Sexual dysfunction in fi bromyalgia patients

ABSTRACTObjective.To investigate the preva-lence of sexual dysfunction in female patients with fi bromyalgia (FM), the impact of FM on sexual activity and the factors associated with sexual dysfunc-tion in these patients.Methods.Thirty-one consecutive wom-en with FM were enrolled; two groups of 20 aged-matched healthy women and 26 patients with rheumatoid arth-ritis (RA) were used as controls. Demo-graphic features were recorded in all patients. A cross-sectional analysis of pain (100-mm VAS scale), anxiety and depression (as determined by the STAI and Beck Depression Inventory scales, respectively) was performed. Sexual function was assessed by the Changes in Sexual Functioning Questionnaire (CSFQ).Results.FM and RA patients showed a signifi cantly higher rate of sexual dys-function compared to healthy controls. Sexual dysfunction was more frequent among FM patients (97%) than in RA patients (84%) but without statisti-cal differences. A univariate analysis showed that age (p=0.0002), marital (p=0.036) and work status (p=0.048), pain intensity (p=0.007), level of anxiety (p=0.002), level of depression (p=0.0005), were signifi cantly associ-ated with sexual dysfunction in FM. However, only the intensity of depres-sion was associated with the sexual dysfunction in patients with FM in the multivariate analysis (p=0.012).Conclusions. Sexual function was very frequently and severely affected in pa-tients with FM and this impairment appeared to be particularly associated with the degree of depression. The rec-ognition of this dysfunction and its in-clusion for the multidisciplanary man-agement of FM may contribute to im-prove quality of life of these patients.IntroductionFibromyalgia (FM) is a common chron-ic disorder affecting predominantly women and characterized by wide-spread pain and fatigue that may cause severe disability and impairment of quality of life. Sexual life is recognized as an important dimension of quality of life and it may be affected by different physical and psychosocial problems. (1-4). Sexual dysfunction has been studied in different chronic conditions but, although sexuality is considered an important domain of quality of life, sexual dysfunction in patients with FM has received relatively little attention and has rarely been addressed in the medical literature. We have investigat-ed the prevalence of sexual dysfunc-tion in female subjects with FM and the impact of this disease on the sexual activity as well as the main factors as-sociated with sexual dysfunction.Materials and methodsA cross-sectional analysis of pain, anxi-ety, depression and sexual dysfunction was performed in 31 consecutive wom-en with FM, according to the 1990 crite-ria of the American College of Rheuma-tology (ACR) (5), who were attending a rheumatology unit in a primary setting. Twenty aged-matched women consult-ing their general practitioners for minor illness (e.g., fl u symptoms or gastroen-teritis) and who were otherwise healthy were invited to participate as a control group. We also included a second con-trol group made up of female patients with rheumatoid arthritis (RA) accord-ing to the ACR criteria (6). As RA is an infl ammatory joint disease associated with chronic pain and affecting physi-cal function and quality of life, we in-cluded female RA patients without sig-nifi cant disability (functional class I-II) as an additional comparative group in order to evaluate possible differences in the sexual dysfunction profi le between these two very different conditions and as a reference to balance results between FM patients and the general population. Study entry was sequential in all groups. Women with gynecologic, hormonal, neurologic or any other con-dition known to affect sexual function were excluded. The study had ethics ap-proval and signed consent was obtained from all participants.Demographic features, including age, marital status and educational level were recorded in all patients. Current level of pain was evaluated using a 100-mm VAS scale. Anxiety and de-pression were determined using the self-reported and validated State-Trait