Comparison of sexual function in Tunisian women with rheumatoid arthritis and healthy controls

Objectives To evaluate sexual function in Tunisian women with rheumatoid arthritis (RA) and to compare it with that in voluntary healthy controls. Methods We conducted a cross-sectional study including 71 women with a confirmed diagnosis of RA according to the American College of Rheumatology/Europe...

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Veröffentlicht in:Clinical rheumatology 2019-12, Vol.38 (12), p.3361-3365
Hauptverfasser: Alia, Fazaa, Rim, Ben Saad, Miladi, S., Ouenniche, K., Kassab, S., Chekili, S., Zakraoui, L., Abdelghani, K. Ben, Laatar, A.
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container_end_page 3365
container_issue 12
container_start_page 3361
container_title Clinical rheumatology
container_volume 38
creator Alia, Fazaa
Rim, Ben Saad
Miladi, S.
Ouenniche, K.
Kassab, S.
Chekili, S.
Zakraoui, L.
Abdelghani, K. Ben
Laatar, A.
description Objectives To evaluate sexual function in Tunisian women with rheumatoid arthritis (RA) and to compare it with that in voluntary healthy controls. Methods We conducted a cross-sectional study including 71 women with a confirmed diagnosis of RA according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 Criteria and 71 healthy age-matched controls. Clinical and sociodemographic characteristics were collected. Patients and controls were asked to complete the Female Sexual Function Index (FSFI). It contains 19 questions, assessing six areas of female sexual function in the previous 4 weeks. The sexual dysfunction was defined as an FSFI score less than or equal to 26.55. The patients’ self-perception of their sexuality was assessed, and the frequency of sexual intercourse was noted. Results The prevalence of female sexual dysfunction in women with RA was 49.3% versus 23.9% in controls, with a significant difference ( p  = 0.002). Comparison between both groups as regards the mean of area scores of FSFI revealed that desire, arousal, and satisfaction in patients with RA were significantly lower than those in the control group ( p  = 0.05, p  = 0.038, and p  = 0.024, respectively). The score of lubrification, orgasm, and pain was comparable between the two groups. In univariate analysis, a significant association was found between sexual dysfunction and pain ( p  = 0.001), tender joint counts ( p  = 0.04), DAS28 ESR ( p  = 0.043), fatigue ( p  = 0.028), and functional disability ( p  = 0.02). No association was found between sexual dysfunction and treatment. In multivariate analysis, only pain was a predictive factor of sexual dysfunction in patients ( p  = 0.05, OR = 1.26 [1.16–1.3]). Based on patients’ self-perception of their sexual function, 26.1% of patients reported a negative impact of RA on their sex life. According to them, the main factors influencing sexuality were joint pain (60.6%) and fatigue (51%). Moreover, 59% of patients reported a decrease in the frequency of sexual intercourse after the diagnosis of RA. However, no statistically significant difference was found between patients and controls in the frequency of sexual intercourse ( p  = 1). Conclusion Our study suggests that patients with RA experience high level of impairment of sexual function in comparison with a control group. Health providers must consider sexual function as an important part of quality of life. A therapeutic education directed to
doi_str_mv 10.1007/s10067-019-04726-8
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Ben ; Laatar, A.</creator><creatorcontrib>Alia, Fazaa ; Rim, Ben Saad ; Miladi, S. ; Ouenniche, K. ; Kassab, S. ; Chekili, S. ; Zakraoui, L. ; Abdelghani, K. Ben ; Laatar, A.</creatorcontrib><description>Objectives To evaluate sexual function in Tunisian women with rheumatoid arthritis (RA) and to compare it with that in voluntary healthy controls. Methods We conducted a cross-sectional study including 71 women with a confirmed diagnosis of RA according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 Criteria and 71 healthy age-matched controls. Clinical and sociodemographic characteristics were collected. Patients and controls were asked to complete the Female Sexual Function Index (FSFI). It contains 19 questions, assessing six areas of female sexual function in the previous 4 weeks. The sexual dysfunction was defined as an FSFI score less than or equal to 26.55. The patients’ self-perception of their sexuality was assessed, and the frequency of sexual intercourse was noted. Results The prevalence of female sexual dysfunction in women with RA was 49.3% versus 23.9% in controls, with a significant difference ( p  = 0.002). Comparison between both groups as regards the mean of area scores of FSFI revealed that desire, arousal, and satisfaction in patients with RA were significantly lower than those in the control group ( p  = 0.05, p  = 0.038, and p  = 0.024, respectively). The score of lubrification, orgasm, and pain was comparable between the two groups. In univariate analysis, a significant association was found between sexual dysfunction and pain ( p  = 0.001), tender joint counts ( p  = 0.04), DAS28 ESR ( p  = 0.043), fatigue ( p  = 0.028), and functional disability ( p  = 0.02). No association was found between sexual dysfunction and treatment. In multivariate analysis, only pain was a predictive factor of sexual dysfunction in patients ( p  = 0.05, OR = 1.26 [1.16–1.3]). Based on patients’ self-perception of their sexual function, 26.1% of patients reported a negative impact of RA on their sex life. According to them, the main factors influencing sexuality were joint pain (60.6%) and fatigue (51%). Moreover, 59% of patients reported a decrease in the frequency of sexual intercourse after the diagnosis of RA. However, no statistically significant difference was found between patients and controls in the frequency of sexual intercourse ( p  = 1). Conclusion Our study suggests that patients with RA experience high level of impairment of sexual function in comparison with a control group. Health providers must consider sexual function as an important part of quality of life. A therapeutic education directed towards a patient could be proposed to approach sexuality. Key Points • The prevalence of female sexual dysfunction is higher in women with rheumatoid arthritis than in controls. • In multivariate analysis, the global pain intensity visual analog scale was the only predictive factor of sexual dysfunction in patients. • Based on patients’ self-perception, joint pain and fatigue are the main factors influencing sexuality.</description><identifier>ISSN: 0770-3198</identifier><identifier>EISSN: 1434-9949</identifier><identifier>DOI: 10.1007/s10067-019-04726-8</identifier><identifier>PMID: 31392560</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Adult ; Arousal ; Arthritis, Rheumatoid - complications ; Arthritis, Rheumatoid - psychology ; Case-Control Studies ; Diagnosis ; Fatigue ; Female ; Health risk assessment ; Humans ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Multivariate analysis ; Original Article ; Pain ; Pain perception ; Patients ; Quality of life ; Rheumatoid arthritis ; Rheumatology ; Self image ; Sexual Behavior ; Sexual Dysfunction, Physiological - epidemiology ; Sexual Dysfunction, Physiological - etiology ; Sexual intercourse ; Sexuality ; Statistical analysis ; Tunisia - epidemiology</subject><ispartof>Clinical rheumatology, 2019-12, Vol.38 (12), p.3361-3365</ispartof><rights>International League of Associations for Rheumatology (ILAR) 2019</rights><rights>Clinical Rheumatology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-9722faef30fcbd3addabfa0a5a42a684a89bced3c2a295a186a3eabcc228751c3</citedby><cites>FETCH-LOGICAL-c375t-9722faef30fcbd3addabfa0a5a42a684a89bced3c2a295a186a3eabcc228751c3</cites><orcidid>0000-0001-6192-5830</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10067-019-04726-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10067-019-04726-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31392560$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alia, Fazaa</creatorcontrib><creatorcontrib>Rim, Ben Saad</creatorcontrib><creatorcontrib>Miladi, S.</creatorcontrib><creatorcontrib>Ouenniche, K.</creatorcontrib><creatorcontrib>Kassab, S.</creatorcontrib><creatorcontrib>Chekili, S.</creatorcontrib><creatorcontrib>Zakraoui, L.</creatorcontrib><creatorcontrib>Abdelghani, K. Ben</creatorcontrib><creatorcontrib>Laatar, A.</creatorcontrib><title>Comparison of sexual function in Tunisian women with rheumatoid arthritis and healthy controls</title><title>Clinical rheumatology</title><addtitle>Clin Rheumatol</addtitle><addtitle>Clin Rheumatol</addtitle><description>Objectives To evaluate sexual function in Tunisian women with rheumatoid arthritis (RA) and to compare it with that in voluntary healthy controls. Methods We conducted a cross-sectional study including 71 women with a confirmed diagnosis of RA according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 Criteria and 71 healthy age-matched controls. Clinical and sociodemographic characteristics were collected. Patients and controls were asked to complete the Female Sexual Function Index (FSFI). It contains 19 questions, assessing six areas of female sexual function in the previous 4 weeks. The sexual dysfunction was defined as an FSFI score less than or equal to 26.55. The patients’ self-perception of their sexuality was assessed, and the frequency of sexual intercourse was noted. Results The prevalence of female sexual dysfunction in women with RA was 49.3% versus 23.9% in controls, with a significant difference ( p  = 0.002). Comparison between both groups as regards the mean of area scores of FSFI revealed that