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.