SAT0324 SEXUAL HEALTH IN WOMEN AND MEN WITH SYSTEMIC SCLEROSIS: A CROSS-SECTIONAL STUDY
Authors: B. Heřmánková, M. Špiritović, H. Smucrova, S. Oreska, H. Štorkánová, K. Bubova, K. Pavelka, J. Vencovský, L. Šenolt, R. Bečvář, M. Tomčík
Journal: Annals of the Rheumatic Diseases (2020)

Background: Systemic sclerosis (SSc) is a chronic multisystem disease that may affect all aspects of life including sexual function. Objectives: To assess sexual function, pelvic floor function in 80 women and 14 men with SSc compared to age-/sex-matched healthy controls (HC) and to analyze the potential impact of clinical features on sexual health. Methods: In total 80 women (mean age: 49, disease duration: 6.1 years, lcSSc/dcSSc: 53/27, mRSS: 9.3, ESSG activity index: 2.1) and 14 men with SSc (mean age: 51.6, disease duration: 3.1 years, lcSSc/dcSSc: 6/8, mRSS: 12.9, ESSG activity index: 2.2) who fulfilled the ACR/EULAR 2013 criteria, filled in 12 well-established and validated questionnaires assessing sexual function, pelvic floor function, quality of life, fatigue, physical activity and depression. Full names of questionnaires are listed in Table 1. These questionnaires were also completed by 80 healthy women and 14 healthy men with identical age. Data are presented as mean±SEM. Table 1. Clinical parameter Correlated parameters r p-value ESSG diseases activity index FSFI Arousal domain -0.300 p&lt;0.0001 IIEF EF -0.597 p=0.0240 CRP IIEF Orgasmic Function -0.668 p=0.0081 mRSS MSHQ Sexual Desire 0.555 p=0.0613 FIS BISF-W -0.410 p=0.0002 MAF FSFI -0.399 p=0.0002 BDI-II BISF-W -0.381 p=0.0002 IIEF EF -0.801 p=0.0005 HAP SQoL-F 0.383 p=0.0006 BISF-W 0.456 p&lt;0.0001 IIEF EF 0.639 p=0.0062 SHAQ FSFI - 0.409 p&lt;0.0001 BISF-W -0.451 p=0.0002 Name of Questionnaires/Acronyms: FSFI: Female Sexual Function Index; BISF-W: Brief Index of Sexual Function for Women; SQoL-F/M: Sexual Quality of Life Questionnaire-Female/Male; PISQ–12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form; PFIQ7: Pelvic Floor Distress Inventory Questionnaire; IIEF: International Index of Erectile Function; MSHQ: Male Sexual Health Questionnaire; FIS: Fatigue Impact Scale; MAF: Multidimensional Assessment of Fatigue; BDI-II: Beck’s Depression Inventory II; HAP: Human Activity Profile; SHAQ: Scleroderma Health Assessment Questionnaire; ESSG: European Scleroderma Study Group; CRP: C-reactive protein; mRSS: modified Rodnan skin score Results: Compared to HC, women with SSc had significantly higher prevalence and greater severity of sexual dysfunction [FSFI total score (SSc: 16.4±1.3, HC: 25.6±1.2, p&lt;0.0001) as well as in all subscales (p&lt;0.0001 for all), BISF-W total score (SSc: 17.2±2.3, HC: 32.0±1.9, p&lt;0.0001)], dysfunction of pelvic floor [(PISQ-12 (SSc: 3.6±0.7, HC: 8.9±0.6, p&lt;0.0001), PFIQ7 (SSc: 33.4±5.6, HC: 6.8±1.4, p&lt;0.0001)], and worse sexual quality of life [SQol-F (SSc: 55.3±3.3, HC: 82.1±2.1, p&lt;0.0001)]. Men with SSc also reported more severe sexual dysfunction: [IIEF - Erectile function (EF) (SSc: 15.4±3.0, HC: 26.2±2.1, p=0.004), IIEF - Orgasmic function (SSc: 6.4±1.2, HC:9.0±0.6, p=0.045), IIEF - Intercourse satisfaction (SSc: 9.7±1.8, HC: 15.7±1.3, p=0.008), MSHQ - Erectile Function (SSc: 9.0±1.2, HC: 12.9±0.9, p=0.005), MSHQ - Satisfaction (SSc: 19.2±2.1, HC: 26.8±0.9, p=0.001)] and worse sexual quality of life [SQol-M (SSc: 68.5±7.4, HC: 86.7±6.2, p=0.023)]. According to the IIEF classification, 71 % of SSc men reported mild to severe erectile dysfunction. No significant differences were found in pelvic floor function. Significant associations with major clinical parameters are presented in Table 1. Conclusion: Both women and men with SSc reported significantly impaired sexual function compared to HC with identical age. Worse scores in SSc were associated with disease activity, increased systemic inflammation, health status, physical activity, fatigue and depression. Acknowledgments : Supported by MHCR 023728, SVV 260373 and GAUK 1578119. Disclosure of Interests: Barbora Heřmánková: None declared, Maja Špiritović: None declared, Hana Smucrova: None declared, Sabina Oreska: None declared, Hana Štorkánová: None declared, Kristyna Bubova: None declared, Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Jiří Vencovský: None declared, Ladislav Šenolt: None declared, Radim Bečvář Consultant of: Actelion, Roche, Michal Tomčík: None declared