N03 The impact of IBD on sexual health: a gender-based cross-sectional comparison with a non-IBD population
Authors: Pérez Martínez Z , Oller E , L Hamilton A , Herrera de Guise C , Mayorga L , Céspedes E , Serra X , Lastiri E , Zuriguel E , Robles V , Borruel N 
Published: January 2025

Abstract

Background
Sexual dysfunction (SD) is common in patients with Inflammatory Bowel Disease (IBD), yet previous research identified depression as a key confounding factor. This is the first study to exclude participants with depression, aiming to isolate the impact of IBD on sexual health.

Methods
Adults with confirmed IBD and non-IBD controls were enrolled. A Hospital Anxiety and Depression Scale1 (HADS) score &gt;16 was an exclusion criteria. Sexual function was assessed with validated tools: the Sexual Desire Inventory2 (SDI) for all participants, Female Sexual Function Index3 (FSFI, cut off ≤26 for dysfunction) for women and the International Index of Erectile Function4 (IIEF, cut off ≤43 for dysfunction and ≤25 for erectile function). Disease activity was measured with Harvey-Bradshaw Index (HBI) for Crohn’s disease and Simple Clinical Colitis Activity Index (SCCAI) for Ulcerative Colitis.

Results
We screened 916 individuals, of whom 597 met inclusion criteria: 435 IBD and 162 non-IBD (Table 1). No overall differences were observed in SDI domains between IBD and non-IBD. However, among patients with active IBD, particularly in those aged 36 to 50, solitary desire was significantly lower compared to those in remission (P = 0.034).
In women, SD was more common in IBD versus non-IBD (37.6% vs 21.5%), with impairments in FSFI domains of arousal and pain (P = 0.023; P = 0.017). Women with active IBD had more SD (66.7% vs 34.1%), more pain and lower desire compared to those in remission (P &lt;.001; P = 0.006). Pain was especially common in IBD women aged 26 to 35 compared to non-IBD, regardless of disease activity (P =0.010). In addition, women aged 51 to 80 with active disease experienced pain, impairment in arousal and desire (P = 0.014; P = 0.031; P = 0.029). Furthermore, women with IBD showed a decrease in solitary sexual desire and dyadic sexual desire compared to women without IBD, with the decline in solitary desire being particularly significant in the 36-50 age group (P = 0.001; P = 0.023).
In men, no SD was observed overall. However, IIEF scores revealed that erectile dysfunction was more prevalent in men with active IBD versus remission (45% vs. 15.3%). Interestingly, solitary desire by SDI was higher in IBD men than those with non-IBD in the 36-50 age group (P = 0.050).

Conclusion
SD occurs in IBD patients regardless of disease activity and in the absence of depression. Women with IBD experience significant impairment in sexual function, including reduced desire, arousal, and increased pain. In men, IBD primarily impacts erectile function during active disease. These findings highlight the need for a tailored approach to sexual health in IBD that considers both gender and disease activity.

References
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