In Women With Systemic Sclerosis Sexual Function Is Affected By Disease-Related And Psychological Concerns

Objective. In Systemic Sclerosis (SSc) patients, sexual function is somewhat impaired. Our aim is to evaluate sexual function in women with SSc in comparison to controls and to investigate the association with socio-demographic and disease characteristics, physical and psychological variables. Methods. 46 women with SSc (age: 56.1 ± 12.4 years; 29 with lSSc, 17 with dSSc) and 46 healthy women (age: 52.0 ± 9.0 years) were assessed for sociodemographic characteristics, gynecological anamnesis and administered with Female Sexual Function Index (FSFI), Short Form-36 (SF36), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (RSES), Coping Orientation to Problems ExperiencedNew Italian Version (COPE-NIV), Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F). Patients were also assessed for disease duration and subset, Female Sexual Function in SSc (FSFS), Hand Mobility In Scleroderma Test (HAMIS), Cochin Hand Functional Disability Scale (CHFDS), Mouth Handicap in Systemic Sclerosis Scale (MHISS), Disability Sexual and Body Esteem Scale (PDSBE); fist closure, hand opening and mouth opening. Results. In SSc patients, only FSFI desire subscale score was significantly lower (p=0.035) versus controls. FSFI scores were not different in dSSc versus lSSc patients (P=NS). Total FSFI score, similar to controls, by bivariate analysis was negatively correlated with age (p=0.014), HADS-d (p<0.001), FACIT-F (p=0.044), COPE-NIV Avoidance Strategies subscale (p=0.012); and positively related with PDSBE (p<0.001), SF-36 summary mental index (p=0.006) scales. FSFI total score was also negatively correlated to HAQ (p=0.022), total MHISS (p=0.038) and HAMIS (p=0.037) scores. At multivariate analysis, in SSc, the factors independently associated with FSFI were vaginal dryness (B=-0.72; p<0.001), PDSBE (B=0.42; p=0.001) and HADS depression scale (B=-0.23; p=0.035). Together, these variables explained 70% of the variance in total FSFI. At multivariate analysis in healthy participants, the factors independently associated with FSFI were age (B=-0.47; p=0.001), FACIT-F (B=-0.36; p=0.006), physical problems PP subscale of SF-36 (B=0.29; p=0.02) and COPE-NIV transcendental orientation scale (B=-0.24; p=0.037), together, explaining 44% of the variance in total FSFI. Conclusion. In SSc, sexual function, although not different from controls, is influenced by specific disease-related and psychological concerns, different from variables affecting sexual function in healthy controls. Thus, it should be included in patients evaluation and assessed in daily practice.