desire, arousal, and satisfaction in patients with RA were significantly lower than those in the control group ( p  = 0.05, p  = 0.038, and p  = 0.024, respectively). The score of lubrification, orgasm, and pain was comparable between the two groups. In univariate analysis, a significant association was found between sexual dysfunction and pain ( p  = 0.001), tender joint counts ( p  = 0.04), DAS28 ESR ( p  = 0.043), fatigue ( p  = 0.028), and functional disability ( p  = 0.02). No association was found between sexual dysfunction and treatment. In multivariate analysis, only pain was a predictive factor of sexual dysfunction in patients ( p  = 0.05, OR = 1.26 [1.16–1.3]). Based on patients’ self-perception of their sexual function, 26.1% of patients reported a negative impact of RA on their sex life. According to them, the main factors influencing sexuality were joint pain (60.6%) and fatigue (51%). Moreover, 59% of patients reported a decrease in the frequency of sexual intercourse after the diagnosis of RA. However, no statistically significant difference was found between patients and controls in the frequency of sexual intercourse ( p  = 1). Conclusion Our study suggests that patients with RA experience high level of impairment of sexual function in comparison with a control group. Health providers must consider sexual function as an important part of quality of life. A therapeutic education directed towards a patient could be proposed to approach sexuality. Key Points • The prevalence of female sexual dysfunction is higher in women with rheumatoid arthritis than in controls. • In multivariate analysis, the global pain intensity visual analog scale was the only predictive factor of sexual dysfunction in patients. • Based on patients’ self-perception, joint pain and fatigue are the main factors influencing sexuality.</description><subject>Adult</subject><subject>Arousal</subject><subject>Arthritis, Rheumatoid - complications</subject><subject>Arthritis, Rheumatoid - psychology</subject><subject>Case-Control Studies</subject><subject>Diagnosis</subject><subject>Fatigue</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Original Article</subject><subject>Pain</subject><subject>Pain perception</subject><subject>Patients</subject><subject>Quality of life</subject><subject>Rheumatoid arthritis</subject><subject>Rheumatology</subject><subject>Self image</subject><subject>Sexual Behavior</subject><subject>Sexual Dysfunction, Physiological - epidemiology</subject><subject>Sexual Dysfunction, Physiological - etiology</subject><subject>Sexual intercourse</subject><subject>Sexuality</subject><subject>Statistical analysis</subject><subject>Tunisia - epidemiology</subject><issn>0770-3198</issn><issn>1434-9949</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kE1r3DAQhkVIyG42-QM9BEEuubjRh21Zx7LkCwK9bK8VY1mOtdjSVpJp999Xm01T6KGXGRg98454EPpEyWdKiLiLudaiIFQWpBSsLpoTtKQlLwspS3mKlkQIUnAqmwW6iHFLCGGNpOdowSmXrKrJEn1f-2kHwUbvsO9xNL9mGHE_O51sHlmHN7Oz0YLDP_1kcrVpwGEw8wTJ2w5DSEOwyUYMrsODgTENe6y9S8GP8RKd9TBGc_XeV-jbw_1m_VS8fH18Xn95KTQXVSqkYKwH03PS67bj0HXQ9kCggpJB3ZTQyFabjmsGTFZAmxq4gVZrxhpRUc1X6PaYuwv-x2xiUpON2owjOOPnqBgThOQ13mT05h906-fg8u8yVUvGKlHLTLEjpYOPMZhe7YKdIOwVJepgXx3tq2xfvdlXh-jr9-i5nUz3sfJHdwb4EYj5yb2a8Pf2f2J_Azo7kfk</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Alia, Fazaa</creator><creator>Rim, Ben Saad</creator><creator>Miladi, S.</creator><creator>Ouenniche, K.</creator><creator>Kassab, S.</creator><creator>Chekili, S.</creator><creator>Zakraoui, L.</creator><creator>Abdelghani, K. Ben</creator><creator>Laatar, A.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6192-5830</orcidid></search><sort><creationdate>20191201</creationdate><title>Comparison of sexual function in Tunisian women with rheumatoid arthritis and healthy controls</title><author>Alia, Fazaa ; Rim, Ben Saad ; Miladi, S. ; Ouenniche, K. ; Kassab, S. ; Chekili, S. ; Zakraoui, L. ; Abdelghani, K. Ben ; Laatar, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-9722faef30fcbd3addabfa0a5a42a684a89bced3c2a295a186a3eabcc228751c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Arousal</topic><topic>Arthritis, Rheumatoid - complications</topic><topic>Arthritis, Rheumatoid - psychology</topic><topic>Case-Control Studies</topic><topic>Diagnosis</topic><topic>Fatigue</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Original Article</topic><topic>Pain</topic><topic>Pain perception</topic><topic>Patients</topic><topic>Quality of life</topic><topic>Rheumatoid arthritis</topic><topic>Rheumatology</topic><topic>Self image</topic><topic>Sexual Behavior</topic><topic>Sexual Dysfunction, Physiological - epidemiology</topic><topic>Sexual Dysfunction, Physiological - etiology</topic><topic>Sexual intercourse</topic><topic>Sexuality</topic><topic>Statistical analysis</topic><topic>Tunisia - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alia, Fazaa</creatorcontrib><creatorcontrib>Rim, Ben Saad</creatorcontrib><creatorcontrib>Miladi, S.