AB0263 SEXUAL FUNCTION IN WOMEN WITH RHEUMATOID ARTHRITIS: A CASE-CONTROL STUDY.
Authors: G. Serna-Peña, S. M. Sánchez Romo, O. Ilizaliturri Guerra, A. Cárdenas, D. Á. Galarza-Delgado, J. C. López Zamarrón
Journal: Annals of the Rheumatic Diseases (2020)

Background: Sexual dysfunction is defined as a change in any component of sexual activity, which may cause frustration, pain and decreased sexual intercourse 1 . Rheumatoid arthritis (RA) is a systemic autoimmune disease, which may lead to decline in joint mobility, pain, and fatigue; these impairments may influence the sexual health of patients 2 . Objectives: The main aim of this study is to determine if there is an altered sexual function in Mexican women with RA and compare if it occurs in a greater proportion than in healthy women. Methods: A case-control study that included Mexican women between 18 and 65 years, with RA diagnosis (according to ACR/EULAR 2010 criteria) and age-matched controls was performed. Patients were excluded if they couldn’t answer the questionnaires reliably or were currently pregnant. They were asked about their sexual activity in the last month, and the Arizona Sexual Experiences Scale (ASEX), Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Chronic Illness Therapy (FACIT) self-questionnaires were applied; disease activity was assessed by DAS-28. Variables were compared between groups with student T test for independent samples and chi-square. Results: We included 102 RA patients and 101 controls. Baseline demographic characteristics between groups are shown in Table 1. Women with RA had less sexual activity than controls (48.03% vs. 90.09%, p &lt;0.001). Out of the total women included, the ASEX was applied only to those that had an active sex life, 49 with RA and 91 controls. Sexual dysfunction (&gt; 18 points) was found in 55.1% of women with RA and in 52.74% of controls, with no significant differences (p = 0.860); the prevalence of severe fatigue was higher in RA than in the healthy group (p = 0.009) (Table 2). Women with RA and sexual dysfunction had higher levels of anxiety (p = 0.024) and fatigue (p = 0.008) than those with RA without sexual dysfunction; however, no significant difference was found in age, depression and level of disease activity between these groups. Table 1. Comparison of demographic variables between groups. RA GROUP (n=102) CONTROL GROUP (n=101) P* Age, years (±SD) 52.98 (+/-13.36) 52.45 (+/- 8.34) 0.738 Sexual activity in the last month, n (%) 49 (48.03%) 91 (90.09%) &lt;0.001 Civil status 0.456 Single, n (%) 26 (25.5%) 18 (17.82%) Married, n (%) 43 (42.2%) 55 (54.45%) Divorced, n (%) 15 (14.7%) 11 (10.89%) Domestic partnership, n (%) 5 (4.9%) 4 (3.96%) Widowed, n (%) 13 (12.7%) 13 (12.87%) Menopause, n (%) 70 (68.6%) 72 (71.28%) 0.760 Has children, n (%) 88 (86.3%) 83 (82.17%) 0.447 T de student or Chi-Square test according to type of variable Table 2. Difference in means of survey scores and frequencies of abnormal scores between groups. RA GROUP (n=49) CONTROL GROUP (n=91) P* ASEX score (±SD) 15.65 +/- 4.82 15.45 +/- 5.07 0.819 Sexual dysfunction, n (%) 27 (55.1%) 48 (52.74%) 0.860 HADS-A, anxiety subscale (±SD) 6.53 +/- 3.95 7.15 +/- 3.98 0.378 HADS- D, depression subscale (±SD) 5.34 +/- 4.12 4.32 +/- 3.20 0.108 Fatigue score (FACIT) (±SD) 34.42 +/- 9.52 39.21 +/- 8.37 0.003* Severe fatigue symptoms, n (%) 17 (34.69%) 13 (14.28%) 0.009* T de student or Chi-Square test according to type of variable * Statistically significant difference. High scores HADS, ASEX and low scores in FACIT indicate severity. Conclusion: In this study, women with RA have less sexual activity than healthy women, but no greater sexual dysfunction. Patients with RA and sexual dysfunction have more anxiety and fatigue; but they have no difference in age, disease activity and depression than those with RA and normal sexual function. References: [1]Henrique P, Queiroz T, Almeida D, et al. Como o reumatologista pode orientar o paciente com artrite reumatoide sobre func, ão sexual. Rev Bras Reumatol. 2014;55(5):458-463. [2]Zhao S, Li E, Wang J, Luo L, Luo J, Zhao Z. Rheumatoid Arthritis and Risk of Sexual Dysfunction : A Systematic Review and Metaanalysis. 2018;45(10). Disclosure of Interests: None declared