of Nephrology,, Postgraduate Institute of Medical Education and Research, Chandigarh, India, 4Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords:

Session Information

Date: Monday, November 6, 2017

Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster II: Damage and Comorbidities

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: This study was carried out to evaluate the impact of disease activity, damage, marital satisfaction, fatigue, psychiatric comorbidity and QoL on sexual function in women with SLE.

Methods: Hundred and twelve premenopausal married women with SLE were included in a one year prospective longitudinal study. Disease activity and damage were assessed using SELENA–SLEDAI and SLICC/ACR damage Index (SDI) respectively. Female sexual function index (FSFI) and Couple Satisfaction Index (CSI) were used to evaluate sexual function and marital satisfaction. QoL was assessed using LupusPRO. Depression, anxiety and Fatigue were assessed using Patient Health Questionnaire 9 (PHQ9), Generalised Anxiety Disorder 7 (GAD7) and Fatigue severity scale (FSS).

Results: The mean age was 34.0±6.8 years. Mean SELENA SLEDAI was 3.67±4.2 and mean SDI was 0.25±0.62. Median steroid dose was 7.5mg of prednisolone. Impaired sexual function was found in 60.7%. More than 90% of the patients reported problems in desire, arousal and lubrication (Table 1). Seventy four percent of the patients had dysfunction in one or more domains. SLEDAI and dose of steroids had a negative correlation with total score of FSFI (Table 2). The mean score of CSI was 130.39±26.17. Eighteen patients (16.1%) had CSI lower than the cut off score (104.5) suggestive of marital distress. There was a significant correlation between FSFI and CSI (r=0.343, p<0.001).  There was a correlation between lupus symptoms, cognition, pain vitality, coping, satisfaction with care and total non HRQoL scores of LupusPRO and total score of FSFI (Table 3). On multivariate regression significant predictors of sexual function were couple satisfaction, corticosteroid dose and SLEDAI (adjusted R square=0.349, p=0.014).

Conclusion: Sexual function is impaired in women with SLE. Disease activity and marital satisfaction were the most important factors influencing sexual function.

Table 1: Female sexual function index in 112 patients and comparison with other studies

     Domain

Cut off scores (Min, Max)

% of Patients with scores    <  cut off

 Our study

(n=112)

 

Morales et al (n=65)

Tseng et al

(n=171)

Desire

4.28  (1.2,6)

104 (92.9%)

2.97 ± 1.08

3.24 ± 1.49

3.1 ± 0.9

Arousal

5.08  (0,6)

106 (94.6%)

2.80 ± 1.55

3.92 ± 1.74

4.0 ± 1.0

Lubrication

5.45 (0,6)

102 (91.1%)

3.6 ± 1.82

3.80 ± 1.93

4.8 ± 0.9

Orgasm

5.05 (0,6)

76 (67.9%)

3.8 ± 1.98

4.22 ±1.85

4.6 ± 1.0

Satisfaction

5.04 (0,6)

59 (52.7%)

4.51 ± 1.76

4.67 ± 1.65

4.9  ± 1.1

Pain

5.51 (0.8,6)

53 (47.3%)

4.42 ±  2.19

4.11 ± 2.03

4.4 ± 1.1

Total Score

26.55 (2,36)

68 (60.7%)

22.14 ± 9.22

24.45 ± 8.04

25.7 ±  4.7

Table 2: Spearman correlation of various domains of FSFI  with demographic and disease characteristics

 

Desire

Arousal

Lubrication

Orgasm

Satisfaction

Pain

Total FSFI

Age                                 

                               

-0.121

(0.202)

-0.028

(0.769)

-0.061

(0.52)

-0.062

(0.517)

-0.078

(0.412)

0.202(*)

(0.033)

-0.049

(0.606)

Duration of marriage     

 

-0.17

(0.073)

-0.125

(0.188)

-0.115

(0.225)

-0.093

(0.328)

-0.124

(0.194)

0.280(**)

(0.003)

-0.091

(0.341)

No of living children

-0.108

(0.258)

-0.059

(0.539)

-0.051

(0.595)

0.062

(0.514)

0.004

(0.967)

0.271(**)

(0.004)

0.031

(0.743)

Disease duration

0.058

(0.546)

0.077

(0.418)

0.093

(0.329)

0.007

(0.945)

0.049

(0.606)

0.198(*)

(0.037)

0.087

(0.36)

SLEDAI

-0.256(**)

(0.006)

-0.227(*)

(0.016)

-0.187(*)

(0.048)

-0.178

(0.061)

-0.15

(0.114)

-0.286(**)

(0.002)

-0.209(*)

(0.027)

SDI

-0.023

(0.813)

-0.118

(0.214)

-0.053

(0.58)

-0.086

(0.365)

-0.142

(0.134)

0.008

(0.935)

-0.098

(0.306)

Dose of Steroids

-0.172

(0.082)

-0.276(**)

(0.004)

-0.253(**)

