Background/Purpose: Systemic sclerosis (SSc) is a chronic, multisystem, connective tissue disorder characterized by fibrosis of the skin and internal organ involvement, which can influence all aspects of life including sexual life. The aim of this study was to assess sexual functioning in female SSc patients compared to age-/sex-matched healthy controls (HC) and to determine the association between sexual health impairment and disease activity, treatment, physical and psychological aspects of the disease.

Methods: In total, 60 women (45 currently have a partner) with SSc (mean age: 49.5, disease duration: 6.2 years, lcSSc/dcSSc: 38/22, mRSS: 11.0, ESSG activity index: 2.4), who fulfilled the ACR/EULAR 2013 criteria, and 60 healthy controls (54 currently have a partner, mean age: 49.5) without rheumatic diseases filled in 12 well-established and validated questionnaires assessing sexual function (FSFI, SFQ28, BISFW, PISQ-12), quality of sexual life (SQoL-F), pelvic floor function (PFIQ-7), fatigue (FIS, MAF), physical activity (HAP), severity of functional impairment (SHAQ – only in SSc patients) and depression (BDI-II). A standard laboratory testing was performed. Data are presented as mean ± SEM.

Results: Patients with SSc had significantly higher prevalence and greater severity of sexual dysfunction (FSFI, BISF-W, SFQ28, PISQ-12 – in all subscales as well as total scores) and worse sexual quality of life (SQoL-F) compared to HC (table). Worse scores in SSc patients were associated with increased inflammation [CRP: FSFI (r=-0.260, p=0.0499), BISF-W (r=-0.273, p=0.0398), SFQ28 Pain Domain (r=-0.362, p=0,0056], disease activity [ESSG activity score: FSFI Pain Domain (r=-0.297, p=0.0210), FSFI Satisfaction Domain (r=-0.263, p=0.0423), PISQ-12 (r=0.403, p=0.0024)], more severe functional impairment [SHAQ: FSFI (r=-0.526, p< 0.0001), BISF-W (r=-0.477, p< 0.0001], greater fatigue [FIS: FSFI (r=-0.490, p< 0.0001), BISF-W (r=-0.458, p=0.0002), MAF: FSFI (r=-0.358, p=0.0011), BISF-W (r=-0.378, p=0.0030)], more severe depression [BDI-II: FSFI (r=-0.411, p< 0.0001), BISF-W (r=-0.419, p=0.0008)], deteriorated quality of life [HAQ: FSFI (r=-0.342, p=0.0073)], and worse ability to perform physical activities [HAP: FSFI (r=0.509, p< 0.0001), BISF-W (r=0.474, p=0.0002)]. No associations were found with disease duration, current prednisone equivalent dose or skin score.

Conclusion: Conclusion: Women with SSc reported significantly impaired sexual function and sexual quality of life and pelvic floor function than healthy controls with identical age. Worse scores in SSc were associated with disease activity, increased inflammation, more severe functional impairment, physical inactivity, fatigue, depression and decreased quality of life.

Acknowledgements: Supported by MHCR 023728 and GA UK 1578119

Table1_Results_SSc_ACR2019

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/sexual-health-in-60-female-patients-with-systemic-sclerosis/