</creatorcontrib><creatorcontrib>Ouenniche, K.</creatorcontrib><creatorcontrib>Kassab, S.</creatorcontrib><creatorcontrib>Chekili, S.</creatorcontrib><creatorcontrib>Zakraoui, L.</creatorcontrib><creatorcontrib>Abdelghani, K. Ben</creatorcontrib><creatorcontrib>Laatar, A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical rheumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alia, Fazaa</au><au>Rim, Ben Saad</au><au>Miladi, S.</au><au>Ouenniche, K.</au><au>Kassab, S.</au><au>Chekili, S.</au><au>Zakraoui, L.</au><au>Abdelghani, K. Ben</au><au>Laatar, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of sexual function in Tunisian women with rheumatoid arthritis and healthy controls</atitle><jtitle>Clinical rheumatology</jtitle><stitle>Clin Rheumatol</stitle><addtitle>Clin Rheumatol</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>38</volume><issue>12</issue><spage>3361</spage><epage>3365</epage><pages>3361-3365</pages><issn>0770-3198</issn><eissn>1434-9949</eissn><abstract>Objectives To evaluate sexual function in Tunisian women with rheumatoid arthritis (RA) and to compare it with that in voluntary healthy controls. Methods We conducted a cross-sectional study including 71 women with a confirmed diagnosis of RA according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 Criteria and 71 healthy age-matched controls. Clinical and sociodemographic characteristics were collected. Patients and controls were asked to complete the Female Sexual Function Index (FSFI). It contains 19 questions, assessing six areas of female sexual function in the previous 4 weeks. The sexual dysfunction was defined as an FSFI score less than or equal to 26.55. The patients’ self-perception of their sexuality was assessed, and the frequency of sexual intercourse was noted. Results The prevalence of female sexual dysfunction in women with RA was 49.3% versus 23.9% in controls, with a significant difference ( p  = 0.002). Comparison between both groups as regards the mean of area scores of FSFI revealed that desire, arousal, and satisfaction in patients with RA were significantly lower than those in the control group ( p  = 0.05, p  = 0.038, and p  = 0.024, respectively). The score of lubrification, orgasm, and pain was comparable between the two groups. In univariate analysis, a significant association was found between sexual dysfunction and pain ( p  = 0.001), tender joint counts ( p  = 0.04), DAS28 ESR ( p  = 0.043), fatigue ( p  = 0.028), and functional disability ( p  = 0.02). No association was found between sexual dysfunction and treatment. In multivariate analysis, only pain was a predictive factor of sexual dysfunction in patients ( p  = 0.05, OR = 1.26 [1.16–1.3]). Based on patients’ self-perception of their sexual function, 26.1% of patients reported a negative impact of RA on their sex life. According to them, the main factors influencing sexuality were joint pain (60.6%) and fatigue (51%). Moreover, 59% of patients reported a decrease in the frequency of sexual intercourse after the diagnosis of RA. However, no statistically significant difference was found between patients and controls in the frequency of sexual intercourse ( p  = 1). Conclusion Our study suggests that patients with RA experience high level of impairment of sexual function in comparison with a control group. Health providers must consider sexual function as an important part of quality of life. A therapeutic education directed towards a patient could be proposed to approach sexuality. Key Points • The prevalence of female sexual dysfunction is higher in women with rheumatoid arthritis than in controls. • In multivariate analysis, the global pain intensity visual analog scale was the only predictive factor of sexual dysfunction in patients. • Based on patients’ self-perception, joint pain and fatigue are the main factors influencing sexuality.</abstract><cop>London</cop><pub>Springer London</pub><pmid>31392560</pmid><doi>10.1007/s10067-019-04726-8</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-6192-5830</orcidid></addata></record>
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subjects Adult
Arousal
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - psychology
Case-Control Studies
Diagnosis
Fatigue
Female
Health risk assessment
Humans
Medicine
Medicine & Public Health
Middle Aged
Multivariate analysis
Original Article
Pain
Pain perception
Patients
Quality of life
Rheumatoid arthritis
Rheumatology
Self image
Sexual Behavior
Sexual Dysfunction, Physiological - epidemiology
Sexual Dysfunction, Physiological - etiology
Sexual intercourse
Sexuality
Statistical analysis
Tunisia - epidemiology
title Comparison of sexual function in Tunisian women with rheumatoid arthritis and healthy controls
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