Abstract
Objective Due to its multisystemic involvement, Systemic Lupus Erythematosus (SLE) can have a significant impact on quality of life (QoL). Sexual (dys)function is a key component of QoL but is often underappreciated. Little is known about sexual dysfunction in SLE patients, a condition that primarily affects women during fertile age. We aimed at determining the prevalence of sexual dysfunction among SLE women and predictors thereof.
Methods We performed a cross-sectional multicentre study in which women (18–70 years-old) with a clinical diagnosis of SLE were included. An anonymous online questionnaire was performed where data on demographics, symptoms of depression and anxiety (HADS), health-related QoL (SF36) and sexual function (Female Sexual Function Index [FSFI] - a 19-item patient-report outcome that assesses female sexual function) were collected. Data on clinical features (disease activity according to the SELENA-SLEDAI, organ involvement and evaluation of comorbidity [Charlson Comorbidity Index]) and on treatment status were collected from medical records. The main outcome was sexual dysfunction, defined as FSFI<26.5 (validated cut-off). A multivariable logistic regression was performed to test the association of clinical and demographic characteristics with sexual dysfunction (present vs absent).
Results In total, 194 female patients with SLE were included (mean age 44 years-old [SD 11]). The mean SELENA-SLEDAI score was 1.7 (SD 2.2), corresponding to low disease activity, and 94% of patients were on cDMARD’s. The mean value of HADS was 9 (0–21), for both depression and anxiety scores. Regarding SF36, the mental component had a mean value of 61 (0–100) and the physical one of 70 (0–100). Sexual dysfunction was present in 128 (66%) patients.
In the multivariable analysis (table 1), older age (OR: 1.04; 95%CI: 1.01; 1.07), higher SELENA-SLEDAI (OR: 1.18; 95%CI: 1.01; 1.40), higher HADS depression score (OR: 1.20; 95%CI: 1.01; 1.43), as well as a lower (that is, worse) SF36 mental component score (OR: 0.97; 95%CI: 0.95; 0.98) were independently associated with sexual dysfunction.
Conclusion Sexual dysfunction is common in women with SLE and is influenced by both physical and mental health components. Clinicians should consider both for the optimal management of their patients in order to improve their sexual QoL.
