Systemic lupus erythematosus (SLE) patients from Brazil and rheumatoid arthritis (RA) patients from France report that their rheumatic conditions negatively affect their emotional relationships and sex lives, according to research presented at EULAR 2010, the Annual Congress of the European League Against Rheumatism in Rome, Italy. Furthermore, findings of the French study specifically revealed a strong correlation between RA disease severity and impact on sex life.
Results of a French study of 1,271 patients (average age 64, 98% receiving treatment) showed that 66% of patients reported that their RA symptoms had negatively impacted their sexual relationships, and 40% reported RA was the sole reason for not being sexually active. For sexually active patients, the main physical problems reported in the RA study were a decrease or absence of libido, reported by 47%, and pain or stiffness in the joints reported by 24%. A mean Health Assessment Questionnaire (HAQ*) score of 1.23 was reported by participants, indicating that RA had a moderate to severe level of impact on their physical functioning.
The study findings also showed that in addition to physical problems, significant emotional consequences were experienced with 39% of RA patients reporting feelings of guilt and frustration. Despite the high physical and emotional impact of RA on their sexual activity, 72% of participants said that they had never talked about the affect of the condition on their sex lives with their physician, with 66% unwilling to address the issue and 62% not considering they needed any help.
"Our study has shown that there is a link between rheumatic disease activity and the negative impact this has on the sex lives of many of our patients," said Professor Gisela Kobelt, Health Economist, Visiting Professor at Lund University, Sweden and President of Rheumatology, Association Nationale de Dιfense contre l'Arthrite Rhumatoοde (ANDAR), Paris, France and lead author of the French study. "What is worrying is that patients are often reluctant to speak to their doctor about this, which means they continue to suffer both physically and emotionally. We encourage doctors to initiate conversations with patients to offer support to those that may benefit."
The results of a separate study of 125 Brazilian women, all of whom were receiving treatment for SLE (mean age 32 years, 52.8% of SLE group married vs 27.5% of controls) showed statistically significant differences between sexual activities reported between patients with SLE and healthy controls including: absence of sexual activity (31.2% vs. 12.5% respectively (p=<0.05)), absence of arousal during sex (58.4% vs. 17.5% (p=<0.05)) and absence of orgasm (67.2% vs. 22.5% respectively (p=<0.05)).
Study designs and key statistics
In the French study, 1,271 (38%) of patients responded to a pre-tested questionnaire distributed to all members of ANDAR, a national RA patient association. The research team collated information on current treatments with 98% of patients receiving treatment at the time of survey, 41% of whom were receiving biological therapies. Twenty percent of patients scored ≤2 in the Health Assessment Questionnaire*, indicating a high impact on health was associated with the condition).
In the Brazilian study, 165 women with SLE registered at the Rheumatology Unit of the State University of Campinas, Brazil, were asked to fill out the Short Personal Experiences Questionnaire (SpeQ) anonymously. Responses were compared against those from 40 healthy women, matched by age, education and socio-economic status. Seventy-five percent of women approached completed the questionnaire, with a mean age of 32 years for the SLE group and 30 years for the control group. Fifty-two percent of patients with SLE reported having current sexual partners vs. 92.5% of controls (p=<0.05) with 32.8% of SLE patients reporting being currently single vs. 72.5% of controls. Abstract Numbers: FRI0131 & AB0411
* Note: HAQ (health assessment questionnaire) is a disability index used by physicians to measure an individual's physical functioning. It assesses ability to undertake everyday activities such as dressing, eating and walking, and whether assistance from another person or disability aids is required. A higher score indicates greater disability.
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