(0.01)

-0.221(*)

(0.024)

-0.248(*)

(0.011)

-0.141

(0.152)

-0.258(**)

(0.008)

Marital  satisfaction (CSI)

0.304(**)

(0.001)

0.208(*)

(0.028)

0.173

(0.067)

0.351(**)

(<0.001)

0.353(**)

(<0.001)

0.304(**)

(0.001)

0.343(**)

(<0.001)

Fatigue (FSS)

-0.148

(0.118)

-0.227(*)

(0.016)

-0.111

(0.243)

-0.116

(0.224)

-0.137

(0.15)

-0.347(**)

(<0.001)

-0.186(*)

(0.05)

Depression (PHQ9)

-0.205(*)

(0.03)

-0.165

(0.082)

-0.182

(0.055)

-0.182

(0.055)

-0.066

(0.487)

-0.342(**)

(<0.001)

-0.195(*)

(0.039)

Anxiety (GAD7)

-0.219(*)

(0.021)

-0.138

(0.147)

-0.104

(0.274)

-0.207(*)

(0.029)

-0.104

(0.274)

-0.238(*)

(0.011)

-0.201(*)

(0.034)

*p<0.05,** p<0.01 {top line- Spearman Rho ;  bottom line – (p value)}

Table 3: Correlation of various domains of Lupus PRO with FSFI domains

 

Desire

Arousal

Lubrication

Orgasm

Satisfaction

Pain

Total FSFI

Lupus Symptoms   

0.136

0.228(*)

0.153

0.211(*)

0.092

0.419(**)

0.206(*)

                       

(0.153)

(0.016)

(0.108)

(0.025)

(0.334)

(<0.001)

(0.029)

Cognition

0.298(**)

0.234(*)

0.093

0.142

0.057

0.291(**)

0.207(*)

 

(0.001)

(0.013)

(0.33)

(0.137)

(0.55)

(0.002)

(0.029)

Lupus Medication

0.159

0.039

-0.057

-0.007

0.018

0.154

0.026

 

(0.093)

(0.683)

(0.554)

(0.939)

(0.848)

(0.104)

(0.786)

Procreation

0.004

-0.06

-0.144

-0.086

-0.008

0.106

-0.058

 

(0.963)

(0.53)

(0.131)

(0.366)

(0.931)

(0.266)

(0.545)

Physical Health

0.139

0.198(*)

0.08

0.056

0.07

0.174

0.116

 

(0.143)

(0.036)

(0.4)

(0.558)

(0.461)

(0.067)

(0.221)

Pain Vitality

0.213(*)

0.293(**)

0.13

0.218(*)

0.134

0.300(**)

0.245(**)

 

(0.024)

(0.002)

(0.172)

(0.021)

(0.158)

(0.001)

(0.009)

Emotional Health

0.227(*)

0.143

-0.024

0.087

0.083

0.193(*)

0.133

 

(0.016)

(0.133)

(0.804)

(0.363)

(0.386)

(0.042)

(0.161)

Body Image

0.176

0.271(**)

0.096

0.144

0.087

0.11

0.172

 

(0.063)

(0.004)

(0.316)

(0.13)

(0.361)

(0.247)

(0.07)

Desires-goals

0.102

0.154

0.107

0.074

0.051

0.145

0.118

 

(0.286)

(0.105)

(0.26)

(0.44)

(0.591)

(0.127)

(0.214)

Social Support

0.058

0.046

-0.083

0.082

0.104

-0.049

0.066

 

(0.545)

(0.628)

(0.382)

(0.389)

(0.277)

(0.606)

(0.489)

Coping

0.151

0.214(*)

0.162

0.295(**)

0.259(**)

0.086

0.257(**)

 

(0.112)

(0.023)

(0.087)

(0.002)

(0.006)

(0.368)

(0.006)

Satisfaction with care

0.092

0.208(*)

0.07

0.342(**)

0.224(*)

0.11

0.239(*)

 

(0.333)

(0.027)

(0.46)

(<0.001)

(0.018)

(0.249)

(0.011)

Total HRQOL

0.234(*)

0.235(*)

0.049

0.133

0.093

0.334(**)

0.179

 

(0.013)

(0.013)

(0.607)

(0.162)

(0.331)

(<0.001)

(0.059)

Total non HRQOL

0.121

0.210(*)

0.066

0.280(**)

0.220(*)

0.102

0.241(*)

 

(0.204)

(0.026)

(0.489)

(0.003)

(0.02)

(0.283)

(0.011)

*p<0.05, **p<0.01 {top line- Spearman Rho; bottom line – (p value)}

 

Disclosure: B. Pinto, None; S. Grover, None; M. Rathi, None; A. Sharma, None.

To cite this abstract in AMA style:

Pinto B, Grover S, Rathi M, Sharma A. Sexual Function in Married Indian Women with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/sexual-function-in-married-indian-women-with-systemic-lupus-erythematosus/. Accessed .

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