Effect of Musculoskeletal Pain on Sexuality of Male Adolescents and Adults with Juvenile Idiopathic Arthritis

Objective. To develop a questionnaire for the evaluation of sexuality of male patients with juvenile idiopathic arthritis (JIA). Methods. A cohort of male patients with rheumatoid factor (RF)-negative polyarticular JIA according to the 2004 revised ILAR criteria and inactive disease was studied. The Health Assessment Questionnaire (HAQ) was applied to all patients. As a control group, 120 age-matched males of the same socioeconomic status were evaluated. A self-administered structured instrument, the Male Sexual Evaluation Questionnaire (MSEQ), was developed by multiprofessional experts to assess sexual life, including satisfaction, practice, and related functional aspects. Results. Thirty-two male patients with RF-negative polyarticular JIA [mean age 20.8 ± 3.8 yrs (range 16–26), mean disease duration 15.4 ± 3.6 yrs (range 13–20)] were studied. Mean HAQ score was 1.25 ± 0.67 (range 0.1–2.1). Masturbation was practiced similarly by patients and controls (87.5% vs 91%; p > 0.999), although joint pain was observed in only 2 (7%) patients. Regular sexual intercourse (≥ once/week) was reported by 78% of patients and 62% of controls (p = 0.86). Joint pain during intercourse was more frequent in patients (48% vs 3% in controls; p < 0.001). The mean HAQ score was higher in the 12 patients with joint pain (hips = 3, knees = 5, and hips + knees = 4) during intercourse compared to the 13 patients without joint pain (1.82 ± 0.27 vs 1.43 ± 0.32; p < 0.05). Preserved desire and satisfaction were universal findings for all JIA patients and controls. Conclusion. The MSEQ was applicable to this cohort of male patients with RF-negative polyarticular JIA and showed that sexual life is preserved despite longterm disease, morbidity/functional dysfunction, and joint pain.